Published by: John Oswald on 6/15/2011 4:21:35 PM
A recent quality ranking of teaching hospitals by Consumer Reports focused on central-line infections in the approximately 400 hospitals of the Council of Teaching Hospitals (COTH) including what appears to be a large majority of the NAPH members. You can read the information here.
So the big question is how to interpret the results? It appears that among COTH members who are the lowest ranking, NAPH members have a slightly smaller proportion of low-ranking hospitals compared to the rest of the COTH hospitals. One of the three worst performing hospitals is an NAPH member. Among the 64 hospitals with the second worst level of ranking, 15 are members of NAPH.
An overall limitation of these data is the inconsistency with which bloodstream infections are reported, especially for ICUs. As acknowledged in the technical report, each state health agency reports on a somewhat different set of ICUs that also cover a particular period of time. For ICU bloodstream infections, not all hospitals have the same assortment of ICUs; a smaller hospital may have only a combined medical/surgical ICU, while a larger hospital may have six or more ICUs, including separate medical and surgical ICUs. Depending on the NAPH member and the state reporting system, these differences may have a major impact on the results. Specialized services such as trauma, transplants and burn care may also skew the results for a given hospital.
Overall, for the full spectrum of conditions in all hospitals (but especially teaching hospitals), having the ability to maintain vigilance on many fronts regarding quality of care all at once is crucial. The number of clinical staff who work with any given patient may contribute to the increased variances in practice and need on-going training as staff rotate through the organization. Resources to address these issues on a consistent basis require significant effort.
This is one more example of the need to stay current about -- and look closely at -- new studies regarding the quality indicators of our members and all hospitals across the country.