New Jersey’s 2010 Hospital Performance Report shows hospitals have dramatically improved patient care since the state began issuing performance reports, and now exceed national standards on most quality and safety measures including preventing one type of potentially deadly healthcare-associated infection (HAI), Health and Senior Services Commissioner Dr. Poonam Alaigh announced today. 

 

          New Jersey ranks 10^th in overall quality of patient care, based on the most recent data from the federal Agency for Healthcare Research and Quality (AHRQ) – a dramatic improvement from the state’s ranking of 43^rd in a 2003 study in the Journal of the American Medical Association.

 

          New Jersey’s 2010 Hospital Performance Report includes the first data on healthcare-associated infections, which are acquired in hospitals or other health care settings.  There are about 1.7 million such infections in the U.S. each year, leading to 100,000 deaths and costing the health care system more than $28 billion in direct medical costs, according to the U.S. Centers for Disease Control and Prevention.  

 

“Through public performance reports, we’ve challenged hospitals to deliver the highest-quality care possible and they have risen to the challenge. On many measures of patient quality care, hospitals are scoring nearly 100 percent,” Dr. Alaigh said.  “New Jersey continues to close the gap on quality care measures among hospitals, which means better care for all patients.

 

“As the report shows, however, there is clearly more work to be done,” the Commissioner added.  “We continue to work with the hospital industry toward the ultimate goal of eliminating errors and healthcare-associated infections.”      

 

“The continued trend in quality improvement in New Jersey hospitals shows that their investment in quality and patient safety – through staffing, energy and resources – is yielding results. Congratulations to New Jersey’s hospitals for working so hard to make quality improvement an ingrained part of our healthcare culture.  Even more important is the good news this brings to New Jersey patients,” said Betsy Ryan, President and CEO of the New Jersey Hospital Association.

 

“The consistent improvement in these quality and patient safety measures shows that every hospital in the state and every physician considers it a central part of their mission to deliver the highest quality, safest care possible.  We are committed achieving this mission every day for every patient,” said Dr. Fred Jacobs, co-chair of the Department’s Quality Improvement Advisory Committee, and Executive Vice President and Director of the Quality Institute for the Saint Barnabas Health Care System.

 

The report describes hospital performance in three key areas – healthcare-associated infections, patient safety, and recommended care for specific health conditions.    

 

 

Central Line -Associated Bloodstream Infections

 

The report focuses on one of the most deadly healthcare-associated infections – central line-associated bloodstream infections (CLABSI) in patients in hospital intensive care units.  A central line is a tube inserted into a patient’s vein to deliver fluids and medications directly to the bloodstream.  Below are some highlights from the report.  Performance is based on a national benchmark set by the U. S. Centers for Disease Control and Prevention (CDC):

 

• New Jersey hospitals performed better than predicted by the CDC in the area of central line infections.  The overall hospital rate of CLABSI was 27 percent lower than expected.
• Ten of 72 hospitals performed better that predicted, with lower-than-expected central line infection rates.
• Fifty-seven hospitals performed the same as expected.
• There were 328 central line infections in 2009; 448 were expected.

 

Patient Safety

 

For the second year, the report compares hospitals on 12 measures called Patient Safety Indicators.  These represent medical errors such as objects left inside patients during surgery, or accidental cuts and punctures to patients.  A highlight from the report:

 

• Overall, hospitals outperformed the nation on 9 of 12 patient safety measures in this year’s report, and tied the nation on one (major reaction to a blood transfusion). 

 

“The inclusion of patient safety indicators in this New Jersey hospital performance report demonstrates an ongoing commitment to quality.  I’m sure we’ll see improvements in safety indicators over time as hospitals continue to incorporate strategies that target safety in their patient care processes,” said Maureen Bueno, Ph.D., R.N., co-chair of the Department’s Quality Improvement Advisory Committee, and Vice President of Care Management and Medical Information at QualCare Inc.

 

 

Recommended Care Measures for Specific Health Conditions

 

Heart attack, heart failure, pneumonia and care of surgical patients are now scored on 24 measures.  These include practices such as giving heart attack patients aspirin on arrival at the hospital to help reduce the severity of the attack.  Here are some report highlights:

 

• New Jersey exceeded national scores on 17 of 24 care measures, and tied the nation on five.
• Hospitals have dramatically increased their score for appropriately giving pneumonia patients a pneumococcal shot before discharge.  The shot can help prevent future bacterial pneumonia.  The overall hospital score rose 98 percent, from 48 in 2003 to 95 in 2009.
• Hospitals scored 100 percent on giving smoking cessation advice to heart attack and heart failure patients with a smoking history, and 99 percent for pneumonia patients who smoke.
• Every hospital scored 92 or higher on overall heart attack treatment.
• New Jersey has significantly improved its score for heart attack patients undergoing angioplasty – a procedure to open blocked blood vessels – within 90 minutes of hospital arrival.  Now 83 percent of patients get the correct timely care, up from 55 percent three years earlier.  The national rate is 87 percent.
• In addition to its lower angioplasty score, New Jersey scored 92 compared with the nation’s 93 for cardiac surgery patients who had controlled blood sugar after surgery.

 

The online Hospital Performance Report can be found on the DHSS web site at: www.nj.gov/health/hpr.  The web-based report allows viewers to compare hospitals by health condition, county or hospital name. 

 

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Questions and Answers

 

How serious are central line-associated bloodstream infections and how do they occur?

 

They occur when bacteria and other germs contaminate the central line, a tube that has been inserted into the patient’s vein, and are then carried into the bloodstream.  The U.S. Centers for Disease Control and Prevention estimates there are 250,000 of these infections annually, costing $2.7 billion to treat.  Central-line infections have a death rate of from 12 to 25 percent.

 

Can they be prevented?

 

Yes. They can be prevented through proper infection control measures and by removing the line as soon as it is no longer needed.  The Hospital Performance Report gives prevention advice for both consumers and providers. 

 

What is DHSS doing to improve patient safety?

 

New Jersey’s Patient Safety Reporting System requires licensed health care facilities to confidentially report all serious preventable adverse events, conduct a root cause analysis to identify underlying causes, and develop and implement a plan to prevent future errors. DHSS monitors the patient safety reporting system for trends, and shares important information through alerts and other reports to the industry. 

 

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