Do Houston Hospitals Provide Appropriate Care for Sepsis?

For several years, sepsis in hospitals has been listed as a serious and life-threatening health risk.  Each year, the Centers for Medicare & Medicaid Services (CMS) collects data about complications and health risks in hospitals.  This data is then scored and compared to national benchmarks.  Data collected in 2017 suggested that several Houston hospitals were failing to provide appropriate care for sepsis.  Some hospital scores were startling, and suggest a serious deficiency in patient safety and healthcare.

Patients deserve to have all the facts about where they seek care – especially if those facts indicate a potential health risk.  In this article, our Houston medical malpractice lawyer provides information about the Houston hospitals that scored poorly, and what those scores could mean for patients.

CMS Data Collection Helps Identify Patient Safety Problems

Data collected from Medicare.gov shows that several Houston hospitals scored far below the national benchmark for appropriate sepsis care.  The way the scoring system works is the lower the score, the smaller percentage of patients that received appropriate care.  So a hospital that scored a zero would indicate that 0% of patients were receiving appropriate care for sepsis at the time the data was collected.

When collecting data, CMS uses a sample of the patient population, and then calculates the percentage of those patients receiving appropriate care on measures, such as:

• How quickly hospitals respond to complications or illnesses.
• How well hospitals provide preventative methods.
• The percentage of patients who receive the appropriate treatment for the risk being measured.

That means that a score of 0 in a sample of 18 patients indicates that none of the patients reviewed were receiving appropriate care.  A score of 25 in a sample of 717 patients indicates that 25 percent of patients reviewed were receiving appropriate care.

Houston Hospitals Failing to Provide Appropriate Care for Sepsis

In terms of appropriate care for sepsis, the Houston hospitals with the lowest – and therefore the worst – scores included:

• United Memorial Medical Center – Scored 0 in a sample of 18 patients.
• Lukes Hospital at The Vintage – Scored 18 in a sample of 55 patients.
• Memorial Hermann Hospital System – Scored 25 in a sample of 717 patients.
• Harris Health System – Scored 25 in a sample of 333 patients.
• Memorial Hermann Texas Medical Center – Scored 29 in a sample of 175 patients.
• Cypress Fairbanks Medical Center – Scored 31 in a sample of 94 patients.
• Memorial Hermann Memorial City Medical Center – Scored 34 in a sample of 166 patients.
• Houston Methodist Hospital – Scored 35 in a sample of 308 patients.
• CHI St. Luke’s Health Baylor College of Medicine – Scored 43 in a sample of 91 patients.
• Park Plaza Hospital – Scored 43 in a sample of 99 patients.
• West Houston Medical Center – Scored 47 in a sample of 175 patients.
• Houston Methodist Willowbrook Hospital – Scored 50 in a sample of 151 patients.

As this data shows, several Houston hospitals score poorly in terms of the percentage of patients receiving appropriate care for sepsis.  The national benchmark for appropriate care for sepsis in hospitals was 49 percent in 2017.  All but one of these Houston hospitals ranked below the national benchmark.

Independent Hospital Grade Information

In addition to the data collected by CMS, there are also independent hospital grading systems.  These hospital grades look at a variety of factors, including patient safety and patient satisfaction.  Independent hospitals grades consider factors like infections, problems with surgery, safety issues, hospital practices, and staff issues.

Some of the hospitals described above also have questionable grades and ratings from independent systems in terms of infections.  One of the most reputable independent hospital grading systems is Leapfrog Hospital Safety Grade.  Leapfrog measures a variety of factors and gives each hospital an overall grade.  Then, each hospital is given a grade or rating on individual measures, including infections.

The best hospital score for bloodstream infections on Leapfrog is 0.000.  The worst hospital score is 2.935.  How do Houston hospitals compare?  Consider the following:

• Memorial Hermann Texas Medical Center – Received an overall grade of B.  Memorial Hermann Texas Medical Center was graded 1.055 for bloodstream infections, which is higher than the average hospital grade.  Memorial Hermann also scored higher than average for surgical site infections (SSIs).
• Park Plaza Hospital – Received an overall grade of C.  Park Plaza was graded 0.710 for bloodstream infections, which is only just under the average score of 0.789.  Park Plaza was graded worse than the average hospital in terms of MRSA, C.diff, Urinary tract infections (UTIs), and SSIs.
• Houston Methodist Hospital – Received an overall grade of A.  Houston Methodist was graded 1.180 for bloodstream infections, which is significantly higher than the average.  Houston Methodist also rated higher than average for C.diff and SSIs.
• Memorial Hermann Memorial City Medical Center – Received an overall grade of A.  Memorial Hermann Memorial City was graded 1.161 for bloodstream infections, which is higher than the average.  Memorial Hermann Memorial City also rated higher than average for SSIs.
• West Houston Medical Center – Received an overall grade of B.  West Houston Medical Center was graded 2.269 for bloodstream infections, which is just below the worst scoring hospital with a grade of 2.935.  West Houston also rated higher than average for MRSA and SSIs, and close to average for C.diff.
• Cypress Fairbanks Medical Center Hospital – Received an overall grade of B.  Cypress Fairbanks was graded 2.186 for bloodstream infections, which is just under the worst hospital score of 2.935.
• Houston Methodist Willowbrook Hospital – Received an overall grade of A.  Houston Methodist Willowbrook scored better than average for bloodstream infections, UTIs, and SSIs.  Houston Methodist Willowbrook scored worse than average for C.diff, and was equivalent to the average for MRSA.
• CHI St. Luke’s Hospital at The Vintage – Received an overall grade of C.  CHI St. Luke’s rated higher than average for bloodstream infections and SSIs, but worse than average for C.diff and UTIs.  For bloodstream infections, CHI St. Luke’s was graded 0.577, which is lower than the average of 0.789.
• CHI St. Luke’s Health Baylor College of Medicine – Received an overall grade of A.  Baylor St. Luke’s was graded 0.642 for bloodstream infections, which is better than the average.  Baylor St. Luke’s scored worse than average for C.diff and UTIs.

Similar to the CMS data, independent grading systems help provide patients with information about the hospitals in their area.  When you need care from a hospital, you want to know that the hospital is equipped to manage your care and prevent complications.

What Benchmarks and Grading Systems Mean for Patients

Infection control policies and appropriate care for sepsis are an important part of any healthcare environment.  The Centers for Disease Control and Prevention (CDC) has a “Hospital Toolkit for Adult Sepsis Surveillance”, a document that uses clinical data to assess current sepsis prevention strategies, early recognition, and treatment programs.

The Hospital Toolkit was developed using research and electronic health records from more than 400 hospitals across the U.S.  Because there is no single diagnostic test that can detect sepsis, and there are many criteria that can impact identification, it is important that hospitals follow infection control and prevention strategies in order to preserve patient health.

The CDC’s Hospital Toolkit is just one available resource that hospitals have to prevent sepsis and ensure appropriate care for sepsis when cases arise.  Numerous studies have been done assessing whether current sepsis prevention, identification, and treatment strategies are working.  Benchmarks and grading systems, like those discussed above, suggest that they are not working in certain healthcare environments.