Olympic Medical Center beats big brethren in patient-safety score

PORT ANGELES — Olympic Medical Center will escape the 1 percent cut in Medicaid funds levied last week on 17 other Washington hospitals for poor records of patient infections, injuries and complications.

The penalized institutions included two of OMC’s Seattle-based partners, Swedish Medical Center-First Hill/Ballard and Swedish Medical Center-Cherry Hill.

OMC’s safety score was 5.35 on a 10-point scale, said Dr. Scott Kennedy, the hospital’s chief medical and operating officer. Hospitals with scores above 7 were penalized.

“We did well in this round,” Kennedy said Friday, “and are working to do well in the future.”

Small “critical-access hospitals” that include Jefferson Healthcare and Forks Community Hospital were exempt from the Medicaid measures.

Three points to assess

Medicare used three measures to assess points:

■ Bloodstream infections caused by tubes used to pump fluids or medicine into veins, also known as central bloodlines.

■ Infections from tubes placed in bladders to remove urine, called catheters.

■ Eight kinds of serious complications, including collapsed lungs, surgical cuts, tears and reopened wounds, and broken hips.

Six other Western Washington hospitals — Cascade Valley Hospital, Arlington; Peacehealth St. Joseph Medical Center, Bellingham; Multicare Auburn Medical Center, Puyallup; Valley Medical Center, Renton; and Harborview Medical Center and Northwest Hospital and Medical Center, both of Seattle — will pay the penalties retroactive to Oct. 1 and running through September 2015.

Across the state, 35 percent of Washington hospitals will be penalized.

Across the U.S., 721 institutions — about one-seventh of the nation’s hospitals — will be punished, including more than half of America’s teaching hospitals. They are expected to lose about $373 million.

Renowned hospitals

The penalties were announced Thursday and will fall upon some of the country’s most-respected medical centers: the Cleveland Clinic; Brigham and Women’s Hospital, Boston; the Hospital of the University of Pennsylvania, Philadelphia; and Geisinger Medical Center in Pennsylvania.

“What Medicare is saying is that they’re not going to pay for what doesn’t produce good outcomes,” OMC’s Kennedy said.

“The government’s incentivizing through penalties, which is sort of an oxymoron, but it’s certainly motivating.”

Federal health law requires Medicare to punish the worst-performing quarter of the nation’s hospitals each year, even if they have been improving.

Other federal “pay-for-performance” regulations levy penalties against hospitals with high readmission rates and award bonuses or penalties based on two dozen quality measures.

Some of the infections Medicare examines have proven hard to reduce, including urinary tract infections.

Seattle’s Swedish Medical Center, which has higher urinary catheter infection rates than do most hospitals, has given nurses more authority to remove catheters so long as they follow guidelines for when removal is appropriate, said Dr. Michael Myint, Swedish’s vice president for quality and patient safety.

Compete but cooperate

OMC works with Swedish through the Washington State Hospital Association’s Partnership for Patients. Its Patient Safety Committee met recently “to review results and review best opportunities,” Kennedy said.

“We compete with each other [for patients], but we share information and we benefit from best practices that we learn from each other.”

Conditions are improving.

The federal Agency for Healthcare Research and Quality said that nationwide, central-line-associated bloodstream infections decreased by 49 percent, and catheter-associated urinary tract infections dropped by 28 percent between 2010 and 2013.

Another recent federal report found the mistakes dropped by 17 percent between 2010 and 2013, an improvement U.S. Health and Human Services Secretary Sylvia Burwell called “a big deal, but it’s only a start.”

Kennedy agreed.

“We want to have zero infections — an infection-free environment and an injury-free environment. Our medical center and our medical staff are committed to this,” he said.

“That’s the goal that we strive for together, and we’re on that path.”

________

Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at jcasey@peninsuladailynews.com.

Kaiser Health News, an editorial independent program of the nonprofit Kaiser Family Foundation, contributed to this report.

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