This is an archived article that was published on sltrib.com in 2011, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Falls, burns or other types of trauma are the most common injuries that patients experience while staying in Utah hospitals, a problem they appear to experience more often than patients nationally.
For the first time, Medicare has disclosed how often hospitals report serious conditions and complications that developed during a patient's stay, from falls to infections caused by catheters to bedsores. The data covers eight types of so-called "hospital-acquired conditions" that the Centers for Disease Control and Prevention consider preventable.
More than 70 percent of hospitals nationwide reported at least one fall or trauma, including electrical shocks or broken bones, during the reporting period of Oct. 1, 2008 to June 30, 2010.
The federal report probably underestimates the number of errors because it is based on hospital billing data, and it only includes patients age 65 and older.
"It's possible that events occurred and hospitals chose to take responsibility and not bill for them," said Iona Thraen, patient safety director at the Utah Department of Health.
Since 2001, Utah hospitals have voluntarily reported errors that cause permanent harm, loss of function or death. But no penalties are imposed for poor track records and the data are published without identifying hospitals. The numbers reported are small; in any given year there are about 60 to 80 reportable errors among hundreds of thousands of hospital visits, said Thraen.
Still, Utah has a higher rate of trauma than the national average, according to the Medicare data.
Of the 31 Utah hospitals analyzed, 17 reported a total of 56 falls or injuries caused by trauma.
Rates, based on the relevant number of patients discharged, were reported for each condition at each hospital. For example, Park City Medical Center reported three trauma cases, which gave it a rate of 22.2 incidents per 1,000 relevant discharges a dramatically higher rate than other Utah facilities.
Utah Valley Regional Medical Center reported nine trauma cases, the most in the state. But its rate was 1.39 per 1,000 discharges, still above the national average of 0.56 per 1,000 but far below Park City.
While Utah hospitals have collectively worked on errors, such as reducing the number of foreign objects left inside a patient after surgery, preventing tumbles have not been a priority.
Jill Vicory, spokeswoman for the Utah Hospitals & Health Systems Association, suspects it will be in the future.
"Falls are something we haven't really looked at yet. They always have been a concern," she said.
Intermountain Healthcare, owner of three of the hospitals with the highest fall rates, including The Orthopedic Specialty Hospital, says the higher rates may be explained by the type of patients the hospitals treat.
Most of the patients at TOSH have had joint replacement or spinal surgeries and those patients have a higher fall risk, said spokesman Jess Gomez. Park City Medical also sees more orthopedic patients than most community hospitals, he said.
"We're certainly very supportive of being as transparent as possible," he said. But "to compare them with a community hospital is a little unfair."
The next most-common condition in Utah was catheter-associated urinary tract infections, with 41 cases reported by 12 hospitals.
Jordan Valley Medical Center, Salt Lake Regional Medical Center and Davis Hospital, all for-profit hospitals owned by Iasis, led Utah facilities in their rates of the infections, and all three had rates between five and six times the national average.
In a statement, Iasis Healthcare questioned Medicare's methodology in analyzing the data. It also noted that the hospitals are "committed to the quality, safety and outcome of the patient care that we provide."
Iasis recently invested in technology to identify sources of infection and initiate early treatment, according to Patricia K. Scott, vice president of quality.
Ten Utah hospitals reported blood infections from catheters. Salt Lake Regional Medical Center had four, while the other nine had one or two. Only Salt Lake Regional, Valley View Medical Center and American Fork had rates above the national average.
For other conditions:
• No Utah hospitals reported making a blood transfusion with incompatible blood.
• No Utah hospitals reported injuries or complications caused by allowing air or gas bubbles to enter a blood vessel.
• Three Utah hospitals reported leaving foreign objects inside a patient after surgery. Salt Lake Regional, LDS Hospital and Ogden Regional Medical Center each reported one case.
• Dixie Medical Center reported two advanced pressure ulcers, commonly known as bedsores, and University Health reported one.
• Only four Utah hospitals reported cases involving poor control of blood sugar in patients with diabetes. Jordan Valley Medical Center had two incidents while Mountain West Medical Center, Ogden Valley Regional Medical Center and McKay-Dee Hospital Center each had one.
Although Jordan had two, its rate per 1,000 patient discharges was 0.64 and Mountain West's rate was higher, at 0.96. The national rate was 0.05.
The eight conditions were chosen because they occur frequently during the hospital stays of Medicare patients, or because they impose high costs on the government program. CMS also believes they can reasonably be avoided when hospitals follow guidelines for appropriate care.
Typically, hospitals were paid more when their patients developed the infections or suffered the injuries because those complications then drove a need for more care. But since 2008, Medicare has not paid for care required by hospital-acquired conditions.
Tribune reporters Kirsten Stewart and Tony Semerad contributed to this report.
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