Consumer Reports: These 31 teaching hospitals are a threat to patient safety

Too many hospitals needlessly expose patients to dangerous bacteria, according to a new analysis that examines the five-year performance of 2,000 hospitals on preventing central-line infections.

Indeed, Consumer Reports identifies 31 teaching hospitals in the U.S. that made its lowest-performing “zero tolerance” list in a report released online today and will appear in its January print issue.

The results were surprising, Doris Peter, Ph.D., director of the Consumer Reports Health Ratings Center, told FierceHealthcare. The investigative team expected to see greater improvement because of federal government reports that hospitals across the U.S. have reduced deadly, but highly preventable, central-line bloodstream infections by 50 percent since 2008.

But after that big drop, Peter notes there has been little progress at teaching hospitals since 2011 even though the organizations have the necessary resources to focus on quality improvement. It’s a concern, she said, because the teaching hospitals “are training the next generation of physicians and are seen as leaders in the field and the place to get care.”

Deadly infections are easily prevented

Central-line infection account for approximately five percent of all hospital-acquired infections but are deadly in up to a quarter of cases and cost an average of $46,000 to treat, the report notes.

However, there are minimal costs to follow an evidence-based protocol to prevent them, Peter notes. And the protocol, a patient safety checklist developed 15 years ago by Peter Pronovost, M.D., Ph.D., director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins, is still the gold standard. The infections are almost entirely preventable when the checklist is implemented.

“I’d [ask] hospitals that really haven’t done anything for five years: 'Why aren’t you investing in this?'” Peter asked.

Some of the teaching hospitals at the bottom of the list are well-known, including Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and Emory University Hospital Midtown in Atlanta.

Although central-line infections make up only a small portion of overall hospital-acquired infections, Peter said the high death rate should be enough incentive for teaching hospitals to act. “Up to 25 percent of patients die,” she said.

Reprinted with permission, Consumer Reports
The key to eliminating the infections is for hospitals to do a root cause analysis to identify the main factor driving the infections. One hospital, Peter noted, determined that there was something wrong with the central lines they used, a problem it rectified when the organization switched suppliers.

The nine-page report includes profiles of two hospitals, Shore Medical Center in New Jersey and Mount Sinai St. Luke’s-Roosevelt in New York, that give insight into how they successfully battled central-line infections, and how they continue to be vigilant and improve.

The lowest scoring teaching hospitals

Consumer Reports list of lowest scoring teaching hospitals, in alphabetic order, includes:

  • Atlanta Medical Center in Georgia
  • Banner-University Medical Center in Tucson, Arizona
  • Brooklyn Hospital Center in New York
  • Community Regional Medical Center in Fresno, California
  • Cooper University Health Care in Camden, New Jersey
  • Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire
  • Emory University Hospital Midtown in Atlanta
  • Eskenazi Health in Indianapolis
  • George Washington University Hospital in the District of Columbia
  • Grady Memorial Hospital in Atlanta
  • Holy Cross Hospital in Silver Spring, Maryland
  • Howard University Hospital in the District of Columbia
  • Hurley Medical Center in Flint, Michigan
  • Indiana University Health University Hospital in Indianapolis
  • Interim LSU Public Hospital in New Orleans
  • Long Beach Memorial Medical Center in California
  • MacNeal Hospital in Berwyn, Illinois
  • Maine Medical Center in Portland, Maine
  • Maricopa Integrated Health System in Phoenix
  • Nebraska Medicine-Nebraska Medical Center in Omaha
  • Palmetto Health Richland in Columbia, South Carolina
  • Robert Wood Johnson University Hospital in New Brunswick, New Jersey
  • Ronald Reagan UCLA Medical Center in Los Angeles
  • SUNY Downstate Medical Center University Hospital in Brooklyn, New York          
  • Truman Medical Center-Hospital Hill in Kansas City, Missouri
  • Tulane Medical Center in New Orleans
  • UC San Diego Health in California
  • UF Health Jacksonville in Florda
  • University Hospital in Newark, New Jersey
  • University Medical Center of El Paso in Texas
  • University of Iowa Hospitals and Clinics in Iowa City, Iowa