Category Archives: Hospital News

Q & A about Public Health’s investigation of an endoscope associated outbreak

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Tcrehe Seattle Times reported this morning that there had been an outbreak of multidrug-resistant “superbug” infections spread by contaminated endoscopes between 2012 and 2014 in which at least 32 patients at Virginia Mason Medical Center were infected .

Neither the hospital nor health officials notified patients or the public, the Seattle Times reported.

In response to the paper’s report, Public Health – Seattle & King County has posted the following  Q & A on its Public Health Insider blog:

Q & A about Public Health’s investigation of an endoscope associated outbreak

Voluntary reporting by Virginia Mason Medical Center led to identification of an outbreak of multidrug resistant bacterial infections in 2013. After months of investigative work, Public Health—working with Virginia Mason Medical Center, Washington State Department of Health and the Centers for Disease Control Prevention (CDC)—linked the outbreak to a procedure called endoscopic retrograde cholanCREgiopancreatography (ERCP). Since discovering the risk from this procedure, our Communicable Disease Epidemiology staff has taken a leadership role in drawing national attention to this issue in the medical community. Dr. Jeff Duchin, Interim Health Officer and Chief of Communicable Disease Epidemiology answered questions about this outbreak.

What is an ERCP used for?

The ERCP procedure uses a scope, or tube, that goes through a patient’s mouth and throat to reach their upper small bowel and bile duct system. ERCP is used in persons with serious medical problems including cancers and other diseases that cause obstruction or narrowing of the bile ducts.

What kind of bacteria caused the infections?

Infections were caused by two closely-related types of bacteria that are resistant to many antibiotics. In some cases, the bacteria were also resistant to powerful antibiotics called carbapenems.  These bacteria are referred to as CRE (carbapenem resistant Enterobacteriaceae).

Was the outbreak caused by a CRE “superbug?”

No. The type of CRE that has caused outbreaks in other healthcare facilities has been referred to as a “CRE superbug.” It usually produces an enzyme that inactivates carbapenem antibiotics. The outbreak we investigated was not caused by this type of CRE, which did not have a carbapenemase enzyme.

What is the role of Public Health in this investigation? Continue reading

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Hospital prices grow at slowest rate in a decade – Modern Healthcare

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Hospital Entrance SignThe price for acute-care hospital care increased last year at its slowest pace in the 10 years for which comparable data is available, Producer Price Index figures show.

The Producer Price Index for acute-care hospitals increased 0.7% in the 12 months that ended in December. That’s well below the annual average of 2.7% recorded by the U.S. Bureau of Labor Statistics since 2004.

via Hospital prices grow at slowest rate in a decade – Modern Healthcare.

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Only a few Obamacare experiments to cut readmissions successful so far

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Illustration of a lightbulb lit up

Photo: Steve Woods

By Jay Hancock
KHN

Obama administration officials have warned that ambitious experiments run by the health law’s $10 billion innovation lab wouldn’t always be successful. Now there is evidence their caution was well placed.

Only a small minority of community groups getting federal reimbursement to reduce expensive hospital readmissions produced significant results compared with those from sites that weren’t part of the $300 million program, according to partial, early results.

The closely watched program is one of many tests to control costs and improve care being run by the Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act.

Dozens of community agencies on aging, from Ventura County, Calif., to southern Maine were offered money to try to ensure that seniors leaving the hospital received care that reduced their chances of being readmitted within a month.

But an early evaluation found that only four groups out of 48 that were studied in the Community-based Care Transition Program significantly cut readmissions compared with those of a control group. Continue reading

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Public health appoints new interim Local Health Officer

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Duchin

Jeffrey Duchin

Dr. Jeffrey Duchin, MD, was appointed today as Interim Local Health Officer for Public Health – Seattle & King County.

Duchin is a familiar figure in the health field, having held the position of chief of the department’s Communicable Disease Epidemiology and Immunization Section since 1999 and frequently serving as a department spokesperson.

In his new role, Duchin will provide leadership in developing priorities and setting strategies for the health department, with a particular role as the key science advisor on program and policy development.

Duchin will split time between his Health Officer duties and his continued direction of communicable disease and immunization activities. He will also maintain an affiliation with the University of Washington as a Professor of Medicine.

As part of his Health Officer duties, he will work with other health officers in Washington State on health issues that cross county borders.

In addition, Duchin will represent Public Health – Seattle & King County on external committees, task forces, and as a liaison to regional and national professional organizations.

Duchin’s is currently the Chair of the Public Health Committee of the Infectious Disease Society of America and has served in many other advisory roles, including the CDC’s Advisory Committee on Immunization Practices and the Institute of Medicine.

The Interim Local Health Officer reports to Patty Hayes, Interim Director of Public Health – Seattle & King County.  Prior to Duchin, the position was held by the previous Director, Dr. David Fleming.

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Which Washington hospitals penalized for having high rates of medical mistakes?

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Kaiser Health News

Medicare is penalizing 721 hospitals with high rates of potentially avoidable mistakes that can harm patients, known as “hospital-acquired conditions” or HACs

Penalized hospitals will have their Medicare payments reduced by 1 percent over the fiscal year that runs from October 2014 through September 2015.

To determine penalties, Medicare evaluated three types of HACs.

  • One is central-line associated bloodstream infections, or CLABSIs.
  • The second is catheter-associated urinary tract infections, or CAUTIs.
  • The final one, Serious Complications, is based on eight types of injuries, including blood clots, bed sores and falls.

Here are the Washington state hospitals that are being penalized:

Cascade Valley Hospital Arlington WA Snohomish
Deaconess Medical Center Spokane WA Spokane
Harborview Medical Center Seattle WA King
Kadlec Regional Medical Center Richland WA Benton
Multicare Auburn Medical Center Auburn WA King
Multicare Good Samaritan Hospital Puyallup WA Pierce
Northwest Hospital & Medical Center Seattle WA King
Peacehealth St Joseph Medical Center Bellingham WA Whatcom
Providence Holy Family Hospital Spokane WA Spokane
Providence Sacred Heart Medical Center Spokane WA Spokane
Providence St Mary Medical Center Walla Walla WA Walla Walla
Swedish Medical Center – First Hill/Ballard Seattle WA King
Swedish Medical Center / Cherry Hill Seattle WA King
Trios Health Kennewick WA Benton
Valley Medical Center Renton WA King
Wenatchee Valley Hospital Wenatchee WA Chelan
Yakima Regional Medical And Cardiac Center Yakima WA Yakima

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

khn_logo_lightKaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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Medicare Cuts payments to 721 hospitals with highest rates of infections, injuries

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Physician and Nurse Pushing Gurney

By Jordan Rau
KHN

In its toughest crackdown yet on medical errors, the federal government is cutting payments to 721 hospitals for having high rates of infections and other patient injuries, records released Thursday show.

Medicare assessed these new penalties against some of the most renowned hospitals in the nation, including the Cleveland Clinic, Brigham and Women’s Hospital in Boston, the Hospital of the University of Pennsylvania in Philadelphia and Geisinger Medical Center in Danville, Pa.

One out of every seven hospitals in the nation will have their Medicare payments lowered by 1 percent over the fiscal year that began Oct. 1 and continues through September 2015. The health law mandates the reductions for the quarter of hospitals that Medicare assessed as having the highest rates of “hospital-acquired conditions,” or HACs.

These conditions include infections from catheters, blood clots, bed sores and other complications that are considered avoidable.

The penalties, which are estimated to total $373 million, are falling particularly hard on academic medical centers: Roughly half of them will be punished, according to a Kaiser Health News analysis.

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How safe are outpatient surgery centers?

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Popularity Of Outpatient Surgery Centers Leads To Questions About Safety

Woman_doctor_surgeonBy By Sandra G. Boodman
KHN and Washington Post

Wendy Salo was alarmed when she learned where her doctor had scheduled her gynecologic operation: at an outpatient surgery center.

“My first thought was ‘Am I not important enough to go to a real hospital?’ ” recalled Salo, 48, a supermarket department manager who said she felt “very trepidatious” about having her ovaries removed outside a hospital.

Before the Sept. 30 procedure, Salo drove 20 miles from her home in Germantown, Md., to the Massachusetts Avenue Surgery Center in Bethesda for a tour. Her fears were allayed, she said, by the facility’s cleanliness and its empathic staff.

Salo later joked that the main difference between the multi-specialty center and Shady Grove Adventist Hospital — where she underwent breast cancer surgery last year — was that the former had “better parking.”

Salo’s initial concerns mirror questions about the safety of outpatient surgery centers that have mushroomed since the highly publicized death of Joan Rivers.

The 81-year-old comedian died Sept. 4 after suffering brain damage while undergoing routine throat procedures at Yorkville Endoscopy, a year-old free-standing center located in Manhattan.

Federal officials who investigated Rivers’ death, which has been classified by the medical examiner as a “therapeutic complication,” found numerous violations at the accredited clinic, including:

  • a failure to notice or take action to correct Rivers’ deteriorating vital signs for 15 minutes;
  • a discrepancy in the medical record about the amount of anesthesia she received;
  • an apparent failure to weigh Rivers, a critical factor in calculating an anesthesia dose;
  • and the performance of a procedure to which Rivers had not given written consent.

In addition, one of the procedures was performed by a doctor who was not credentialed by the center.

Continue reading

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Boeing, Starbucks demand and get better healthcare for their workers – LA Times

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starbucks-logoSeattle’s big companies have pushed local hospitals and doctors to meet the kinds of rigorous standards they use to build airplanes or brew coffee, reports The Los Angeles Times. Also in the news are a look at the SHOP exchanges for small businesses and the rate increases some of those employers are facing.

Where employers use quality control to shape healthcare – LA Times.

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King County man found not to have Ebola, released from hospital

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Map of SeattleThe King County resident who had been tested for Ebola has been found not does not have the virus, according to the results from the Washington State Public Health Laboratory, Public Health – Seattle and King County said Monday.

The man had developed a fever and a sore throat after traveling in the West African nation of Mali and had been admitted to UW Medicine’s Harborview Medical Center for evaluation. By late Sunday afternoon, his symptoms had improved and he was able to go home.

Following the CDC’s protocol for anyone arriving from Mali, his health will continue to be actively monitored by our Communicable Disease and Epidemiology staff until he has cleared the time frame in which Ebola could develop.

Learn more about Ebola: www.kingcounty.gov/health/Ebola

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King County man tests negative for Ebola

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Map of SeattleA King County man who developed fever after returning to the area from Mali has tested negative for Ebola, Public Health – Seattle & King County health officials said Sunday.

The man who also had a sore throat — but none of the of symptoms typical of Ebola infection —  was admitted to UW Medicine’s Harborview Medical Center for evaluation.

The US Centers for Disease Control and Prevention (CDC) recommends close monitoring of anyone with fever and other symptoms of Ebola who has recently travelled in Ebola-affected countries. Mali has had only 8 cases of the disease.

Here’s the announcement from Public Health – Seattle & King County:

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Cambia gives its largest grant ever to UW Medicine: $10 million for palliative care – Puget Sound Business Journal

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Dr. Randy Curtis, right, director of the UW Palliative Care Center of Excellence.

Dr. Randy Curtis, right, director of the UW Palliative Care Center of Excellence.

The grant is Cambia’s largest ever given to any organization and will come in four separate parts, creating three endowments totaling $8 million and $2 million dedicated to immediately improving care at the center.

via Cambia gives its largest grant ever to UW Medicine: $10 million for palliative care – Puget Sound Business Journal.

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A Comparison of Hospital Administrative Costs in Eight Nations: U.S. Costs Exceed All Others by Far – The Commonwealth Fund

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hospital magnify thumbnailAdministrative costs account for 25 percent of total U.S. hospital spending, according to a new study that compares these costs across eight nations. The United States had the highest administrative costs; Scotland and Canada had the lowest. Reducing U.S. per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011.

via A Comparison of Hospital Administrative Costs in Eight Nations: U.S. Costs Exceed All Others by Far – The Commonwealth Fund.

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Humana and Multicare launch accountable care program

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image003MultiCare Health System and Humana Inc. will launch a new accountable care partnership for Humana’s Medicare Advantage members in South King County and Pierce County, the companies announced this week.

Accountable care partnership will provide Humana membership with more coordinated care that will emphasize preventive services, the companies said.

Humana offers Medicare Advantage HMO plans, a prescription drug plan and Medicare supplement policies to Medicare recipients in the Tacoma area.

MultiCare is made up of five hospitals including Allenmore HospitalAuburn Medical CenterGood Samaritan HospitalMary Bridge Children’s Hospital and Tacoma General Hospital as well as outpatient specialty centers, primary and urgent care clinics.

The not-for-profit health care organization has more than 10,500 employees and a comprehensive network of services throughout Pierce, South King, Thurston and Kitsap counties.

Humana aims to work closely with doctors and hospitals through its Accountable Care Continuum, the companies said.

For a Primer on Accountable Care Organizations go here.

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Fred Hutch recruits D. Gary Gilliland as its new president and director

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1416499943573Fred Hutchinson Cancer Research Center announced today that it has named an expert in cancer genetics and precision medicine. D. Gary Gilliland, M.D., Ph.D., a physician-scientist with a background in academic medicine and the pharmaceutical industry, as its new president and director. Gilliland will take the helm as Fred Hutch’s new leader on Jan. 2.

via Fred Hutch recruits D. Gary Gilliland as its new president and director.

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Eight Washington hospitals identified for Ebola care

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ebolaAlthough all hospitals in the state are making plans to rapidly identify, isolate and safely evaluate people with suspected Ebola, eight hospitals are preparing to care for a person with Ebola for the duration of the illness.

These are:

  • CHI Franciscan Health (Harrison Medical Center – Bremerton campus),
  • MultiCare Tacoma General Hospital,
  • Providence Regional Medical Center Everett,
  • Providence Sacred Heart Medical Center and Children’s Hospital in Spokane,
  • Seattle Children’s Hospital,
  • Swedish Medical Center (Issaquah),
  • Virginia Mason Hospital, and
  • UW Medicine (Harborview Medical Center, UW Medical Center, Valley Medical Center)

“The chance of a confirmed case of Ebola in Washington is very low, but in the event it happens we want to be sure we have the capacity to provide ongoing care to a patient,” said Dr. Kathy Lofy, state Health Officer. “Patients with Ebola can become critically ill and require intensive care therapy. Care needs to be delivered using strict infection control practices. We are working with each of the committed hospitals to ensure we are coordinated and thorough in our response.” Continue reading

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