San Francisco Citizen

All right, Consumer Reports has a few notes about San Francisco hospitals in another Missive from Yonkers this AM. Actually, the people at CR sound a little hacked off, and for a couple of reasons.

Item One: They’re using a hospital’s ICU Central Line Associated Bloodstream Infection Rate as a yardstick of performance. Why? Why not. Here’s how CR feels:

“The procedures needed to eliminate ICU infections are simple, low-tech, and inexpensive, requiring a change of mindset and culture. All ICUs should be able to dramatically reduce if not eliminate these infections.”

O.K., so who has a central line infection rate of zero, who’s perfect?

Saint Luke’s Hospital

Saint Francis Memorial Hospital

Saint Mary’s Medical Center

After all those Saints go marching in, which San Francisco hospitals are doing less-than-perfect but better than average?

California Pacific Medical Center-Pacific Campus

Kaiser Foundation Hospital- San Francisco

But who’s left, who in the 415 is ”on the other end of the spectrum” with a reported infection rate that’s 80 percent worse than the national average when compared with similar ICUs?

UCSF Medical Center

Ouch.

Take a look for yourself on this almost-legible chart. Goran nasai, Gentle Reader - click to expand:

Do you buy all that? Well, for one, Steven E.F. Brown does, over at the San Francisco Business Times.

But what’s this - how about a little feedback from a California-licensed physician? Comes now Dr. Steven Suydam, who took a look at CR’s press release today and reacted thusly:

“Central line infections occur in every hospital, but some institutions, especially public academic institutions are simply more forthright about reporting them, and are more likely to have candid effective quality assurance programs in place, than private, for-profit institutions. In addition, hospitals have the latitude to classify a bloodstream infection as coming from an alternate source, if one is available, thereby avoiding the dreaded “CLABI” label. The alternative explanation, that UCSF physicians place central lines under less sterile conditions than private hospitals and maintain such lines with less care is simply nonsense.” 

O.K. then. But as always, You Make The Call. It certainly would be interesting to hear about what UCSF thinks of all this. Moving on… 

Widening our purview to the whole bay area gets us this:

“In the larger Bay Area, where Consumer Reports Health rated 29 hospitals, Consumer Reports found extreme variation between hospitals, even hospitals run by the same health care system.  For example, Kaiser Foundation Hospitals in Hayward, Santa Rosa, Vallejo, and South San Francisco reported zero central line infections, while Kaiser Foundation Hospital in San Jose had an infection rate that was 14 percent worse than the national average and the Kaiser Foundation Hospital in San Francisco reported a rate that’s 40 percent better than average.”

Item Two: CR doesn’t like getting blown off when it goes nosing around for data. So it has lots of criticism for the way California as a state is handling reporting of statistics. The California Department of Health should have data for us by January 1, 2011, but CR isn’t optimistic about this deadline getting met.

Anyway, who’s on the Naughty List (CR’s Health Ratings Center’s Director is Dr. Santa, srlsy) with naught to report?

San Francisco General Hospital Medical Center

O.K. then.

What’s it all mean? No se, mi amigo/a. One thing for certain though, this news release means that Consumer Reports Health wants your money. Sign up for a free 30-day trial that you’ll soon forget about until you get your credit card statement in two or three months – I don’t care what you do with your money. (Frankly, I object to the whole Consumer Reports-is-my-Bible mentality that certain people have. IMO, CR is just another data point in the constellation of information out there.)

Anyway, read the whole thing for yourself, after the jump.

Stay healthy.  (more…)