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Patients At Seven Miami-Dade Hospitals Are More Likely To Develop Infections

Seven Miami-Dade hospitals fell below national standards for combating infections acquired by patients in hospitals, and patients at one hospital — North Shore Medical Center in Miami — were more likely to develop infections than patients at any other hospital in South Florida, according to data collected by the federal government as part of a national effort to reduce such infections.

The Centers for Disease Control and Prevention tracks how hospitals around the nation perform on preventing six types of frequently occurring infections, including bloodstream and urinary tract infections that result from catheters and surgical site infections that develop after colon and hysterectomy operations.

North Shore Medical Center did worse than national standards in controlling four types of infections.

Only one other Florida hospital, UF Health Jacksonville, a teaching hospital in Duval County, underperformed the CDC benchmarks in more than two categories, and only seven hospitals in the nation underperformed in four categories.

Cristy Martinez Paez, a spokeswoman for North Shore Medical Center, wrote in an email that the hospital provides “high-quality patient care” and is engaged in an “ongoing effort to reduce hospital-acquired infections by implementing proven methods such as a comprehensive safety program on every unit.”

She wouldn’t provide details of the safety program, saying only that “we continue to work toward a goal of zero cases.”

The CDC collected the data on infections from 4,683 hospitals around the county, including 179 in Florida, between October 2012 and September 2013.

“These kinds of infections usually occur because of fairly simple problems and errors by healthcare providers — and they have simple solutions that can be easily enacted,” said Robert Brooks, a patient safety expert who served as secretary of the Florida Department of Health between 1999 and 2001.

One in 25 patients develop an infection on any given day while in hospital care and one in nine people infected will die in the hospital, according to the CDC.

“We as a society need to continue to bring attention to facilities that don’t meet community standards in relation to medical errors or hospital-acquired infections,” said Brooks, who is also an adjunct professor at the University of South Florida.

In Miami, North Shore did worse than national benchmarks in four categories: central-line bloodstream infections, catheter-associated urinary tract infections and infections from two types of antibiotic-resistant bacteria, MRSA and C. diff.

Tenet Healthcare, the Dallas-based company that owns North Shore, did not respond to a request for comment.

UF Health Jacksonville, part of the University of Florida health system, also underperformed in four categories.

“Safety-net hospitals like ours tend to be at a disadvantage in these studies when compared to other hospitals because of our unique patient population,” said Daniel Leveton, a spokesman for UF Health Jacksonville, in a statement.

Leveton said the hospital tends to treat patients with more severe conditions who haven’t had adequate access to preventive care. “Treating them can be more of a challenge, one we accept as part of our mission in helping this community,” he said.

Jackson Memorial Hospital in Miami, also considered a safety-net institution, exceeded expectations for bloodstream and urinary tract infections but failed to meet them for MRSA.

Nancy Foster, vice president of patient safety at the American Hospital Association, said the CDC data were by and large “very well crafted,” but it might be penalizing to hospitals that aggressively diagnosed and treated infections. She also said the overuse of antibiotics could lead to problems.

“We don’t want to over-prescribe antibiotics because that leads to even more antibiotic resistant organisms,” Foster said.

As a whole, Florida hospitals are performing significantly better than national benchmarks in three areas: bloodstream, urinary tract and colon infections, according to CDC data released in March.

Bruce Rueben, president of the Florida Hospital Association, a trade group, said hospitals in the state were working together to find effective strategies for reducing infections and other hospital-related injuries like falls and medication overdoses. Patients and providers would benefit from focusing on the problems, Rueben said, in part because hospitals have higher treatment costs when patients develop complications under their care.

The federal government compiles scores for individual hospitals based on a broad range of patient safety measures, including hospital-acquired infections.

In December, the government will announce the first round of financial penalties, assessed through Medicare payments, for hospitals with low safety scores. The program was established as part of the Affordable Care Act.

The government is also expected to release updated infection rates for hospitals by the end of December.

Standardizing procedures that nurses and doctors perform on patients can help prevent infections, said Dr. Robert Goldszer, chief medical officer at Mount Sinai Medical Center in Miami Beach.

“More variation means more opportunities for things to go wrong,” Goldszer said. “We’re trying to design the easiest way to provide our patients with the right care all the time.”

Mount Sinai performed worse than national benchmarks in preventing MRSA and post-surgical colon infections but exceeded for urinary tract and C. diff infections.

Goldszer said Mount Sinai had worked with the Florida Hospital Association and other healthcare institutions to identify ways to improve its fight against infections including increased hand-washing, special soaps to clean a patient’s skin before surgery, avoiding the over-use of catheters and investigating how every new infection occurs.

He said the hospital had reduced the frequency of colon infections from 20 cases in 2013 to five as of September this year, and had also seen a moderate drop in its rate of MRSA infections.

“We need to continuously measure and assess our progress,” Goldszer said.

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