HMC earns A for pa­tient safety

Hawaii Tribune Herald - - FRONT PAGE - By JEFF HANSEL

Hilo Med­i­cal Cen­ter re­ceived a top grade from the non­profit Leapfrog Group — a lead­ing pro­po­nent of pa­tient safety.

Leapfrog gave HMC an A, its high­est mark for hos­pi­tal safety.

That helped place Hawaii among five states na­tion­wide with the high­est per­cent­age of hos­pi­tals re­ceiv­ing an A.

Med­i­cal er­rors don’t tend to end up on lists of death con­trib­u­tors, but ac­cord­ing to Leapfrog statis­tics they rank right be­hind heart dis­ease and can­cer as the third-lead­ing cause of death in the United States.

Med­i­cal er­rors are “never events” — the kind of avoid­able mis­takes in the health care set­ting that should never hap­pen.

But they do, cost­ing about 1,000 lives per day na­tion­ally, Leapfrog re­ports.

Med­i­cal er­rors in­clude such events as op­er­at­ing on the wrong body part, al­low­ing a pres­sure ul­cer to form, op­er­at­ing on the wrong pa­tient, giv­ing the wrong dose of medicine, us­ing a con­tam­i­nated drug or de­vice, hav­ing a pa­tient get a hos­pi­tal-ac­quired in­fec­tion, dis­charg­ing a pa­tient to the wrong per­son when the pa­tient isn’t cog­ni­tively able to rec­og­nize the er­ror, loss of a spec­i­men or leaving sur­gi­cal tools in­side a pa­tient af­ter surgery.

Hawaii does not have a cen­tral­ized data­base for hos­pi­tals to com­pare their med­i­cal er­ror rates with other health fa­cil­i­ties. But Leapfrog al­lows them a way to see how they com­pare na­tion­ally.

Chad Shibuya, Hilo Med­i­cal Cen­ter’s in­fec­tion con­trol di­rec­tor, said in­fec­tion preven­tion re­quires the buy-in of the en­tire staff, not just nurses and physi­cians will­ing to wash hands af­ter touch­ing any sur­face other than the pa­tient. Laun­dry staff, main­te­nance per­son­nel and di­etary crews also play a crit­i­cal role in in­fec­tion con­trol, which en­com­passes ev­ery­thing from food to sur­gi­cal pro­ce­dures, IV in­ser­tion and air qual­ity.

“It does come down to even mak­ing sure that our air con­di­tion­ing sys­tems are work­ing prop­erly,” Shibuya said.

Hilo Med­i­cal Cen­ter’s med­i­cal di­rec­tor Dr. Jon Martell over­sees the elec­tronic med­i­cal record sys­tem. He said the hos­pi­tal with­held com­pen­sa­tion from hos­pi­tal­ists — physi­cians who spe­cial­ize in tak­ing care of hos­pi­tal­ized pa­tients — and they had to win it back by demon­strat­ing in­fec­tion con­trol as a top pri­or­ity. So. it was an all-hands-on-deck ef­fort to raise the hos­pi­tal’s pa­tient safety record.

Hilo Med­i­cal Cen­ter was the only Big Is­land hos­pi­tal to re­ceive an A rat­ing. It scored a C in 2014, a B in 2015 and an A for 2016.

Hilo Med­i­cal Cen­ter ranked above av­er­age for MRSA in­fec­tions, C. dif­fi­cile in­fec­tions, in­fec­tions in the blood dur­ing ICU stays, uri­nary tract in­fec­tions dur­ing ICU stays and sur­gi­cal site in­fec­tions af­ter colon surg­eries.

The hos­pi­tal didn’t re­port data about hand wash­ing and per­formed be­low av­er­age when com­mu­ni­cat­ing about pa­tient dis­charge. But in terms of pa­tient falls, pres­sure ul­cers and air or gas bub­bles in the blood, Hilo Med­i­cal Cen­ter per­formed bet­ter than av­er­age.

It also ranked high for staff re­spon­sive­ness and com­mu­ni­ca­tion with nurses.

Martell said HMC is a “very data-driven hos­pi­tal” and that helps when pro­tect­ing pa­tient safety.

For ex­am­ple, the hos­pi­tal be­gan a spe­cial­ized pro­gram to rec­og­nize sep­sis and pro­vide rapid treat­ment — even be­fore a na­tional man­date was in­sti­tuted.

“We’re proud,” Martell said.

Shibuya said teach­ing points are in­te­grated into the elec­tronic med­i­cal records to make sure pa­tients get the knowl­edge they need about their health.

“We just have to work re­ally hard to keep do­ing what we’re do­ing and pos­si­bly even get bet­ter over time,” he said.

HOL­LYN JOHN­SON/Tri­bune-Her­ald

Hilo Med­i­cal Cen­ter re­ceived an A grade from the non­profit Leapfrog Group, a lead­ing pro­po­nent of pa­tient safety.

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