Nationa health performance authority reveals Australia’s worst hospitals for superbug Golden Staph infections

A HIT LIST of the nation’s hospital hot spots reveal more than 1700 patients caught killer superbug infections in public hospitals last year.

Golden Staph is a bloodstream infection that proves fatal in between 20-35 per cent of cases and it is used as a key measure of hospital quality and safety. National Health Performance Authority chief Dr Diane Watson says the new figures allow poorly performing hospitals to measure themselves against the hospitals with the lowest infection rates and lift their game.

Patients can also use the data if they are wondering which might be the best hospital to use for surgery but she warns that patients should be cautious about data for small hospitals where a single case could have a dramatic and unrepresentative impact on the hospitals performance. Health ministers have signed up to a target that aims to keep rates of infection below 2 cases per 10,000 days of treatment. The Prince Charles Hospital in Brisbane had the nation’s lowest rate of infection among major hospitals with just nine cases and a rate of 0.47 cases per 10,000 days of treatment. South Australia’s Royal Adelaide Hospital had the worst rate of infection.

NEW SOUTH WALES

Four of the five major hospitals with the worst infection rates in the country are in NSW. Westmead Hospital in Sydney had the second worst rate of golden staph infection in the country with 62 cases in 2011-12 data from the National Health Performance Authority (NHPA) shows. But St George Hospital (45 cases), John Hunter Hospital (55 cases) and Prince of Wales (39 cases) also had rates of infection that exceeded acceptable levels of two cases per 10,000 days of treatment. The states best performing major hospital in NSW was St Vincents Public which had twelve cases of golden staph and an infection rate of just 0.9 per 10,000 days of treatment.

VICTORIA

While the highest number of cases of golden staph infection occurred at the Monash Medical Centre – where 40 patients caught the bug – the rate of infection was lower at 1.71 cases  per 10,000 treatment days compared to 2.3 at the Peter MacCallum Cancer Institute. The Alfred hospital reported 38 cases of golden staph infection (a rate of 1.58 per 10,000 treatment days) and the Austin Hospital 34 (a rate of 1.48 per 10,000 treatment days). Three hospitals in Victoria – Peter MacCallum, Goulburn Valley Health (2.7 cases per 10,000 treatment days) and the Bairnsdale Regional Health Service (2.01 cases per treatment days) – all had infection rates slightly above the target 2 cases in 10,000 days of treatment rate. Peter MacCallum treats vulnerable cancer patients who are at high risk of infection but it improved its performance over 2010-11 when it had 16 cases of golden staph.

QUEENSLAND

Queensland can boast the lowest infection rate in the country. The Prince Charles Hospital in Brisbane had the nation’s lowest rate of infection among major hospitals with just nine cases and a rate of 0.47 cases per 10,000 days of treatment data from the National Hospital Performance Authority (NHPA) shows. The worst performing hospital in the state was Innisfail Hospital but it treats just over 12,000 patients a year and NHPA chief Dr Diane Watson says reports for hospitals of this size are not reliable because a single extra case can have a huge impact on infection rates. Princess Alexandria Hospital was the worst major hospital with 53 infections in 2011-12 and an infection rate of 1.72 cases per 10,000 days of treatment.

SOUTH AUSTRALIA

The Royal Adelaide Hospital had the highest infection rate in the country among Australia’s major hospitals. Sixty two patients caught a deadly staph infection while being treated at Royal Adelaide Hospital in 2011-12, a rate of 2.15 per 10,000 days of treatment, the highest of any major hospital in the country. The Flinders Medical Centre was the best performing major hospital in the state with just 19 cases and a rate of 0.84 per 10,000 days of treatment. Over the past nine months, the RAH has seen significant improvement with the SAB rate for March 2013 sitting at 1.41 per 10,000 patient bed days,” a SA Health spokesperson said. The golden staph infection rate for South Australia, as at YTD March 2013, is 0.89, a significant improvement from 1.11 per 10,000 days in 2012, and well below the national benchmark.

TASMANIA

Just 10 patients caught golden staph while visiting the Royal Hobart Hospital and another 10 came down with the infection while using the Launceston General Hospital data from the National Hospital Performance Authority shows. The worst performing hospital in the state was Mersey Community Hospital which had three cases among its 22,944 treatment days but the NHPA say data in hospitals this small is unreliable because a single case an have a huge impact on the rate. The rate of infection at the Royal Hobart Hospital was 0.66 cases per 10,000 days of treatment which compares favourably with the hospital with the hospital with the nation’s lowest infection rate – The Prince Charles Hospital in Brisbane (0.47 cases per 10,000).Launceston General Hospital had an infection rate of 0.92 cases per days of treatment.

Deadly disease

“If you get one of these infections they are pretty serious, you have high fever, sweat, chills, it goes to the bones and heart valves,” Australian National University Professor of Infectious Diseases Peter Collignon says. “Overall about 20 per cent of patients die within 30 days,” he said. Patients whose infections were resistant to most antibiotics had an even higher death rate of 35 per cent , he said. Golden Staph is carried by lots of people on their skin and in their nasal passages but it is when it enters the bloodstream through a surgical wound or an intravenous drip line that it becomes dangerous. Poor hand washing rates by doctors and nurses and poor management of intravenous lines were responsible for higher infection rates, Professor Collignon said. Some patients such as those recovering from burns, bone marrow transplants immune system disorders, transplants and renal failure are at higher risk of golden staph. That is why NHPA chief executive Dr Diane Watson says her report groups hospitals into 8 different peer groups reflecting hospital size and the proportion of vulnerable patients in the hospital to make the comparison fair.

Qld hospital closing, health jobs going

There is growing angst across Queensland over cuts to public health services.

Workers have rallied about job cuts at a Brisbane Hospital today, and the Wide Bay Health and Hospital Service (WBHHS) has confirmed it has plans to close one of its hospitals. Meanwhile a public meeting will be held in central Queensland this evening over the future of the Moura Hospital. The action comes as Premier Campbell Newman steps up the war of words with the Queensland Nurses Union (QNU).

WBHHS has announced it has plans to close the Eidsvold Hospital, relocating services to nearby Mundubbera, and privatise the Yaralla Place Nursing Home in Maryborough. CEO Adrian Pennington says the hospital has not been able to recruit a full-time doctor or head of nursing, creating concerns about the quality of patient care. Health Minister Lawrence Springborg says closing the Eidsvold Hospital is a last resort, and the local board must consult with residents first. “They know full well that the Government’s policy is proper and full and appropriate consultation, where all options are taken to people and the community has to be comfortable with those options,” he said. “This is very, very early days and the board knows that they have to go out there and consult and work very hard to attract and find those doctors before they even consider these options.” Expressions of interest will be sought from private or not-for-profit organisations to run the 96-bed aged care facility in Maryborough.

There will also be job losses in the corporate office, and the home and community care service will be out-sourced. Mr Pennington says about 300 staff members will be affected in total. “I suspect that a large number of the current jobs that we have will transfer into those organisations,” Mr Pennington said. “I don’t believe for one minute that 300 people are going to lose their job in their entirety.” Rockhampton Health and Hospital Services Board chairman Charles Ware says changes at the Moura Hospital will not leave the town worse off. “We’ve developed a proposal for a new model of care that will preserve all existing services that are there in the main and we will explain what that is today,” he said. The community won’t be any worse off. “What we will be asking for tonight is for the community to put in place a smaller community reference group that can continue the discussion directly with the board.” In Brisbane, nurses and maintenance workers have rallied at the Princess Alexandra Hospital over job cuts.

Several hundred nurses marched through the PA chanting ‘hands off our jobs’. Mr Newman has told nurses they should take their grievances to health board members. “Their names are on the internet – it’s well known who they are – and make the case,’ Mr Newman said. “That’s what the QNU should be [doing]. “There has been no cut, there’s been a huge increase to the budget and if they think that more money should go into certain areas that is at odds with a health board I’d encourage them to engage with them.” QNU members have confronted the Premier on his regional tour in Cooktown, Townsville and Mt Isa. Mr Newman says it is politically motivated. “It’s fascinating to see that we have an orchestrated state-wide campaign from the nurses’ union,” he said. “I respect people’s right to protest but frankly this is a union that kept quiet while their members weren’t being paid.” QNU organiser Bernadette Sinclair says that is wrong. “It is insulting to our members, it’s insulting to the staff who have actually worked long hours to try to make sure people had money in their bank accounts.” The Rockhampton Health and Hospital Service Board will address a public meeting tonight to discuss the future of the hospital.

Local Member Jeff Seeney says the hospital is unsustainable in its present form, with an average of just one patient a night.

Liver test could save lives

A new ‘traffic light’ test could make it easier for doctors to diagnose liver disease early on and save lives.

Liver disease develops silently without symptoms, and many people have no idea they have liver failure until it is too late.

A third of people admitted to hospital with end-stage liver disease die within a few months.

Now, a research team from the University of Southampton and Southampton General Hospital believe their test will save lives by catching the disease earlier and allowing sufferers to address their behaviour.

The result of the Southampton Traffic Light Test comes in three colours.

Green means that there is no cirrhosis and the patient is highly unlikely to die from liver disease over the next five years.

Amber means there is at least a 50:50 chance of scarring with a significant possibility of death within five years, and patients are advised to stop drinking to avoid further disease and death.

Red means that the patient has liver scarring (fibrosis) and may even have cirrhosis.

Dr Nick Sheron and colleagues tried the test on more than 1,000 patients, with their progress carefully followed and monitored afterwards – in some cases for years – to assess how accurate it was.

The test, although not a substitute for clinical judgement or other liver function tests, was found to be accurate in severe liver disease.

It could provide GPs with an objective means to accurately assess the potential severity of liver fibrosis in high-risk patients such as heavy drinkers, those with type II diabetes, or the obese.

‘We are reliant on general practitioners detecting liver disease in the community so they can intervene to prevent serious liver problems developing, but so far we haven’t been able to give them the tools they need to do this,’ said hepatologist Dr Sheron.

‘We hope that this type of test for liver scarring may start to change this because the earlier we can detect liver disease, the more liver deaths we should be able to prevent.’

Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance, said: ‘One of the challenges of liver disease, which is rising dramatically in this country, is the silent nature of the condition until it is often too late to reverse the damage.

‘However, minor changes in standard liver blood tests are so common that it is difficult for GPs to know when to refer for specialist advice. This large study from Dr Sheron and colleagues in Southampton may prove really useful for guiding the right patients towards specialist care in a timely way.’

Hospitals now using social media to draw new patients

Hospitals are turning to social networking in an effort to market themselves to new patients who seem to be looking more to social media to choose the kinds of products and services they use. Hospitals have ramped up their online marketing campaigns after finding that many patients rely less on referrals and more on social media when picking services.

Earlier this year, a Baltimore television station incorrectly reported that Greater Baltimore Medical Center had been invaded by an armed robber. Naturally, the Twitter-verse was aflutter. After the news broadcast, Michael Schwartzberg, media relations manager of GBMC, sent out a slew of tweets correcting the misinformation. This is new territory for medical marketing. Ten years ago, it was innovative if hospitals had websites. Now, medical institutions are tweeting, creating Facebook pages, making videos for YouTube, and posting photos to Flickr.

In this technology-driven age, consumers are relying less on word-of-mouth referrals and looking more to social-media outlets to choose the kinds of products and services they use—including health care. In response, hospitals have ramped up their online marketing campaigns.

“I think the amount of competition in this direct area affects a lot of the things we do [in social media],” said Betsey Haley, communications and social-media manager for LifeBridge Health.LifeBridge spreads its online presence throughout five different social-media platforms plus its website.The LifeBridge Twitter account and Blogspot blog is updated regularly and provides health care information to patients, while its Facebook page is used as a job and career board. LifeBridge also has its own channels on YouTube and ICYou, an online health video source. “We look at social media as a new and interesting way to communicate with people,” Haley said.

Federal health reform is helping to put patients at the center of their care too, which means consumers will have more options.“With or without health care reform, social media has a relevant place in our landscape of navigating health information and health care decisions,” said Kathy Smith, director of market development for Johns Hopkins Medicine. Hopkins has social-media communities on Facebook, Twitter, and YouTube. “By actively engaging in social media, we have the opportunity to reach audiences on a platform where they feel comfortable,” Smith said. She said patients are definitely paying attention to different social-media avenues as a way to connect with health care professionals and get health information at the click of a mouse.

“Today’s health consumer is much more mobile than they once were,” Schwartzberg said. Schwartzberg said GBMC uses its social-media platform for media relations, customer service, crisis communication—such as H1N1 updates, community relations, and human resources.

Kevin Cservek, a spokesman for Baltimore Washington Medical Center, said the hospital has a Facebook page and Twitter account that are updated daily. Cservek also runs a YouTube channel, which so far features interviews with physicians about heart disease. A Flickr site boasts photos from various events.

Cservek said social media won’t replace traditional marketing, but it is another avenue hospitals can use to reach patients. At a recent free screening for prostate cancer, Cservek said that out of 100 people that attended, about a handful of men said they found out about the screening on Facebook.

“For commercial brands like an energy drink or a new line of clothing, I think social media has a lot of value,” said Vivienne Stearns-Elliott, media relations officer for St. Joseph Medical Center in Towson, Maryland.But she is still skeptical of the value of social media for hospitals, especially since many elderly and low-income patients do not have regular access to a computer.