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Roswell Park and Kaleida say bloodstream infections are down

Consumer Reports recently said that Roswell Park Cancer Institute and Kaleida Health ranked below the national average in preventing bloodstream infections among intensive care patients in 2009 -- but the hospitals noted that data is already out of date.

Both facilities said they dramatically cut their infection rates in 2010 after noticing the higher-than-usual rates a year earlier.

Bloodstream infections are a hugely important measure of hospital quality, just because such bugs prove to be fatal for 25 percent to 30 percent of the patients who get them, said Dr. Richard Santa, who prepared the Consumer Reports study.

The danger of such infections prompted Roswell Park officials to act when they saw the bloodstream infection rate among intensive care patients spiking in 2009 to a rate of 6.1 per 1,000 patient days in the ICU unit.

Consumer Reports said that was 239 percent worse than the national average, ranking Roswell Parkas having as one of the three worst infection rates in the country.

The spike happened after the hospital decided in 2008 to move patients who were having bone marrow transplants to the intensive care unit, said Maureen Kelly, vice president of patient care services and chief nursing officer at Roswell Park.

Cancer patients undergoing bone marrow transplants have weak immune systems, and once the hospital saw their infections increasing, "we got a huge multidisciplinary team together to look at how we can fix this," Kelly said.

As a result of that work, the hospital began using different antibiotics in some circumstances and changed its policy on the dressing of wounds -- moves that reduced the infection rate to 1.5 per 1,000 patient days in 2010, Kelly said.

Similarly, Kaleida reported an infection rate of 2.8 per 1,000 intensive care unit days in 2009 -- which, Consumer Reports said, was 18 percent worse than the national average.

In response, Kaleida reviewed its best practices and instituted a system whereby nurses could call a stop to a medical procedure if they notice a physician or resident violating the hospital's infection prevention procedures, said Mary Pruski, vice president and chief quality and patient safety officer.

Those changes drove down Kaleida's infection rate to 1.8 per 1,000 ICU days in 2010, Pruski said.

Roswell Park and Kaleida were just two of 67 hospitals nationwide that Consumer Reports singled out for having unusually high rates of bloodstream infections among ICU patients in 2009.

Some of the nation's most highly regarded hospitals -- including the Cleveland Clinic and the Johns Hopkins Bayview Medical Center in Baltimore -- were among those with high infection rates.

"It's unsettling, isn't it?" said Santa, the Consumer Reports analyst. Big name hospitals "have a lot of priorities, and this isn't one of them."

Still, "the good news is that once a hospital focuses on this, the improvement can be dramatic," he added.

Santa found that Sisters Hospital had an infection rate that was 8 percent higher than the national average, while Kenmore Mercy Hospital's rate was 12 percent lower than the national average. The Catholic Health System declined to repond to the report.

And Erie County Medical Center, with an infection rate of 0.64 per 1,000 patient days, performed 70 percent better than the average hospital. "Erie County Medical Center is doing a good job of this," Santa said.


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