Consumers deserve full transparency about the performance of the hospitals they choose

Consumer Reports / By Catherine Roberts / April 06, 2017
www.consumerreports.org

More than 1,000 U.S. hospitals perform heart surgery, and about half voluntarily share their complication and mortality rates with Consumer Reports.  

That’s a good start, and up 16 percent from 2014, when we first published heart hospital ratings. But it also means that many hospitals still don’t make heart surgery success rates readily available to patients.

That’s a problem, says David Shahian, M.D., who oversees data and quality measures at the Society of Thoracic Surgeons (STS), the organization that gathers the numbers from hospitals and shares them with Consumer Reports.

Public reporting not only provides vital information to patients about where to get heart surgery but also encourages hospitals to improve, “by comparing them to their peers and showing them where they are falling short,” he says. “We believe transparency and sharing your outcomes is a professional ethical responsibility.”

We contacted these 23 hospitals that perform a large number of heart surgeries but don’t publically report through STS or Consumer Reports to ask why not—and if they would share results with us, and with patients.

• Arkansas Heart Hospital, Little Rock, AR
• Baptist Memorial Hospital, Memphis, TN
• Christiana Care Health System, Newark, DE
• Dartmouth-Hitchcock Medical Center, Lebanon, NH *
• Florida Hospital, Orlando, FL*
• Forrest General Hospital, Hattiesburg, MS
• Hackensack University Medical Center, Hackensack, NJ*
• Hospital of the University of Pennsylvania, Philadelphia, PA*
• Houston Methodist Hospital, Houston, TX
• Kansas Heart Hospital, Wichita, KS
• Leesburg Regional Medical Center, Leesburg, FL
• Mayo Clinic Hospital, Rochester, MN*
• Methodist Hospital, San Antonio, TX
• Mount Sinai Medical Center, Miami Beach, FL
• New Hanover Regional Medical Center, Wilmington, NC
• Northeast Georgia Medical Center, Gainesville, GA*
• NorthShore University Health System, Evanston, IL
• OhioHealth Riverside Methodist Hospital, Columbus, OH
• Penn Presbyterian Medical Center, Philadelphia, PA*
• Saint Francis Hospital and Medical Center, Hartford, CT
• St. Vincent's Medical Center Riverside, Jacksonville, FL
• The University of Vermont Health Network University of Vermont Medical Center, Burlington, VT
• University of Maryland Medical Center, Baltimore, MD*

* This hospital does not currently make its data publicly available but has committed to doing so in the next update.

More on Heart Health

• Take Charge of Your Heart Health
• Understanding the Stages of Heart Disease
• The Healing Power of a Heart-Healthy Diet
• How Heart Attacks in Women and Men Are Different
• Slowing Down the Rush to Open Heart Surgery
• Top Hospitals for Congenital Heart Disease
• Who Really Needs Cholesterol and Blood Pressure Drugs
• Blood Pressure Monitor Buying Guide  

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What Hospitals Say About Heart Surgery Success Rates

Some hospitals, such as the Mayo Clinic in Rochester, Minn., said they missed the deadline. One, Kansas Heart Hospital in Wichita, told us that it doesn’t report due to the costs of belonging to the STS database, which usually come to several thousand dollars per year.

Note that some hospitals, including prominent hospitals such as  Cedars-Sinai Medical Center in Los Angeles and New York-Presbyterian Hospital in New York City, do provide heart surgery success rates to STS, and make it available on the STS website, but don't consent to publish that information through Consumer Reports.

Providing patients with that information should be a priority for any facility, especially those with national standing, says Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center. “Hospitals that do these procedures likely profit nicely from them, and I would expect them to invest some of that into improving quality and sharing data with the public.”

How to Get the Data You Need

Shahian says that if the hospital you’re considering doesn’t share its data with Consumer Reports or STS, try to get that information on your own.

But calling the hospital directly isn’t the best bet: When we tried that at several hospitals, the staff wasn’t able to connect us with the right person to answer our questions.

Instead, Shahian recommends asking your surgeon these questions:

• Does the hospital where you perform surgery participate in the Society of Thoracic Surgeons database?
• If so, how does it perform in the STS ratings, and would you be willing to go over their most recent report with me?

If the surgeon won’t have that discussion or says the hospital doesn’t collect the data, Shahian says to consider another doctor and medical center.

Many Well-Known Hospitals Fail To Score 5 Stars In Medicare’s New Ratings

The federal government released its first overall hospital quality rating on Wednesday, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones.

By Jordan Rau / July 27, 2016

The Centers for Medicare & Medicaid Services rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry, which has been pressing the Obama administration and Congress to block the ratings. Hospitals argue the ratings will make places that treat the toughest cases look bad, but Medicare has held firm, saying that consumers need a simple way to objectively gauge quality.

Just 102 hospitals received the top rating of five stars, and few are those considered as the nation’s best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession.

Medicare awarded five stars to relatively obscure hospitals and at least 40 hospitals that specialize in just a few types of surgery, such as knee replacements. There were more five-star hospitals in Lincoln, Neb., and La Jolla, Calif., than in New York City or Boston. Memorial Hermann Hospital System in Houston and Mayo Clinic in Rochester, Minn., were two of the only nationally known hospitals getting five stars.

Medicare awarded the lowest rating of one star to 129 hospitals. Five hospitals in Washington, D.C., received just one star, including George Washington University Hospital and MedStar Georgetown University Hospital, both of which teach medical residents. Nine hospitals in Brooklyn, four hospitals in Las Vegas and three hospitals in Miami received only one star.

Some premiere medical centers received the second highest rating of four stars, including Stanford Health Care in California, Massachusetts General Hospital in Boston, Duke University Hospital in Durham, N.C., New York-Presbyterian Hospital and NYU Langone Medical Center in Manhattan, the Cleveland Clinic in Ohio, and Penn Presbyterian Medical Center in Philadelphia. 

In total, 927 hospitals received four stars.

Medicare gave its below average score of two-star ratings to 707 hospitals. They included the University of Virginia Medical Center in Charlottesville, Beth Israel Medical Center in Manhattan, North Shore University Hospital (now known as Northwell Health) in Manhasset, N.Y., Barnes-Jewish Hospital in St. Louis, Tufts Medical Center in Boston and MedStar Washington Hospital Center in D.C. Geisinger Medical Center in Danville, Pa., which is a favorite example for national health policy experts of a quality hospital, also received two stars.

Hospital Stars

Medicare has released for the first time star ratings for more than 3,600 hospitals around the country. The government says the ratings, which award between one and five stars to each hospital, will be useful to consumers trying to evaluate quality. More than 100 facilities received five stars, the highest rating, while 129 got only one star.

Nearly half the hospitals — 1,752 — received an average rating of three stars. Another 1,042 hospitals were not rated, including all hospitals in Maryland.

Medicare based the star ratings on 64 individual measures that are published on its Hospital Compare website, including death and infection rates and patient reviews. Medicare noted that specialized and “cutting-edge care,” such as the latest techniques to battle cancer, are not reflected in the ratings.

Dr. Kate Goodrich, who oversees Medicare’s quality ratings, said in a statement that it has been using the same type of rating system for other medical facilities, such as nursing homes and dialysis centers, and found them useful to consumers and patients. Those ratings have shown, she said, “that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries.”

In a statement, Rick Pollack, president of the American Hospital Association, called the new ratings confusing for patients and families. “Health care consumers making critical decisions about their care cannot be expected to rely on a rating system that raises far more questions than answers,” he said. “We are especially troubled that the current ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor.”

A sizable proportion of the nation’s major academic medical centers, which train doctors, scored poorly, according to a Kaiser Health News analysis. Out of 288 hospitals that teach significant numbers of residents, six in 10 received below-average scores, the analysis found. Teaching hospitals comprised one-third of the facilities receiving one-star. A number were in high poverty areas, including two in Newark, N.J., and three in Detroit.

“Hospitals cannot be rated like movies,” Dr. Darrell Kirch, president of the Association of American Medical Colleges, said in a statement. “We are extremely concerned about the potential consequences for patients that could result from portraying an overly simplistic picture of hospital quality with a star rating system that combines many complex factors and ignores the socio-demographic factors that have a real impact on health.”




TAGS: CMS, Hospitals

jrau@kff.org | @JordanRau

How to Avoid a C-Section Procedure

Consumer Reports/ April 13, 2016
Picked up from Yahoo News

A third of babies born in the U.S. are delivered by cesarean section, and researchers estimate that about half of those surgeries are medically unnecessary.

A number of hospitals have taken steps to reduce the number of C-section procedures. For example, the 30 hospitals across the country that are affiliated with the Kaiser Permanente healthcare system, most of them in California, have an average C-section rate of 22 percent for low-risk deliveries, which is below the national target. Kaiser tends to do well in part because its structure allows it to identify best practices, and then quickly spread them to all of its facilities, says Tracy Flanagan, M.D., a board-certified obstetrician-gynecologist and director of women's health with Kaiser. Those practices include staffing the labor and delivery floors with certified nurse-midwives, and establishing standards for how to interpret electronic fetal monitoring.

And lowering C-section rates can take years of hard work, according to Robert Silverman, M.D., chief of the Department of Obstetrics and Gynecology at Crouse Hospital in Syracuse, N.Y. His hospital had the lowest C-section rate for low-risk pregnancies in our Ratings among facilities with at least 3,500 births, at just 11 percent. "We have spent literally decades on educating the physicians at our institution about really good prenatal care," Silverman says. "Everything we can do to prevent that first C section from occurring, we try to do."

Since it can take so long time for hospitals to change their approach to childbirth, it may be up to you to reduce your risk of having a C-section procedure. Here are some steps you can take.

1. Find Out Your Hospital’s C-Section Rate

Start with our hospital Ratings. If your hospital is not included, ask the person who will deliver your baby about the hospital’s rates. A hospital’s C-section rate for low-risk deliveries for first-time moms should be below 23.9 percent. If your hospital does not publicly report its data, ask why—and ask what their rate is. If they don't tell you, consider going to another hospital. Note that some hospitals may have low C-section rates because they transfer women at higher risk to other hospitals, so ask the hospital how they handle such patients.

2. Choose Your Provider Carefully

It’s good to know the C-section rates for your doctor, too, so ask whether his or her practice tracks their C-section procedures. “Even if they don’t know the exact percent, providers should be able to articulate their philosophy about supporting vaginal birth,” Caughey said. Also ask how the new guidelines may affect the practice’s approach to labor and delivery. If your provider is unaware of the new standards, or is dismissive of them, you may want to find a different one.

3. Consider a Midwife

Women with low-to-moderate-risk pregnancies can consider using a nurse midwife as a primary care provider. Midwives stay with women throughout labor and do not do surgery, so they only transfer a woman to an obstetrician’s care when C-section is medically necessary or serious complications arise, says Amy Romano, a certified nurse midwife (C.N.M.) who formerly taught midwifery at the Yale School of Nursing and is currently senior vice president of clinical programs for Baby+Company, a network of midwife-led maternity clinics based in North Carolina.

4. Watch Your Weight

If you are overweight, strive to shed excess pounds before becoming pregnant. Overweight and obese women have a much higher risk of having a C-section procedure than normal weight women. And once you’re pregnant, talk with your provider about what is a healthy weight gain for you. Women who are overweight should plan to gain less than those who are not.

5. Stay Fit

Women who take part in structured exercise during pregnancy are less likely to need a C-section procedure, research suggests. Talk to your healthcare provider about appropriate forms of exercise, such as walking, swimming, and aerobic or yoga classes for pregnant women.

6. Don't Rush

Doctors should not try to induce labor unless there’s a good medical reason—for example, if a woman’s membranes rupture (her “water breaks”) and labor doesn’t start on its own or she is a week or more past her due date. Trying to induce labor before a woman’s body is ready can lead to surgical delivery if labor doesn’t progress.

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More on Pregnancy and Childbirth

Childbirth: What to Reject When You're Expecting
Your Biggest C-Section Risk May Be Your Hospital
Preparing for Pregnancy: What to Do Right NowNearing Your Due Date: Plan for Your Baby's ArrivalGiving Birth: What to Do Right Away
What to Do If You Need a Cesarean Section
Having a Baby in CaliforniaThe Safest Strollers, Car Seats, Cribs, High Chairs, and Other Baby Products

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7. Don't Worry Too Much About Big Babies

The possibility of a large baby is frequently used to justify a cesarean delivery, but that’s not warranted, according to the new ACOG/SMFM guidelines. To begin with, methods used to assess the baby’s weight toward the end of the pregnancy are not very accurate. Also, babies typically have to be 11 pounds or larger to justify a cesarean, according to Caughey.

8. Get Support During Labor

Consider hiring a doula, a trained birth assistant who can provide physical and emotional support throughout labor and delivery. Women who have continuous support from someone who is not a friend, family member, or a member of the hospital staff labor for shorter periods and are less likely to need interventions, research shows. Ask your insurer if it will cover doula care.

9. Ignore the Clock

The new guidelines call for allowing more time in each phase of labor and delivery. In general, decisions on whether to intervene should be based on how well mothers and babies are doing, not how much time has passed.

Editor's Note: This report is supported in part by the California HealthCare Foundation, based in Oakland, Calif.

NJ c-section raties

At Hackensack University Medical Center, 42% of first-time mothers with low-risk deliveries had a C-section. This worse than the national target of 23.9% and places Hackensack University Medical Center in CR’s bottom Rating category for avoiding C-sections. 

Read more about Consumer Reports c-section Ratings at http://bddy.me/1XygSdm. Photo by @ICAN

source: Facebook, April 14, 2016

Consumer Report's Hospital Ratings Receive National Attention

Consumer Reports released their most recent analysis of hospital infection data last week showing that many well-known teaching hospitals are performing poorly in CR's Ratings and putting patients at risk. (Their hospital Ratings are now free to all consumers.) CR released the story in conjunction with a CDC press conference about antibiotic resistance, which included Tom Frieden, M.D., CDC director, and Peter Pronovost, M.D., from Johns Hopkins Hospital. CR's timely and relevant content was referenced in the first question from the media when an NBC News reporter asked about Johns Hopkins' low score in preventing the hospital-acquired infection, C. diff. This story is part of CR's ongoing hospital safety coverage.

How your hospital can make you sick

Consumer Reports’ new Ratings of more than 3,000 U.S. hospitals show which do a good job of avoiding MRSA, C.diff, and other deadly infections

www.consumerreports.org / Published: July 29, 2015

In the ongoing war of humans vs. disease-causing bacteria, the bugs are gaining the upper hand. Deadly and unrelenting, they’re becoming more and more difficult to kill. You might think of hospitals as sterile safety zones in that battle. But in truth, they are ground zero for the invasion.

Though infections are just one measure of a hospital’s safety record, they’re an important one. Every year an estimated 648,000 people in the U.S. develop infections during a hospital stay, and about 75,000 die with them, according to the Centers for Disease Control and Prevention (CDC). That’s more than twice the number of people who die each year in car crashes. And many of those illnesses and deaths can be traced back to the use of antibiotics, the very drugs that are supposed to fight the infections.

Terry Otey appears to be one casualty in that ongoing battle. Three years ago, a few weeks after an overnight stay for back surgery at Providence Regional Medical Center in Everett, Wash., he went to the emergency room vomiting, dizzy, and with excruciating back pain. Bacteria known as MRSA (methicillin-resistant staphylococcus aureus) had taken hold in his surgical incision and quickly spread to his heart. He died in the hospital about three months later, following a cascade of serious health problems. “He just wanted to ease his back pain enough to play golf,” says his sister, Deborah Bussell.

Kellie Pearson, 49, a farmer in northern California, says she encountered a different kind of bug after having heart surgery last April. Her doctors prescribed an antibiotic in the hopes that it would prevent a postsurgical infection. Instead the drug killed off healthy bacteria in her body, and another germ, C. diff (clostridium difficile), swooped in, causing diarrhea so severe that she had to stay in the hospital an additional five days until doctors could rein in the potentially deadly infection.

She recovered but soon realized that she wasn’t the only patient suffering. “When I was able to walk down the hall in the hospital,” she says, “I was horrified to see room after room with C. diff caution signs on their doors warning that the patients inside, like me, had been infected.”

In the danger zone

“Hospitals can be hot spots for infections and can sometimes amplify spread,” says Tom Frieden, M.D., director of the CDC. “Patients with serious infections are near sick and vulnerable patients—all cared for by the same health care workers sometimes using shared equipment.”

Making the situation even more dangerous is the widespread, inappropriate use of antibiotics that’s common in hospitals, which encourages the growth of “superbugs” that are immune to the drugs and kills off patients’ protective bacteria.

It’s “the perfect storm” for infections to develop and spread, says Arjun Srinivasan, M.D., who oversees the CDC’s efforts to prevent hospital-acquired infections. “We’ve reached the point where patients are dying of infections in hospitals that we have no antibiotics to treat.”

But there’s hopeful news: Some hospitals are taking steps to reduce infections and end inappropriate antibiotic use. “But others have made little effort,” Srinivasan says.

'Be your own advocate'

Kellie Pearson recovered from a life-threatening case of C. diff caused by antibiotics she got in the hospital. But shortly after, she says, her doctor wanted to prescribe a broad-­spectrum antibiotic to prevent infection in her incision. “I was shocked because that could trigger the C. diff all over again,” she says. Her takeaway: “You have to be your own advocate.”

Red flags for bad bacteria

Methicillin-resistant staphylococcus aureus (MRSA)

We are focusing on C. diff and MRSA for two important reasons.

First, the infections are common and deadly. More than 8,000 patients each year are killed by MRSA; almost 60,000 are sickened by the infections. The bacteria often find their way into patients’ bodies through the lines and tubes that doctors use to deliver medication and nutrition to patients, or via surgical incisions, as happened to Terry Otey.

C. diff is an even bigger concern. Kellie Pearson is one of the 290,000 Americans sickened by the bacteria in a hospital or other health care facility each year. She was lucky: At least 27,000 people in the U.S. die with those infections annually.

Second, poor MRSA or C. diff rates can be a red flag that a hospital isn’t following best practices in preventing infections and prescribing antibiotics. That could not only allow C. diff and MRSA to spread but also turn the hospital into a breeding ground for other resistant infections that are even more difficult to treat.

For example, as dangerous as MRSA is, an infection can be cured if it is treated promptly with vancomycin, long held out as an “antibiotic of last resort.” But, in part because that drug is now so often used in hospitals, another resistant strain of bacteria—vancomycin-resistant staphylococcus aureus, or VRSA—is emerging. “VRSA infections pose special challenges; they can be even more difficult to treat than MRSA,” Srinivasan says.

Hospitals that rate well

Clostridium difficile (C. diff)

To earn our very top rating in preventing MRSA or C. diff, a hospital has to report zero infections—an admittedly high bar. Still, 322 hospitals across the country were able to achieve that level in our MRSA ratings, and 357 accomplished it for C. diff, showing that it is possible. (Experts say some hospitals might game the system. Read more about how hospitals fudge the numbers, and help us identify those that might not accurately report infections.)

More hospitals were able to earn either of our two highest ratings—indicating that they reported either zero infections or did much better than predicted compared with similar hospitals: more than 623 hospitals received high marks for MRSA, and 917 did so for C. diff.

Hospitals really begin to distinguish themselves when they earn high ratings against both infections: 105 hospitals succeeded in that. Even better, some hospitals excel against not only MRSA and C. diff but also other infections that the CDC tracks and that are in our hospital Ratings. Those include surgical-site infections and infections linked to urinary catheters or central-line catheters, large tubes that provide medication and nutrition.

“Hospitals that do well against infections across the board have figured something out and deserve special mention,” Peter says. Only nine hospitals in the country—those featured in the “Highest-Rated in Infection Prevention” chart earned that high honor. (Note that some of hospitals listed in that chart differ from those in the September 2015 issue of Consumer Reports magazine because new data was released by the federal government after the magazine went to press.)


And hospitals that don't

You won’t find any familiar, big-name hospitals on that top-performing list. In fact, several high-profile hospitals got lower ratings against MRSA, C. diff, or both, including the Cleveland Clinic in Cleveland, Johns Hopkins Hospital in Baltimore, Mount Sinai Hospital in New York City, and Ronald Reagan University of California Los Angeles Medical Center.

Those are all large teaching hospitals in urban areas, which in our analysis did not do as well as nonteaching hospitals of similar sizes in similar settings. That could be because teaching hospitals may do a better job of reporting infections. Or, as a representative for Ronald Reagan UCLA Medical Center told us, they may see sicker patients or have more patients undergoing complex procedures.

Although the CDC adjusts the data to account for some of those factors, teaching hospitals tend to perform worse. For example, only 6 percent of teaching hospitals received one of our two top scores against C. diff, compared with 14 percent of similar nonteaching hospitals.

“Yes, teaching hospitals face special challenges. But they are also supposed to be places where we identify best practices and put them to work,” says Lisa McGiffert, director of the Consumer Reports Safe Patient Project. “Obviously, that is not happening as well as it should.”

Larger hospitals also tended to do worse in our Ratings. That could be because patients in smaller hospitals are less likely to be exposed to infections. But some larger hospitals managed to do a good job avoiding infections. Case in point: Harlem Hospital Center in New York City earned high ratings against MRSA and C. diff. Or consider Northwest Texas Healthcare System in Amarillo, Texas. It made it onto our list of top hospitals in the prevention of all of the infections included in our Ratings.

What safe hospitals do

Good hospitals focus on the basics:

Use antibiotics wisely

Almost half of hospital patients are prescribed at least one antibiotic, Srinivasan says, but “up to half the time the drug is inappropriate.” To combat antibiotic misuse, many good hospitals have “antibiotic stewardship” programs, often headed by a pharmacist trained in infectious disease, to make sure that patients get the right drug, at the right time, in the right dose.

Such programs often monitor the use of broad-spectrum antibiotics. Doctors at some hospitals use three times more of those all-purpose bug killers than others. Reducing broad-spectrum prescriptions by 30 percent would “cut hospital rates of C. diff by more than 25 percent, plus reduce antibiotic resistance,” says Clifford McDonald, M.D., a CDC epidemiologist.

Keep it clean

C. diff and MRSA can live on surfaces for days and can be passed from person to person on hospital equipment or the hands of health care workers. To prevent that, hospitals must be kept scrupulously clean. “Infection control is all about the basics, starting with hand hygiene,” says Christine Candio, president and CEO of St. Luke’s Hospital in Chesterfield, Mo., which earned higher Ratings against both MRSA and C. diff.

She reminds patients, “it’s your right to ask” staff to wash up. In fact, fastidious hand washing slashes rates of C. diff, MRSA, and other infections. St. Luke’s also “prioritizes cleanliness,” in some cases exceeding infection-control guidelines—cleaning the rooms of C. diff patients twice daily, for example, and replacing curtains between patients.

What more needs to be done

Steps such as those, plus federal mandates for some public reporting of infections data, have already led to reduced rates of certain infections. Still, McGiffert says hospitals need to do more:

• Consistently follow the established protocols for managing superbug infections, such as using protections including gowns, masks, and gloves by all staff.
• Be held financially accountable. Already, hospitals in the bottom 25 percent of the government’s data at preventing certain complications now have Medicare payments docked 1 percent. But they should also have to cover all costs of treating infections patients pick up during their stay.
• Have an antibiotic stewardship program. That should include mandatory reporting of antibiotic use to the CDC.
• Accurately report how many infections patients get in the hospital. And the government should validate those reports.
• Be transparent about infection rates. For instance, Cleveland Clinic acknowledges its below-average performance in C. diff prevention on its website. “That’s refreshingly candid,” Peter says.
• Promptly report outbreaks to patients, as well as to state and federal health authorities. Those agencies should inform the public so that patients can know the risks before they check into the hospital.

Germ warfare: Protect yourself against superbugs

First step: Check our Ratings to see how hospitals in your community compare in preventing infections and other measures of hospital safety. 

But bad things can happen even in good hospitals. For example, Terry Otey developed his infection after a 2012 surgery in a hospital that now gets one of our higher ratings against MRSA. Our experts say there are several things you can do when you’re in the hospital and after you’re discharged to minimize your risk and spot symptoms of possible infection early:

In the hospital

Consider MRSA testing. A nasal swab can detect low levels of MRSA and allow medical staff to take precautions, such as having you wash with a special soap before your procedure.

Insist on cleanliness. Ask to have your room cleaned if it looks dirty.

Take bleach wipes for bed rails, doorknobs, and the TV remote. Insist that everyone who enters your room wash his or her hands.

Keep your own hands clean, washing regularly with soap and water.

Question antibiotics. Make sure that any anti­biotics prescribed to you in the hospital are needed and appropriate for your infection.

Watch out for heartburn drugs. Medications such as Nexium and Prilosec increase the risk of developing C. diff symptoms by reducing stomach acid that appears to help keep the bug in check. So ask whether the drug is needed and request the lowest dose for the shortest possible time.

Ask every day whether ‘tubes’ can be removed. The risk of infection increases the longer items such as catheters and ventilators are left in place. If you’re not able to ask, be sure a friend or family member does.

Say no to razors. If you need to be shaved, use an electric hair remover, not a razor, because any nick can provide an opening for infection.

At home

If you’ve been in the hospital, “assume you’ve been exposed to potentially dangerous bacteria,” says Lisa McGiffert, director of the Consumer Reports Safe Patient Project. Here’s what to do when you get home to keep yourself and your family safe:

Watch for warning signs. They include fever, diarrhea, worsening pain, or an incision site that becomes warm, red, and swollen. People at particular risk include adults older than 65 as well as infants, anyone on antibiotics, and people with a compromised immune system.

Practice good hygiene. If you or someone you live with receives a diagnosis of a hospital-acquired infection after being discharged from the hospital, take extra precautions to make sure that it doesn’t spread. Steps you should consider take include cleaning frequently touched surfaces with 1 part bleach mixed with 10 parts water and reserving a bathroom for the infected person. If that’s not possible, use the bleach solution to disinfect surfaces between uses. And don't share toiletries or towels; use paper towels rather than cloth hand towels.

Editor's Note:
This article also appeared in the September 2015 issue of Consumer Reports magazine.

Note that there are some differences between the print and online versions of the story because new data was released by the federal government after the issue went to press.

more info on c-sections

For more information regarding c-sections, refer to Consumer Reports--

The risk of C-sections: What hospitals don't want you to know

http://www.consumerreports.org/cro/2014/05/what-hospitals-do-not-want-you-to-know-about-c-sections/index.htm?EXTKEY=NS0N01503

How can this happen?

Man found dead in NYC hospital waiting room more than 8 hours after entering

http://www.cbsnews.com/news/man-found-dead-in-st-barnabas-hospital-waiting-room-8-hours/

By Michelle Castillo CBS News January 27, 2014, 4: 22 PM

Reports have emerged that a man died in a hospital waiting room in New York City more than eight hours after he sought emergency care.

According to multiple reports, 30-year-old John Verrier entered the emergency room of St. Barnabas Hospital in the Bronx at around 10 p.m. on Jan. 12 complaining about a rash. He was found dead in the waiting room about 6:40 a.m. the next day when a guard failed to wake him up.
St. Barnabas Hospital spokesperson Steve Clark confirmed the timeline around Verrier's death to CBS News, but said the details of what actually happened had been glossed over by many.

“Probably this scenario in this shape and form has happened in any big hospital in New York City,” he said.
When Verrier arrived at St. Barnabas, he had his vitals taken in the triage area and was told to wait in the waiting room until his name was called to see a doctor, according to Clark. At 12:35 p.m., his name was called for the first time, but Verrier did not respond. That night, his name was called two more times to see the doctor, but the patient did not acknowledge his name was being called.

“People have personal responsibility when your name is called,  you have to get up and see the doctor,” Clark said.

It was determined through employee accounts and security footage that Verrier was alive at least until 3:45 a.m. A security guard woke him up after he had fallen asleep, and he had been recorded walking around the waiting room.

The cause of death for Verrier has yet to be determined, pending a medical examiners report.

The case has been investigated internally, and the hospital said it was determined that officials had done everything according to protocol.

“This could have happened anywhere outside in the cold,” said Clark.

He couldn’t confirm the reason Verrier was asking to see a doctor, citing patient confidentiality laws. He did say that Verrier was called for as soon possible, after more pressing cases were attended to.
“It was a busy night, waiting 2 hours and 30 minutes is not that long a time considering what his complaint was,” Clark said.

He added that on many cold nights in New York City, many people use the hospital as shelter and stay in the waiting room to keep warm. People aren't allowed to loiter or sleep in the facilities, however. In order to stay inside the hospital, the patients have to come in with a medical complaint. Many of the times, the issue they present with is just a ruse in order not to be kicked out, he said.

He emphasized that this scenario may or may not relate to Verrier’s case, but could explain why some people spend time sitting in a waiting room without entering the hospital, even if their name was called multiple times.
“People come in with no desire to see the doctor,” he said.

An anonymous St. Barnabas Hospital emergency room employee told WABC that despite Verrier’s name being called three times, he had not been checked on personally. The employee added he or she believed Verrier died because there was “not enough staff to take care of the number of patients we see each day.”

Clark dismissed the comments, saying that the hospital did not think staff numbers played a role in this scenario.

“It is a tragedy that a young man died, yet following an internal review, it was concluded that all hospital guidelines were met,” the hospital said.

According to a ProPublica report, the average person in New York spends 2 hours and 35 minutes waiting in the emergency room to see a doctor, and about 1 percent leave without being seen. The report determined that St. Barnabas patients waited 5 hours and 6 minutes on average before seeing a doctor, and 18 percent left without being seen. 

A Consumer Reports ratings summary on the hospital found that when it came to patient experience, St. Barnabas was worse than average.

Dr. John Santa (Consumer Reports) on CBS This Morning

I wanted to share with you a truly superb interview this morning with Dr. John Santa on CBS This Morning on the topic of hospital safety.

Best hospitals for safety: Consumer Reports issues safety score for hospitals



http://www.cbsnews.com/8301-505269_162-57575510/best-hospitals-for-safety-consumer-reports-issues-safety-score-for-hospitals/

CONSUMER REPORTS

is turning '75 years bold'

and they want you

there with them to celebrate!

Join CR for a free, two-day celebration Oct. 28-29 at Grand Central Terminal in New York City. You’ll get a special look inside their state-of-the art testing labs, meet the experts and even see how they test products right there on the spot.

Check out the details here – and get ready to party!
http://www.consumerreports.org/cro/2011/10/consumer-reports-celebrates-its-75th-anniversary/index.html#Annual_meeting_&_exhibit

The featured event Friday will focus on the safety of our nation’s food supply. From salmonella in chicken to Bisphenol A in canned food, Consumer Reports’ lab tests and critical reporting has helped inform consumers about dangers in our food.

The panel of experts will expand on current national food safety issues, and what needs to happen to make sure your family is protected.

If you’re in a more festive mood, consider purchasing a ticket to attend the Friday night reception and dinner, where you will meet the President and Board of Directors. Or sit in on the Saturday annual meeting to learn more about CR's yearly achievements.

Check out the schedule of events.
http://www.consumerreports.org/cro/2011/10/consumer-reports-celebrates-its-75th-anniversary/index.html#Annual_meeting_&_exhibit

If you can’t make it, but know someone in the area who might be interested, please forward the information to them.

And thank you for your continued support as CR continues working for a fair, safe, and just marketplace for the consumer!