Your Hospital is Not Invisible

With apologies to John Donne, no hospital is an island.

It doesn't matter if your hospital is in midtown Manhattan or Manhattan, KS. It doesn't matter how many licensed beds you have or how high you scored with HealthGrades. If you've got problems at your hospital—from labor disputes, to HIPAA violations, to dirty sheets—you'd better be prepared to have answers for the government, public advocacy groups, plaintiffs' attorneys, and the news media.

In the era of the Internet, specialized trade journalism, and the 24-hour news cycle, every misstep is a headline waiting to happen.     

That was apparent this week when Washington, DC-based Public Citizen issued an alarming press release detailing potentially dangerous infection risks at one Wyoming hospital located 1,849 miles due west of the nation's capitol.

According to Public Citizen, 88-bed Sheridan Memorial Hospital made a decision to stray from the manufacturer's guidelines and failed to adequately sterilize reusable laryngeal mask airways. As a result, "several hundred patients" were potentially exposed to assorted infectious viral and bacterial agents between May and November of 2011.  

"The hospital's decision to abandon steam sterilization was reckless and potentially dangerous for patients undergoing surgery at the hospital," Michael Carome, MD, deputy director of Public Citizen's Health Research Group, said in a statement which was sent to media outlets across the country.

After being contacted by HealthLeaders Media on Tuesday and shown Public Citizen's accusations, SMH issued a statement saying that the problem had been identified in November, reported to the state, and resolved.

"The (WY) Department of Health directed the hospital to change procedures to include steam autoclaving," the statement read. "SMH immediately implemented the new procedure, developed a procedure spreadsheet, and posted directions for the staff. The plan of correction was implemented that day and no further corrective actions were recommended by the state."

Hospital officials said they had received no reports of infections or complications related to the problem, which they suggested had been resolved.

"The medical staff executive committee based on surgery department reports and consultation with the state Department of Health believe that compliance with the state recommendations have been achieved and that any risk of infection to surgery patients prior to the change is very low," said SMH Chief of Staff John Addlesperger, DO. 

The Wyoming Department of Health also issued a statement indicating that the issue had been resolved:

"Following receipt of the anonymous complaint in November, our department did investigate the issues surrounding the airway devices at the hospital in Sheridan. They addressed concerns about the tracking of the use of the devices as well as the sterilization procedures. Our department ordered those issues to be fixed and they were fixed that same day at the hospital. Since then, there have been no related reports of illness made to the hospital or to our department," the statement read.

After HealthLeaders Media showed SMH's statement to Public Citizen, the advocacy group issued a counter-counter-statement ridiculing the hospital's assurances that former patients were not in danger.

"The claim by the hospital that ‘there have been no infections or complications that have been reported in relation to this situation' is ludicrous for two reasons," Carome told HealthLeaders Media.

"First, because the hospital did not proactively notify affected surgical patients of their exposure to inadequately sterilized devices, patients experiencing any infections or complications would not have attributed such events to the exposure since they were unaware that inadequately sterilized LMAs had been used. Second, certain infections may be asymptomatic, and without appropriate screening, may have gone undetected so far."

It was not clear at deadline if SMH was planning a counter-counter-counter statement. It almost doesn't matter. Did SMH correct the problem, as it claims? Or did the hospital sweep it under a gurney, as Public Citizen suggests?

Who knows?! The rest of us don't have to pick a side. For us, the back-and-forth between the hospital and the advocacy group is better seen as a cautionary tale about questionable decisions that can come back to haunt you. 

The moral of the story: No matter its size or prominence, if your hospital deviates from SOP, no matter how seemingly innocuous at the time, you'd better have a good reason and you better be prepared to explain it to the world.