Exeter Hospital, site of the state’s first-ever hospital-based hepatitis C outbreak, (related story, Page A3) had high rates of in-hospital infections four years ago, according to federal data that examines hospital risk factors.
Exeter Hospital said the 2008 data is outdated and more recent analysis puts the hospital at or above state and national benchmarks for infection control.
But the director of New Hampshire Patient Voices, an interest group that encourages use of hospital-performance data, said one of the statistics regarding Exeter Hospital raises a red flag.
Data accessed last week at the website WhyNottheBest.org, showed that Exeter Hospital had a rate of 35.5 cases of risk-adjusted post-operative sepsis per 1,000 patients in 2008. The year is the latest available through the website.
That is more than four times the state average of 7.76 sepsis infections per 1,000 patients. The term sepsis refers to blood infection.
“That would scare me; that would raise red flags for me,” said Lori Nerbonne, a nurse and co-founder of New Hampshire Patient Voices. “I would want to ask questions.”
WhyNottheBest also reports a higher-than-average rate of risk-adjusted selected infections due to medical care at Exeter Hospital for 2008. It was 3.15 per 1,000, which is twice the state average of 1.5 per 1,000.
Bed sores were also twice the state average — 122.76 per 1,000 vs. 58.39 per 1,000.
WhyNottheBest was created and maintained by the Commonwealth Fund, a private foundation that says it is working toward a high-performance health system.
Exeter Hospital spokesman Debra Vasapolli said the website’s data is old and post-operative sepsis is not a true indication of infection. The federal Centers for Medicare and Medicaid Services no longer uses it in its published metrics, Vasapolli wrote in an email.
“For all accepted metrics related to surgery, Exeter Hospital continually performs at or ahead of national and state averages,” she wrote.
She points to a more recent report by the New Hampshire health officials on 2010 hospital-associated infections.
It reports overall hospital infections at Exeter Hospital at seven, a number that the report said is in line with what would be expected, based on national data. All seven infections were surgical site infections.
It reports no central-line associated blood stream infections, Vasapolli stressed. She said Exeter Hospital was one of the first in New Hampshire to adopt the Institute for Healthcare Improvement’s best-practices bundle for the intensive care unit, which includes a checklist for preventing central line infections.
“As a result we have had no infections for central lines in our intensive care unit this year,” Vasapolli wrote. The central-line category refers to a bloodstream infection that occurs after an intravenous line is inserted near the heart.
WhyNottheBest used data available from the U.S. Agency for Healthcare Research and Quality to report on hospital-based infections.
“Certainly, these (Exeter Hospital) numbers are awful, but I could not make a full assessment,” said Dr. Jose Montero, New Hampshire director of public health, who reviewed the data at the request of the New Hampshire Union Leader.
He said the website does not provide information such as confidence intervals, data sources and the purpose of the analysis.
Montero said the state effort to compile and analyze hospital-acquired infections is similar to that of WhyNottheBest. But New Hampshire health officials painstakingly analyzed each data submission to ensure proper comparisons, he said.
He said Exeter Hospital scored “right in the middle” in the state analysis.
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Mark Hayward may be reached at email@example.com.