Hospitals in Michigan Struggle in Preventing Infections

Troubling New Report on Hospital Infections Comes While the Centers for Medicare & Medicaid Services Considers Discontinuing Publicly Reporting Rates

Each day, one out of 25 hospital patients in the U.S. contracts a healthcare-associated infection (HAI), resulting in billions of wasted dollars and an alarming 90,000 deaths annually. Unfortunately, a new report published by The Leapfrog Group and the Economic Alliance for Michigan (EAM) and analyzed by Castlight Health shows that the percent of hospitals achieving zero infections has declined dramatically since 2015, indicating many patients are still at risk.

The report, “Healthcare-Associated Infections,” found that the percentage of hospitals reporting to the Leapfrog Hospital Survey and achieving zero infections has declined dramatically since 2015. This is true for all five of the infections examined on the Survey, including Central Line Associated Blood Stream Infections (CLABSI), Catheter Associated Urinary Tract Infections (CAUTI), Surgical Site Infection after Colon Surgery (SSI: Colon), Methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile (C. diff).

In Michigan, no hospitals achieved the “fully meets standards” for all five infections surveyed. Only one hospital, Covenant Healthcare in Saginaw, fully met standards in four of the five categories.

Slightly over half of the hospitals in Michigan declined to respond, raising concern over the lack of willingness in providing performance outcomes to the public.

“A key way to improving patient safety and quality of care is by participating in transparency but we need all hospitals in Michigan to do so,” said Bret Jackson, president, EAM. “Taking the necessary steps in identifying areas where a hospital can improve will contribute to the lowering of healthcare costs.”

The report notes that a patient who endures a hospital acquired infection will have additional costs of $1,000 to $50,000. These costs are not covered by the hospital but forward onto employers, the patients and others.

A dangerous low percentage of Michigan hospitals have a zero-infection rate in one of the five reported infections. Below is a list of hospitals with zero-infections by category:

• For CLABSI: McLaren Greater Lansing and McLaren Oakland in Pontiac.
• For CAUTI: Dickinson County Healthcare System in Iron Mountain and Helen DeVos Children’s Hospital in Grand Rapids.
• For MRSA: Henry Ford Hospital West Bloomfield, DMC Huron Valley-Sinai in Commerce, McLaren Oakland in Pontiac and MidMichigan Health in Midland.
• For SSI Colon: LakeHuron Medical Center in Port Huron, MidMichigan Health in Midland, St. Joseph Mercy Chelsea and St. Joseph Mercy Oakland in Pontiac.
• For C. diff: Spectrum Health Gerber Memorial in Fremont and Spectrum Health United in Greenville.

“Given this disturbing trend in performance showing hospitals making less progress on the spread of healthcare-associated infections, it’s concerning that the Centers for Medicare & Medicaid Services (CMS) is proposing to decrease public reporting and transparency around infection rates and other measures of problems in hospitals. We urge all consumers to join with us in advocating for CMS to reconsider these changes,” said Leah Binder, president and CEO of Leapfrog. “Leapfrog and its purchaser members remain committed to getting this data voluntarily from those hospitals willing to be transparent with their data should CMS choose to move forward with their proposal.”

CMS recently issued its proposed rule for the Fiscal Year 2019 Inpatient Prospective Payment System (IPPS). Among the proposed changes is removal of healthcare-associated infections from the Hospital Inpatient Quality Reporting (IQR) program. Leapfrog will be issuing comments to CMS during the public comment period. Want to support Leapfrog’s comments, you can show support at www.leapfroggroup.org/news-events/leapfrog-issues-call-action.

CMS often consolidates the data from multiple facilities under a single Medicare Provider Number (MPN). The report also found hospitals that report as part of the same health system under the same MPN sometimes perform significantly differently on preventing infections. Leapfrog is the only organization to report infection rates by individual facility, providing critically needed transparency for patients evaluating hospitals for care.

The good news is that the report’s findings showed the majority of hospitals reporting had fewer infections than would be expected according to the Centers for Disease Control and Prevention’s (CDC) Standardized Infection Ration (SIR) methodology. SIRs compare the actual number of infections reported to what CDC would have predicted for that facility, given various facility and/or patient-level factors. A SIR of 1.0 means the number of HAIs is exactly what the CDC would have expected. Less than 1.0 means there were fewer HAIs than predicted; a SIR higher than 1.0 indicates more HAIs than the CDC would have predicted. The majority of hospitals reporting to the 2017 Survey had a SIR between 0.001 – 1.0 for each of the five HAIs examined.

The complete Healthcare-Associated Infections Report is available online. Other publicly available resources include:

• Healthcare-associated infection data by hospital, based on results of the Leapfrog Hospital Survey
• Resources and tools for patients, employers and purchasers