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Four OKC-area hospitals penalized by Medicare

Photo by Nate Billings, The Oklahoman
Photo by Nate Billings, The Oklahoman

Oklahoma City — Four Oklahoma City-area hospitals were among 16 statewide that will take a financial penalty from Medicare after too many patients developed infections.

The Centers for Medicare and Medicaid Services will dock 1 percent off payments to OU Medical Center, AllianceHealth Midwest, Integris Edmond and Integris Southwest Medical Center this year.

So does that mean you should avoid the hospitals on the list? Not really.

The federal agency penalized hospitals that were in the top 25 percent nationwide when it came to five types of patient infections and some other problems, like blood clots. That means the hospitals that were penalized had more infections than at least 75 percent of other hospitals around the country.

The federal government relies on hospitals to report data such as infections and blood clots after surgery, and that can make facilities that are diligent about searching for complications look worse, even if it means they catch a problem before it can do much harm to a patient, said Dr. Karl Bilimoria, a surgeon at Northwestern Medicine who has studied health care quality.

“Some of these rating systems end up penalizing higher-quality hospitals inadvertently,” he said.

It also isn't clear that there's a meaningful difference in patient safety between a hospital that is in the top 25 percent for infections and one that is in the top 26 percent based on the composite score, but that's where CMS has drawn the line for penalizing hospitals, Bilimoria said.

“It results in hospitals getting a penalty even if they're almost no different,” he said. “These rankings need to be interpreted cautiously, because they frequently mislead patients.”

Emily Kezbers, spokeswoman for AllianceHealth Midwest, said the hospital has increased staff education about infections and adopted new protocols, including more screening of patients. The rate of infections developed in the hospital has fallen 22 percent since the data was collected, she said.

“AllianceHealth Midwest is committed to providing safe, quality care for every patient,” she said in a written statement. “Our physicians, nurses and other clinicians work to continually improve care, and measurement helps identify progress and opportunities to further improve.”

OU Medicine said in a statement it had added three key executive positions with teams dedicated to quality initiatives.

"We evaluate quality data in real-time so we keep the focus on constant quality improvement for the benefit of our patients. Our initiatives are focused on standardization and reduction in variability of care, which is a best practice within our peer group at other academic medical institutions across the country," said Cathy Pierce, chief nursing executive for OU Medicine.

Dr. Tommy Ibrahim, chief medical officer for Integris, said the Edmond and Southwest hospitals have made progress on reducing infections and other types of harm since the data were collected. The most recent information on infections used to compute the scores is from December 2016. Some information dates as far back as July 2014.

Integris set up “care transformation teams” to decide on the best practices for patient safety in each area, and assigned a safety “champion” in each unit to see that staff are carrying them out, Ibrahim said. For example, the champion checks if patients who have catheters and intravenous lines still need them, he said. If the tube isn't necessary, they take it out to eliminate the risk of infection through it. If the patient still needs it, the champion makes sure nurses are keeping it clean to reduce the risk of germs getting in.

Integris Edmond has had only one bloodstream infection linked to intravenous lines in the last year, Ibrahim said, and Southwest Medical Center has eliminated respiratory failure incidents by giving patients oxygen as they wake up from surgery, he said.

“Our goal at Integris is to make sure we have zero harm,” he said.

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›