Jennifer Meddings, MD, MSc

There are many hospital rating systems out there and each follows a different grading system.

The latest Center for Medicare & Medicaid Services (CMS) hospital “star” ratings and the U.S. News and World Report’s Best Hospital Rankings and Ratings are already earning pushback from health care institutions and organizations.  

As reported by Karen Bouffard in her recent article ‘Feds give most Michigan hospitals mediocre scores’, critics claim the current CMS rating system doesn’t provide enough detail about the performance of each individual hospital, or doesn’t take into account enough of the differences between hospitals. And while some criteria used for hospital rating systems can be disputed, there is one criterion — perhaps the most important — all agree is critical to improve: patient safety.

Surprisingly, almost two million people in the US each year are affected by healthcare-associated infections and research shows about 70 percent of them are preventable. This is a strong and valid reason for including infection rates in measurement systems, as CMS and US News have done.

Where do these infections come from? We know that devices inserted in patients’ bladders and bloodstreams, called catheters, are a leading cause. They most often relate to the use of urinary catheters and Peripherally Inserted Central Catheter (PICC) lines. Unfortunately, the most common cause of these infections is the simple fact that healthcare workers do not always follow safety protocols and best practices when placing these devices in their patients. For example, providers may not be determining if the benefit outweighs the risk when inserting a catheter, or they may also not be adhering to the detailed steps needed to safely insert and maintain these catheters.
 
My colleagues Dr. Sanjay Saint and Dr. Vineet Chopra and I are working to help address these issues in the current healthcare atmosphere through research and developing simple-to-follow best practices.  
 
Healthcare providers can start by practicing “mindful medicine” when making decisions on catheter device use — thinking mindfully about whether it is appropriate to use a catheter device, and how long a patient needs it.
 
Healthcare professionals must all be aware and intentional about decisions when it comes to patient health and safety, but patients and family members also have an important role in reducing unnecessary catheter use. Whenever a patient is hospitalized, they should be encouraged to ask daily if the catheter is still needed because each day of use increases the risk of serious complications.
Another vital step in reducing infections linked to healthcare is simple hand washing. Alarmingly, only 40 percent of health care providers currently comply with recommended hand washing guidelines or policies. Again, mindfulness could be the key to improvement and reduce overall risk of infection for patients.

As our society increasingly rewards and punishes hospitals based in part on safety performance, these infections should be  everyone’s concern. We have developed several research-based, easy-to-use resources for people who work in healthcare to learn more about these issues,  including the websites Catheterout.org and ImprovePICC.com and are sharing tips on social media using the hashtag #MindfulMedicine.
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Together, with enhanced communication between providers, patients and families and being mindful of best practices, health care providers will improve both patient safety and their hospital’s ratings. 

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