At this morning’s Public Health Council meeting, the MA Department of Public Health released its most recent public report on healthcare-associated infections at MA hospitals. You can find the report here. Please note that there are many pages of appendices that will not be posted on-line until Friday. Because there are multiple graphics on those pages, it is taking a few more days to get them posted. Those pages will include hospital-specific data, with one page per hospital looking at central line-associated bloodstream infections and surgical site infections. The pages will also provide other relevant data, including rates of flu vaccination among hospital staff. As DPH staff said at today’s meeting, it would be terrific if each hospital would take its individual page, laminate it, and distribute it across the hospital so everyone knows what the hospital’s infection rates are and where they need to improve.
The report that you can find on-line today gives a wealth of information about infections, the work taking place across the state to reduce infections, the process of gathering the infection data, and more. This report also provides aggregate data about infections in Massachusetts and does list some specific hospitals that are outliers for surgical site infections.
How can consumers use this data? Now that we have a few years’ worth of data, it is possible to look at improvement trends both statewide and within individual hospitals, and as each new report is issued that will be something to look at more closely. If you are interested in one or a few specific hospitals,, you can see the data and you can then ask your doctor or your hospital (especially if you have a planned surgery or other reason to plan a hospital visit or if you have a loved one in the hospital or who may be admitted) questions about what they are doing to prevent infections. You can find out more by contacting the Quality Improvement Office or the Patient Advocacy Office of the hospital. You can also ask either of those offices what their Patient and Family Advisory Council (PFAC) is doing to work with the hospital on preventing infections. It is often said that everyone has a role in preventing infections, but if patients and families are expected to have roles in the prevention effort, then the hospitals should get their PFACs involved in figuring out what they are and how to educate about them.
A few comments arose during this morning’s Public Health Council meeting that I want to highlight. One Council member mentioned the PFAC role and stated that the reports should be brought to the PFACs’ attention. A doctor talked about how the infection prevention collaboratives in MA have encouraged a “positive competition” among hospitals to reduce infection rates and also that the public reports have been a driver in making infection prevention a priority. One member asked about disparities, and the DPH representatives said they hope to have enough data to look more closely at that in the next report. And another member of the Council said that DPH was off to a fantastic start and “don’t lose money…keep doing this.”
Which leads us to state the obvious-DPH needs money to do the many fantastic things it does, including all of the work taking place to prevent, track, investigate and report on infections. The Governor’s budget, released two weeks ago, provides $263,646 to the Infection Prevention Program at DPH and $6,318,316 to the Division of Health Care Quality and Improvement. While this is not nearly enough for all of the work that needs to get done, it is imperative that funding not be cut further.
Many kudos to DPH staff, including the Quality Division Director Dr. Madeleine Biondolillo, Iyah Romm, who directed much of the work in putting together the report, and Eileen McHale who coordinates the infection prevention program. Health Care For All and the Consumer Health Quality Council gave many suggestions and comments to DPH following the release of its last report, and our concerns and recommendations were very seriously taken into account as this new report was developed. They have produced a report that is accessible and useful for consumers and hospitals. And they are using this data as well as the data in the recent Serious Reportable Events report to look at areas that may need more work (eg. vaginal hysterectomy infection rates; reporting of medication errors). As MA looks to save money and improve quality through payment and delivery system reform, the infection prevention work at DPH is a great example of an area where this is already happening.
If the continuation of this work is important to you, make sure you mention it to your state senator and representative, as budget season has begun. Also mark March 6, 9:30-10:30am, on your calendar. We are coordinating a State House event in Members Lounge that will highlight the HAI and SRE reports. Speakers will include staff from the DPH Division of Quality and Safety and some of the legislative champions for patient safety-Senator Richard Moore, Representative Jeffrey Sanchez, and Representative Denise Provost. All are welcome, but please RSVP to Deb Wachenheim at dwachenheim@hcfama.org.
Comments
To add a comment to the original post, click here.
You must be signed in to post a comment.
Sign in now[...] 1999 Institute of Medicine report and the CDC. Medical errors injure too many people, acknowledges A Healthy Blog, “But it doesn’t have to be this way.” Share| Posted by Daniela Nuñez in Hospital [...]
[...] I thought instead I’d look at the real voices in our health care system. Credit goes to the Consumer Health Quality Council for collecting stories and producing these videos. [...]
Oral health is about so much more than the health of your teeth. It also encompasses the health of your gums, tongue, throat and entire mouth. Traditionally, dentists have focused primarily on teeth. However, dentists and other medical professionals have become increasingly aware of the relationship between systemic diseases such as diabetes, heart disease and pneumonia and the health of one’s mouth.
According to the American Diabetes Association (ADA), 7.8% of the population, 23.6 million children and adults in the U.S., have diabetes. Diabetes can be fatal and was the seventh leading cause of death in the U.S. in 2006.
Recent studies have demonstrated a positive correlation between diabetes and periodontal disease. Periodontal disease affects the structures supporting teeth including the gums, the bone and the connective tissues. Symptoms include bleeding gums, loose teeth, odors and severely receding gums. A large evidence-based study in 2006 demonstrated that diabetes is associated with the severity and extent of periodontal disease. It has been suggested that periodontal disease may negatively impact the control and severity of diabetes.
According to the American Heart Association, cardiovascular disease is the number one killer in the U.S., responsible for 35.3 percent of all deaths. Several studies have also found evidence of a relationship between cardiovascular disease and periodontal disease. Certain bacterial pneumonias, particularly “ventilator-associated pneumonia” in institutionalized patients, are also related to poor oral health. Similarly, studies have shown that periodontal disease and maternal gingivitis are risk factors for preterm birth and other adverse pregnancy outcomes. While we expect to continue to find additional correlations between oral health and overall health, we already have ample evidence that the health of the mouth has a direct connection to the health of the rest of the body. An infection in the mouth will eventually affect the rest of the body. Other diseases can also be caused or exacerbated by active oral diseases. Strategies for maintaining overall health include brushing teeth three times a day, routine use of dental floss, and management of one’s diet. Also, regular visits to the dentist are critical since they provide an opportunity for a thorough examination to ensure that your entire mouth is clean and healthy.
A dental visit is necessary for individuals with dentures so that your dentist can continue to monitor and evaluate the fit of your dentures. In addition, routine dental visits are important so that your dentist may perform an oral cancer screening. This is particularly critical for tobacco and alcohol consumers. According to the American Oral Cancer Foundation, one American dies every hour from oral cancer. Oral cancer is often detected at late stages where the primary tumor has already spread. However, if detected early, oral cancer is treatable and curable. Clear evidence demonstrates that a healthy mouth serves as an essential element and indicator of overall health.
It is imperative that we work towards the goal of ensuring that all Americans have access to dental care as a key component of overall access to health care. In an effort to close the Massachusetts budget gap, MassHealth adult dental benefits have been compromised. The current elimination of coverage for all services except cleanings twice a year and extractions is harming our communities. This is forcing patients with major dental problems to seek care in hospital emergency rooms, a much more expensive alternative than receiving regular dental care in a dental office. Removing the dental benefits will be more expensive in the long run and will have a significant negative impact on the state of oral health and overall health in the Commonwealth.
It is also force dentists to perform supervised neglect on patients who need health critical treatment. For the past few years, the Massachusetts Dental Society has worked to recruit more dentists to become MassHealth providers, increasing access to dental care for those who need it the most. It is disheartening to see the State take away what has taken years to build.
As a Dentist who has treated MassHealth patients since 2002, I believe that these cuts will cause irreversible damage to 700,000 of the most vulnerable Massachusetts residents. I urge the Legislature to reconsider the funding of the MassHealth adult dental benefit.
Dr. Abdul
covering children for health care is a good way to keep the foundations of any are strong, hopefully other states can learn from the work in Massachusetts
There is a big reason why other states have not adopted this bad legislation. It does not bring down the cost of medicine or medical devices. It only hurts commerce at restaurants, entertainment venues and golf courses. Additionally, it limits the physicians from learning about new innovative treatments which frequently improve survival and quality of life. The last thing I want is my state rep operating on me or choosing my medicine, but this is what we currently have in Massachusetts. Please overturn this horrible legislation.
I’m in the same boat as the gentleman mentioned in this article/blog. Because I got a new job that paid good money, I did not reapply for MassHealth because I knew I would make too much money. I had been shopping around for health coverage and had no idea of an enrollement period or that I had to do it within 62 days. My current job does not offer me coverage because I’m considered a “temporary fulltime worker”, which is basically considered a “contract employee”. Now I’m simply screwed, because I’ve gone beyond 62 days of coverage and I missed the enrollment period. While the Office of Patient Protections Services told me to contact my State reps office, I’m doubtful that they will be able to get anyone help for me. There are contacting the Mass Connector to see what they can do. I too will most likely have to wait for 6 months before I can apply for the PCIP goverment plan since I do have a pre-existing condition. I pray that I do not have a serious health issue as a result of my condition, that needs immediate attention or I will be screwed!
Unbelieveable, I need health insurance, I do have money for health insurance, buth they won’t let me buy health insurance, but when I was unemployed and had no money, I could get Mass Health insurance, WTF!!???
Frankly, I don’t see the issue with this type of marketing. You get a coupon for a drug, sounds like a win for the consumer.
How can I help?
Only 7% of those polled know that the statement, “The healthcare reform bill requires that everyone has or buys health insurance”, is false?
HCFA, can you spread some more disinformation, in order to knock those numbers down?
[...] a victory in the Massachusetts Supreme Judicial Court that requires the Commonwealth to restore full Commonwealth Care coverage for eligible legal [...]
I had no idea there were such shortages. I’m glad they are looking into this so we can come up with a solution. This is kind of scary to me.
[...] Gov. Patrick included $974 million in funding for Commonwealth Care in his proposed FY13 budget, and has made a commitment to maintaining benefits in MassHealth and CommCare. The CommCare funding level includes $156 for reintegration of “special status” legal immigrants, who will be reinstated into CommCare in FY12 (see our report for details on the reintegration plan). [...]
Of course CommCare could use the same rates as MassHealth, risk adjusted of course, and save over $50M enough to restore adult dental if only we’d stop this nonsense that this is private insurance coverage.
And if the games between certain state officials would stop, you’d find that there is at least $50M to be saved by using the MassHealth rates for the Connector population, enough to restore adult dental. Now who are we trying to serve and protect, providers?plans? the Connector?
[...] mentioned earlier this week, the Department of Public Health has released its latest public report on healthcare-associated [...]
[...] Community Connect to Research Educational Fair TOMORROW! (hcfama.org) [...]
This is an excellent initiative. In Massachusetts, they have managed to attain a 99.5% of the total number of children to have health insurance. I hope the same result can be replicated on all the other states.
What if states does not implement the basic health program?
What’s an individual?
What’s a resident?
What’s an inhabitant?
What’s an inhabitant?
What’s an inhabitant?
What’s an …
Thank you for the information and the update. It is also worth noting that effective September 2010, children (below age 19) with pre-existing conditions may not be denied access to their parents’ health plan and insurance companies will no longer be allowed to insure a child, but exclude treatments for that child’s pre-existing condition.
[...] Association said all of its members offer coverage. Bill Vernon, head of the NFIB, a vocal opponent of health reform in 2005, opposes the ACA but now says the law “works for Massachusetts.” “My guess is [...]
[...] Conversations About End-of-Life Care (hcfama.org) [...]
[...] Health Aging Forum Looks at Patient-Centered Care For Seniors (hcfama.org) [...]
“The gift ban legislation was highlighted this week during a 90-minute gubernatorial forum on the biotechnology industry in Massachusetts, sponsored by MassBIO. During the forum, Democrat Deval Patrick, Republican Charles Baker and Independent Tim Cahill all said “they saw defects with the current gift ban.” According to the News Service, “Baker and Cahill said they would fight to remove the ban outright, while Patrick said he would seek to conform gift rules to those that the pharmaceutical industry uses to police itself.”atrick. He is realizing that the Gift Ban needs to be repealed”
Hi Jim,
Great post and I’m psyched to follow your blog and learn more about your work. Having a clear ‘destination’ is no small thing! If all stakeholders can be on board with it, incl nurses, docs, patient advocates, pharmaceutical companies, (and other vendor types), and lawyers. I believe we can get there.
So for now, here’s to celebrating a vision of high-quality, safe, and continuously improving health and healthcare centered on, and in partnership with, the patient, the family, the public, and their community. I’d like to see something about equity in there too.
Beth
Jim,
Thank you for reminding us that research is a responsibility for all those organizations (and leaders) who would play an active and intelligent role in health care improvement: “The healthcare community should be a learning community, asking questions, conducting research, performing tests of change, innovating and more. In the process, results may have us scratching our heads. Do we have the right questions, metrics, samples, or maybe, just maybe, are there mental models, things we believe to be true, that aren’t?”
Indeed, the spirit of inquiry you advocate is in the tradition of Kurt Lewin who several decades ago coined the term “action research” to describe a kind of practical, applied use of reflection and critical inquiry to guide our most important problem-solving efforts. We must be critical consumers of “data” from others’ studies. We must inform ourselves by regularly reviewing the findings from larger-scale, formal studies. However, at the end of the day, we must also study what we are doing in our own organization – action research. We must intelligently apply new practices or methods, learn from our experience, and adapt them as necessary to fit the unique circumstances in our organization.
Therefore, we might ask: What are our specific problems? Do we have hypotheses concerning the nature of these problems or potentially effective solutions? Have we reviewed the literature or consulted with subject matter experts to enrich our thinking? How will we test our working hypotheses or apply proven practices that seem relevant to our organization?
The real world, which Jim Conway and Kurt Lewin address, is seething with variation. Every organization is composed of unique combinations of people, structure, processes, and culture. Implementing change to improve safety and quality outcomes will never be reduced to mere cook-book solutions. Those who lead this change must also be action researchers.
Bill Macaux, Ph.D. MBA
Generativity LLC
AARP is nothing but a dumping ground for all advertisers who offer all false advertisement by sympathising with seniors and their advertisers offer even higher rates. There is no difference in prices between seniors and standard general public.
[...] first year that such data was collected and made public. It is unclear how much of this drop is a result of the gift ban law, and how much can be attributed to other policies that further restrict gifts from drug and device [...]
you mean obamacare
I]f you don’t want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn’t have insurance, then we have to care for them in the hospitals, give them free care. So we said, no more, no more free riders.”
So kindly explain why the Mass couple with “catastrophic insurance” was still fined, because their plan had a high deductable? And while you’re at it, explain why healthy uninsured people should be forced to but insurance which, along with other mandates, includes contraception? Last time I checked, if one needs contraception to avoid getting pregnant, one’s body IS FUNCTIONING NORMALLY, therefore contraceptives have no place in unsurance coverage.
And lastly, as long as us ininsureds pay for the doctor visits IN CASH, like it WAS NONE decades ago, we ARE NOT freeriders. Until I cost the public one cent, the public should shut up! Yeah, you MASS Libs, too!
where can i get a copy of this report. Such reports go a along way in enabling the public get awareness on some of the mishaps that happen in hospital for which the health management ought to take responsibility
[...] CHEST: X-Rays No Help in Cutting Lung Cancer Deaths – MedPage TodayStudy: Annual Chest X-Rays Do Not Reduce Lung Cancer MortalityNew American Lung Association Report Cites Lung Cancer Disparities [...]
Great Post and a great summary of the recent accomplishments of the Coalition. The Massachusetts healthcare community is truly fortunate to have such a strong, collaborative resource working to improve patient safety.
I’ll echo you on that. Indeed the sickest act is taking advantage of the sick and the weak. And I believe most of the drugs covered under this litigation are for cancer patients. Sad.