Hallman: Patients need reliable hospital safety data
August 23, 2013
I have no way of judging the credibility of the Consumer Reports study rating St. Anthony's Frisco last among Colorado hospitals for surgical complications, reported Aug. 14, 2013, in the Summit Daily News.
Most all hospitals have problems with surgical infections and other complications. Without solid evidence to the contrary, it's hard to image why St. Anthony's would be any different. According to the Center for Disease Control, 1 percent to 3 percent of surgeries lead to site infections. While these percentages may seem low, if you have an internal surgical infection the consequences are significant.
My surgical infection occurred after out-patient shoulder surgery in late May of this year. The surgery was performed at St. Anthony's Frisco.
The infection did not manifest itself until several weeks after surgery. It is best characterized as a deep incisional surgical site infection. I was infected with P-acnes; a common non-contagious bacteria that produces acne.
A second surgery was required to irrigate the infection site with antibiotic solution and remove surgical implants, followed by six weeks of twice-a-day hospital-administered intravenous (IV) antibiotic-infusion therapy using a central-line catheter. The next phase is four weeks of oral antibiotics, then three months to let my body "settle back down." I also have several months of physical therapy. If all goes well, I should be able to start over again from scratch with another shoulder tendon repair operation to replace the implants and reattach the tendon. After that, if I'm lucky, I will have another two to three months of physical therapy. I don't want to think about what would happen if the infection comes back.
While my medical circumstance pales compared with many patients, it is not to be taken lightly.
During my 85 infusion therapy treatments I have gotten to know many of the St. Anthony's nurses. They come with an assortment of experience and training. Across the board they have been friendly, cheerful and helpful. But the hospital protocol for IV infusions lacks detail, as does the catheter manufacturer's instructions. Not surprisingly different nurses interpret procedures differently, sometimes resulting in inconsistencies.
Extensive reporting requirements cause many nurses to use computer keyboards, monitoring equipment and other cross-contamination-friendly surfaces concurrently while performing medical procedures. Distractions can also cause problems.
When your surgeon tells you there is a danger of surgical infection take him seriously. Bacteria introduced through surgery can stay dormant in the body for long periods before causing serious harm. Certain infections may not show up for years. Some studies have indicated possible links between P-acnes and brain abscesses, prostate cancer and other serious medical conditions.
St. Anthony's Hospital is a wonderful asset to our community, giving easy access to hospital care for injured skiers and boarders, mothers and newborns, kids, families and senior citizens. Our hospital provides good jobs and is important to the local economy.
Having said this, we as patients and prospective patients have no way of knowing whether St. Anthony's is better than comparable hospitals, or even as good. Dr. David Lennon in a recent letter to the Summit Daily strongly condemns the Consumer Reports study. The good doctor might like us to believe that St. Anthony's has no real surgical complications. As a St. Anthony's patient recovering from a surgical infection, I find Dr. Lennon's "kill the messenger" response overly defensive and counterproductive. Dr. Lennon argues that St. Anthony's has "extremely high quality" medical standards, but cites no statistics backing his claim.
St. Anthony's is not perfect; no hospital is. Yet Dr. Lennon fails to acknowledge that surgical complications do exist. Nor does he offer ideas for improving quality of service. His only advice is "trust your doctor." Medical consumers (patients and prospective patients) need reliable data to compare hospitals, particularly when that comparison relates to patient safety.
Unfortunately, many hospitals strongly resist making data on patient safety public. From a business perspective I can understand their unwillingness to disclose statistics about infections and other hospital-related complications. From a medical perspective I cannot. We as medical service consumers deserve good data in order to make informed decisions.
Howard Hallman lives in Silverthorne.
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