Infection control and sepsis care policies are among the most important aspects of patient safety in any healthcare setting. Hospitals have a great responsibility to protect patients from preventable complications.
Data collected by the Centers for Medicare & Medicaid Services (CMS) measures how well hospitals perform in a variety of measures, including appropriate care for sepsis. In 2017, CMS data suggested that some Dallas hospitals fell below the national benchmark for sepsis care. What does that mean for patients?
As a patient, when you seek medical attention at a hospital, you trust that your safety and care is the top priority. All hospitals have infection control policies, but it is up to those working there to ensure that these policies are upheld. Failing to abide by infection control policies can have a devastating impact on patient safety.
At Brown, Christie & Green, our Dallas medical malpractice attorneys know how devastating medical complications can be. Inadequate sepsis care can lead to a host of complications that can be potentially deadly. Our goal is to help you be informed about the safety of local hospitals so that you can make the best decisions possible for your health.
In this post, we take a look at how Dallas hospitals rank in terms of sepsis care. This review includes data from CMS, as well as independent grading systems, which provide helpful information about hospital safety and performance.
CMS Data on Sepsis Care in Dallas Hospitals
Every year, CMS collects data and publishes it on their website at Medicare.gov. These datasets provide an abundance of information about how hospitals perform on measures like complications, timely and effective care, surgical quality, readmission rates, and sepsis care. The data is compiled and then can easily be compared to national benchmarks.
CMS data includes scores, which range from 0 to 100, which 0 being the “worst” score possible. Hospital scores related to sepsis care are based on a patient sample, with the score equaling the percentage of patients receiving appropriate care for sepsis. Therefore, a score of 13 with a patient sample of 194 means that only 13 percent of those 194 patients reviewed were receiving appropriate care for sepsis.
A low score with a large patient sample indicates a more serious discrepancy in how hospitals are managing sepsis care.
Dallas Hospitals Scored on Sepsis Care
Dallas hospitals overall scored better on CMS data than many other cities in Texas. The lowest score among Dallas hospitals was 39. The hospitals that scored lower or equal to the national benchmark of 49 included the following:
- Methodist Charlton Medical Center – Scored 39 with a patient sample of 150.
- Methodist Dallas Medical Center – Scored 44 with a patient sample of 110.
- Parkland Health and Hospital System – Scored 45 with a patient sample of 296.
- Texas Health Presbyterian Hospital Dallas – Scored 48 with a patient sample of 106.
- City Hospital at White Rock (formerly Baylor Scott and White Medical Center White Rock) – Scored 50 with a patient sample of 326.
These five Dallas hospitals are the ones that scored equal to, or below, the national benchmark. Several patient samples in Dallas were large, and even though the scores are close to the national benchmark, there is still reason for concern. Sepsis care is an important measure, and any score indicating that patients are not receiving appropriate care should give patients and the healthcare industry pause for concern.
Independent Hospital Grades for Dallas Hospitals
When used appropriately, the internet can be a great place to find information about local businesses, including hospitals. The website for Leapfrog Hospital Safety Grade is a valuable and reliable source of information about hospitals in many cities across the United States.
Leapfrog grades hospitals using an A-F grading system. The system also looks at individual measures, such as infections, safety problems, surgical problems, and more. These grades are scored against the average score of hospitals for the same measure. For example, for bloodstream infections, the average hospital score was 0.789 in 2018. The worst hospital score was 2.935, and the best hospital score as 0.000. These scores represent the average number, or percentage, of expected bloodstream infections based on previous and current data.
Because sepsis can develop from any sort of infection, it is important to consider how hospitals rank in terms of the rates of various types of infection. Leapfrog includes scores for Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C.diff), bloodstream infections, urinary tract infections (UTIs), and surgical site infections (SSIs). The average score in 2018 for each of these infections was:
- MRSA – 0.881
- C.diff – 0.793
- Bloodstream infections – 0.789
- UTIs – 0.874
- SSI’s – 0.859
The Dallas hospitals discussed above received the following grades on Leapfrog:
- Methodist Charlton Medical Center – Methodist Charlton Medical Center received an overall grade of A. Methodist Charlton scored better than average for MRSA (0.723) and bloodstream infections (0.452). The hospital scored worse than average for C.diff (1.053), UTIs (1.147), and SSIs (1.259).
- Methodist Dallas Medical Center – Methodist Dallas Medical Center received an overall grade of A. Methodist Dallas scored better than average for MRSA (0.341), C.diff (0.685), and SSIs (0.646). The hospital scored close to average for UTIs (0.860), and worse than average for bloodstream infections (1.014).
- Parkland Health and Hospital System – Parkland Health and Hospital System received an overall grade of C. Parkland scored better than average for bloodstream infections (0.497), UTIs (0.744), and SSIs (0.716). Parkland scored worse than average for MRSA (1.356) and C.diff (0.925).
- Texas Health Presbyterian Hospital Dallas – Texas Health Presbyterian Hospital Dallas received an overall grade of A. The hospital scored better than average for MRSA (0.491), C.diff (0.712), and bloodstream infections (0.613). It scored worse than average for UTIs (0.995) and SSIs (1.564).
- City Hospital at White Rock – City Hospital at White Rock received an overall grade of C. City Hospital scored better than average for all infections, with scores – MRSA (0.000), C.diff (0.699), bloodstream infections (0.374), and UTIs (0.000). Scores on SSIs was not available.
Importance of Sepsis Care Benchmarks and Grading Systems
Benchmarks and grading systems are important because they help identify problem areas in local hospitals. Once problems are identified, regulators and healthcare administrators can take action to improve scores and, ultimately, improve patient safety and quality of care.
Sepsis benchmarks and scores in hospitals is important because hospital patients are at a greater risk of developing an infection than their non-hospitalized peers. Sepsis often develops in patients who have IV lines inserted, have had surgery, or who have catheters in place. The reason is that any time there is a break in the skin, or a foreign object is placed in the body, there is a risk of exposing that patient to germs that can cause infection.
Sepsis is a complication of infection, and can develop in patients with bacterial, viral, or even fungal infections. While health individuals can fight off infection with relative ease, hospital patients are more vulnerable due to their medical conditions, compromised immune systems, and potential for exposure to different types of germs in the hospital setting.
Clinical Guidelines and Sepsis Care
Each year, over 750,000 people are diagnosed with sepsis, and many of those cases could have been prevented with appropriate care and management. That is why it is so important for hospitals to be graded or scored in terms of sepsis care. That includes preventing infections overall, as well as managing infections to prevent sepsis or other complications, and providing appropriate care for patients who have sepsis.
Ultimately, appropriate sepsis care comes down to healthcare providers and medical staff following clinical guidelines and infection control policies. Guidelines and policies for infections and sepsis are well documented and are a part of every healthcare environment.
To help healthcare facilities prevent sepsis and properly manage cases that do develop, the Centers for Disease Control and Prevention (CDC) has established guidelines for clinical practice. These guidelines include a “Hospital Toolkit for Adult Sepsis Surveillance”. This toolkit offer comprehensive data on sepsis, prevention strategies, early recognition, and appropriate treatment guidelines.
In collaboration with the CDC, the Surviving Sepsis Campaign offers healthcare facilities the “International Guidelines for Management of Severe Sepsis and Septic Shock”. This is a highly informative guideline for sepsis care once an infection has developed.
Clinical guidelines consistently reiterate the importance of infection control and prevention as the best tool in ensuring patient safety. When infections do occur, it is important that complications are recognized early, and that sepsis care strategies are implemented early on. Early detection and treatment of sepsis saves lives.