When a Surgical Site Infection Sends a Friend Through Hell

Cheryl Clark, for HealthLeaders Media , February 16, 2012

Muncie and Jaffe have yet to interest any legislators. But the Virginia Hospital and Healthcare Association, which represents hospital, health plan,  and doctor groups in the state, crafted this statement in June 2009:

"We are engaged in several initiatives to measure, report and support improvement in patient safety and care quality. However we recognize that despite these efforts situations and errors may occur while caring for patients that can have serious and sometimes fatal results.

"These events are tragic for all involved–patients, families and caregivers." There are inherent risks, the statement continues, "not all of which can be predicted or prevented.

"But when errors do occur and preventable serious adverse outcomes result, Virginia's hospitals and health systems believe that information about the error should be promptly and openly communicated to patients and their families, and that those financially responsible for the related healthcare service ­ patients, insurers or employers – should not be asked to pay for that care."

Doug Gray, the association's executive director who had heard about Muncie's case, said, "this is an issue that should fall in an area of discussion for non-payment. The golden rule is what we ought to be practicing. In this case, did they do what they could to avoid a surgical site infection?...If I were the hospital's attorney, I would be worried."

I hope my friend Muncie and his wife get through this ordeal quickly. Sometimes terrible events like this expose system flaws that zeal and transparency serve to fix.

"We want to save lives," Muncie said. We believe very strongly that if these safeguards were put into effect, these systems, these rates will plummet. And if the monetary system is also put into place that incentivizes hospitals to save patients, more people won't get infected during surgery."

Well said, John.

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5 comments on "When a Surgical Site Infection Sends a Friend Through Hell"

jody jaffe (2/21/2012 at 2:23 PM)
According to the CDC, 70% of hospital acquired infections (HAIs) can be prevented. No one is saying all HAIs can be prevented, but 70%? That is shameful. So I have to disagree with Dr. Hirsch's premise that hospitals shouldn't be responsible for the costs of these HAIs until it can be proven they are all preventable. The bottom line is hospitals can do more, it just costs money. For example, Martha Jefferson Hospital, where my husband was infected and treated for THREE HAIs, defunded its two infectious disease nurses and refused to pay for an infectious disease doctor to be on its Infection Committee. According to Dr. Dan Sawyer, the infectious disease doctor at Martha Jefferson, infection rates went down when he was in the Operating Rooms, observing and gathering data. And the rates went back up when he stopped. Don't tell me Sentara, Martha Jefferson's parent company, can't afford to fund these positions. It posts net revenues of $3.5 BILLION and paid its CEO, David Bernd, $3.5 million in 2008.

Ray McEachern (2/20/2012 at 1:58 PM)
Rather than citing stats and making excuses, medical professionals must learn to take responsibility for possible mistakes that were the direct or likely cause of this type of infection. There should be a root cause analysis of this specific infection with the intention of finding how it could have happened. Unless there are documented procedures in this patient's record that establish beyond a reasonable doubt that all infection control procedures were followed during his entire stay, the hospital should take responsibilty. Just as airlines have black boxes to help determine cause when things go wrong, hospitals must have checklists and other records to prove their best practices were followed.

AHNguyen (2/17/2012 at 1:08 PM)
Physicians, nurses, and hospitals are not in the business of causing harm to patients. They do not celebrate complications/infections because they are getting paid extra for these events. This premise is idiotic. It is well known in the scientific community that a zero percent infection rate is an impossibility. There are myriad variables contributing to this process, most of which we do not have a complete understanding or comprehension in terms of identification, prevention, or intervention. We have identified the disparate variables contributing to SSIs. These include appropriate hair removal, skin decontamination, prophylactic antibiotics, body temperature, glucose control, and so forth. Adherence to proposed guidelines could reduce the incidence of SSIs significantly, but this rate is not ZERO. With regards to the author's claim of efficacy with preop washing, the current scientific data is "despite repeated demonstrations of a reduction in surface bacteria at the operative site using a CHG shower, meta analyses have shown only a NONsignificant reduction in wound infections in large number of patients." We all feel bad and horrible when someone has a bad outcome. However, without further information from this article, it is imprudent to assign accountability and culpability.




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