Wesley, Via Christi fare well in hospital quality rankings

When you go to a hospital, the last thing you want is to come out with more problems than when you went in.

Newly released data from the federal government compares the quality of hospitals around the nation, including the four main hospitals in Wichita: Wesley Medical Center and three Via Christi hospitals: St. Francis, St. Joseph and St. Teresa.

The data compares hospital-acquired infections, hospital deaths, readmissions, value of care, efficiency and patient satisfaction surveys.

Both local hospital systems fell within the national benchmark on most metrics, and even fared better than the nation’s average in a few categories.

If you’re treated at either hospital system in Wichita, you have a better chance than the national average that you won’t be readmitted.

And the cost and quality of care for patients with heart problems or pneumonia are better in Wichita than the national average.

But there is a downside. Via Christi hospitals had higher overall rates of hospital-acquired infection, an issue the hospital system had in the past.

While Via Christi has higher infection rates than Wesley, its rates are still close to the national average. The only exception is infections at Via Christi associated with colon surgery, which are higher than the national average. Colonoscopies are not included in that rate.

And emergency room patients who had broken bones waited longer to receive pain medication at Via Christi than at Wesley. Via Christi’s average wait was an hour and a half at St. Francis and St. Joseph and 71 minutes at St. Teresa – higher than Wesley’s average (32 minutes), the Kansas average (46 minutes) and the national average (54 minutes).

The government collects these numbers to help patients make informed decisions about their care. The hospitals use the data to improve care for patients.

For example, Via Christi hired an outside company to manage its emergency rooms, which has reduced wait times, according to the hospital. Its parent company is also spending money to identify the cause and find solutions for colon surgery infections.

The U.S. Centers for Medicare and Medicaid Services collects quality data about hospitals and health care providers around the country, in part to hold them accountable for Medicare and Medicaid payments.

Medicare and Medicaid are government-funded insurance programs. Medicare is for those 65 years and older. Medicaid is for people with low incomes or who are disabled.

The hospital quality data encompasses all patients, not just Medicare and Medicaid patients.

The collections are recognized as some of the most reliable health care-related data.

Hospital-acquired infections

Via Christi Hospital St. Francis and Via Christi Hospital St. Joseph file joint data because the two share a license, so the report doesn’t distinguish rates between those hospitals. St. Teresa files its own data with the government, but it didn’t have enough information for many of the categories.

It did not have enough data about hospital-acquired infections to include the hospital in the comparison because of the low number of patients, Via Christi said.

Two years ago, the combined rates from St. Francis and St. Joseph showed Via Christi had higher-than-normal rates of C. diff – formally called clostridium diffcile, which inflames a person’s colon.

This time around, Via Christi lowered its rate to the national average. The new data refers to cases from April 1, 2014, through March 31, 2015.

But Via Christi’s rate of infections from colon surgery rose during the most recent reporting period. It’s above the national average and almost twice the rate at Wesley Medical Center.

The Centers for Medicare and Medicaid Services uses a number called a “standardized infection ratio” to compare hospital-acquired infections. The ratio adjusts for the number of patients applicable to that infection and the expected number of infections.

Zero is the best ratio score. The national average is 1. Via Christi’s colon surgery infection ratio was 2.47. Wesley Medical Center’s score was 1.31.

Changes at Wesley

Brett Hartkopp, director of quality, infection prevention and safety for Wesley Healthcare, said he and his quality management staff analyze data to keep Wesley’s infection rates low.

For example, they look at trends about when infections occur – from day of the week and time of day – and the individual nurses and doctors caring for patients who develop infections.

Hartkopp said that’s how the hospital reduced its catheter-associated urinary tract infections by more than half – from 55 in 2014 to 25 in 2015.

He said the hospital did that in two ways.

The first was simple: use the catheters less. “The best way to prevent catheter infections is to not utilize the catheters,” he said.

He said that includes better patient evaluations before hooking up a catheter, and removing catheters as soon as medical staff determines they’re not needed.

Hartkopp also said the hospital noticed more urinary tract infections when a patient moved from a hospital ward to an intensive care unit. That’s because the patient typically had a simple catheter in the first ward and received a more complex catheter in the intensive care unit. Changing catheters created an opportunity for infection.

The fix, Hartkopp said: Switch the entire hospital to the more advanced catheter.

Hartkopp said better patient satisfaction in the emergency room, and in the hospital in general, is tied to better health outcomes.

“If you have to sit for two hours before seeing anyone, it’s very stressful,” he said.

Changes at Via Christi

Karen Bally, director of infection control for Via Christi, said her team noticed an uptick in colon surgery infections in late 2014, but said the hospital has not yet identified the source of the problem.

She said the hospital formed an internal committee to address the problem and recently received more money and resources from its parent company to improve the infection rate.

Bally said colon surgery infections had improved, but she did not provide data about the infection rates.

“With any hospital-acquired condition, you’re striving to be at zero,” she said. “You don’t want any patient to have a complication, because they came to you for their care.”

When Via Christi had higher-than-normal rates of C. diff, an infection that inflames the colon, the hospital took three measures that improved its rate.

Bally said the hospital started using UV light machines that disinfect rooms of bacteria, as well as hospital-approved bleach wipes, and improved nurse and doctor hand hygiene by requiring them to use sanitizer every time they go in a room and every time they leave a room.

Michael Chang, medical director of emergency services at Via Christi Hospital St. Francis, said Via Christi hired an outside company to provide emergency care at its Wichita hospitals. The hospital hired the outside company in June, so the improvements weren’t reflected in the Medicare and Medicaid data.

In an e-mail, Chang said the switch led to several improvements, including:

▪ The average length of an emergency room visit decreased 20 percent.

▪ The wait to see medical staff decreased, on average, from 40 minutes to 18 minutes.

This story was originally published January 7, 2016 at 7:36 PM with the headline "Wesley, Via Christi fare well in hospital quality rankings."