Caring About Quality And Cost Leads To Better Care

By Dr. Tim Bartholow

It's the thing you don't realize we doctors worry about. It's lurking in our minds and, quite literally, in our hospitals and health care facilities.

I'm talking about an infection. They are uncommon, but here's why you should care: some places have much better infection rates than others. Those variances could mean the difference between a speedy recovery from surgery and months in the hospital.

If you're going to have surgery done, wouldn't you want to know what the chance of getting an infection is before you go in?

Don't assume quality of care. Ask questions.

You don't need to know all the medical mumbo jumbo to be a smarter consumer. Just ask questions.

Let's say you're planning a surgery. Just ask your doctor, "What is the infection rate at this hospital? How many cases of infection have you had?" When you ask, you are making it better for you and for the next 100 people to get care because you're saying THIS MATTERS.

Doctors and the hospitals of the WI Hospital Association are working hard on this issue. We need to support their efforts by asking about physician and facility infection rates whenever we can.

Through Medicare, even the federal government is asking about infection rates. In fact, it's cutting payments to 721 hospitals nationally for having high rates of infections and other patient injuries. Some states are even issuing their own fines. And some of those 721 hospitals include the most respected names in health care (See the full list here). It's not been comfortable for every facility, but it's a great opportunity to focus on this area of quality improvement.

Are you at higher risk?

Some surgical procedures like heart transplants are more prone to what we call SSIs (surgical site infections). But even more common procedures like orthopedic surgeries are a source of concern.

Serious SSIs can occur within 14 days post-operation, thus complicating care and adding up to 300% to the cost of what you thought would be a somewhat common knee, hip, or shoulder surgery. In fact, having an SSI can add 7 to 10 days to a hospital stay and add more than $27,600 to the cost of hospital care, according to the Agency for Healthcare Research and Quality. More importantly, an infection can cause you long term problems and even loss of life.

What can you do?

To start, wash with those special soaps the night before and the day of your surgery, exactly as you are asked. No kidding. Have all of your family, and of course the team that takes care of you, use hand sanitizer as they come close to support or to examine you. Hand washing turns out to be dramatically important in avoiding infection.

Keep asking tough questions and comparison shopping on infection rates. Voice as much concern about infection metrics as you do about cost. Do this and you will pressure the health care industry to be more effective medically and more efficient economically.

In other words, you'll be reclaiming healthcare.

I'll write more about infection rates in my next blog. We'll even touch on the complications caused by HACs (health care associated conditions).

Until then, take care.

Dr. B

Dr. Tim Bartholow is the WEA Trust's Chief Medical Officer. Prior to joining the Trust in 2014, Dr. Bartholow was the CMO for the Wisconsin Medical Society for 6years and a practicing physician for 16 years.

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Surgery Infection Reclaiming-Healthcare Quality Health-Plan


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