By Carol Gentry, Tampa Tribune, Fla.
Nov. 9–TAMPA–Tampa General Hospital and six other Bay area hospitals received among the worst ratings in the state for patient infections in a study released by state regulators Tuesday.
Administrators at hospitals that received low ratings argued the study is flawed.
With the release of the study, Florida became the first state in the nation to begin publicly rating hospitals for their infection rates, a move praised by some consumer rights advocates.
“It’s a really historic first step,” said Lisa McGiffert, director of a hospital infection project at Consumers Union. “This is the kind of report that gives consumers what they want.”
The report, which lists charges, caseload, and length of stay, in addition to infections and other measures of patient safety, was issued Tuesday by Florida’s Agency for Health Care Administration.
It can be viewed online at: www.floridacomparecare.gov or floridacomparecare.org.
Four hospitals in the area — Pasco Regional Medical Center, Spring Hill Regional Hospital, Manatee Memorial Hospital, and Blake Medical Center in Bradenton — did better than average on measures of infections acquired from medical care.
Seven in the region did worse. Those include three in Hillsborough County: Tampa General, Memorial Hospital of Tampa, and Brandon Regional Hospital.
Administrators at Tampa General and others that received worse ratings argued the methods the state used weren’t appropriate and that the study could mislead people.
Tom Danzi, chief medical officer at Tampa General Hospital, said the hospital works hard to prevent patient infections. “Believe me, we’re striving every day to get to 100 percent” infection-free, he said. “We’re very proud of the excellent care we provide.”
The state study showed that Tampa General’s infection rates, adjusted for risk, was less than 1 percent.
The report was compiled using hospital billing codes, rather than patient medical records. Once data on infections were obtained, researchers adjusted the results to allow for the fact that some hospitals treat sicker patients who are more prone to infections.
Tampa General’s situation, for example, is complex. It has unusually large numbers of immune-suppressed patients because it has a burn unit, a heavy trauma caseload, a neonatal intensive care unit, and one of the nation’s largest heart transplant centers.
A number of government and private organizations that measure hospital performance have rated Tampa General above-average on a number of performance standards. For example, the Joint Commission on Accreditation of Healthcare Organizations recently gave Tampa General awards for heart patient care.
All Children’s Hospital in St. Petersburg is another local hospital that fell into the higher-than-expected group for infections. Like Tampa General, All Children’s is a teaching hospital affiliated with the University of South Florida.
Its patients include some of the sickest children in the region. The measures used to draw up the comparison were designed for adult facilities, not pediatrics, said physician Jack Hutto, vice president for quality for All Children’s. It will be another year before appropriate measures are designed for children’s hospitals, he said.
The measures used in the report, called patient safety indicators, were devised by the federal Agency for Healthcare Quality and Research in Rockville, Md.
Marybeth Farquhar, that agency’s senior adviser on quality initiatives, said that it might be wise for the state to note on the Web site that ratings can be misleading for hospitals such as Tampa General and All Children’s.
“We want to promote quality initiatives,” Farquhar said, “but we don’t want to set up a perverse incentive that would punish hospitals that take the riskiest cases. That scares me to death.”
Hospital-acquired infections are typically caused by professionals and other staff forgetting to wash their hands when they move from one room to another.
Infections can occur from catheters, intravenous lines and other tubes in the body, and from organisms invading a surgical wound. Tampa General and All Children’s scored in the expected range for risk of post-surgical infection.
The Centers for Disease Control and Prevention estimates that 2 million patients a year catch infections after they check in to the nation’s hospitals. Of those, the CDC says 88,000 patients a year die from those infections. Hospital infections rank as the nation’s sixth-leading cause of death.
Patient advocates and state officials said it is important to give the public tools to evaluate health care, even if the ratings system isn’t perfect. The state’s Web site allows users to compare hospital safety rates by procedures or conditions as well as by infections and complications.
However, even the site’s biggest supporters agree it still has room for improvement.
Alan Levine, secretary of the state agency, said he expects people to squabble over the way the study was done. He urged the public not to compare one hospital with another, but to compare a hospital’s results this year with its results next year, when the report is updated.
“This does not determine which hospitals are good and bad,” he cautioned.
The author of the bill that led to the study and Web site, Rep. Frank Farkas, R-St. Petersburg, said it’s important to give consumers information on health care safety .
“This stuff is monumental,” Farkas said. “It’s ground-breaking. The rest of country should follow.”
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