"Unfortunately yes. And so yes, if I've done all that I know to do to prevent that—and this is a national discussion—how do we address that? I understand that for the individual, this is 100% and it's awful and it's expensive."
Martha Jefferson does monitor infection rates within its specialties, although it does not yet publicly report them, he continued. That day is coming. The hospital's relatively small surgical caseload means it doesn't have a good risk adjustment tool, although its recent merger with Sentara Healthcare may help integrate electronic data.
In recent years before and since the new building, Ashby said, Martha Jefferson has reduced rates of MRSA. It conducts root cause analyses when infections occur, and uses black lights and secret shoppers to screen for cleaning and handwashing protocols. And, he said, patients are asked to wash their skin with a Hibiclens kit, a chlorhexadine solution prior to surgery.
A nurse works part time in infection control to oversee procedures.
Muncie and Jaffe say much more can be done. They want tougher state and federal laws requiring infection disclosure, so the public can compare surgical infection rates for orthopedic procedures before they choose a hospital. Martha Jefferson's central line infections are not listed on the federal Hospital Compare, which shows that the hospital has too few cases.
It's clear hospitals have a lot of work to do. According to a Centers for Disease Control and Prevention paper last month, hospitals reporting to the National Healthcare Safety Network had a 1.9% surgical site infection rate in 2006-2008 across 849,659 operative procedures.