AUGUSTA — A poor rating because of the number of patients who contracted avoidable infections could cost MaineGeneral Medical Center as much as $450,000.
That is based on a rating by the Centers for Medicare and Medicaid Services of in-patient experience in 2013, when MaineGeneral had inpatient beds both at its Thayer campus in Waterville and on East Chestnut Street in Augusta for 10 months, prior to combining the beds at a new hospital in north Augusta.
The hospital was one of eight in Maine to face fines for having higher-than-average infection rates. Maine Medical Center in Portland scored the worst in Maine, followed by MaineGeneral. Others in the state facing fines are Mercy Hospital in Portland, Central Maine Medical Center and St. Mary’s Regional Medical Center in Lewiston, Eastern Maine Medical Center in Bangor, York Hospital and Maine Coast Memorial in Ellsworth.
Dr. Steven Diaz, MaineGeneral Medical Center’s chief medical officer, says the hospital takes the federal report seriously and has made significant improvements on the two types of avoidable infections for which the hospital received the lowest rating: catheter-associated urinary tract infections and surgical site infections.
On Thursday, Diaz said the urinary tract infection rate is easier for hospital personnel to address than the other type. He said best practice now is to do away with the catheter as soon as possible, and that a team of health care providers works with the patient to do so.
The numbers, which the hospital provides to the federal regulators, show improvement since 2013, the year it had 26 infections from 8,813 catheter days, a rate of 2.95 infections per 1,000 catheter days.
In 2014, the hospital had 12 infections with 6,552 catheter days, or a rate of 1.83 infections per 1,000 catheter days. That has dropped still lower this year to 0.77 infections per 1,000 catheter days. Figures for 2015 to date show five infections with 6,456 catheter days.
Dealing with the rate of surgical site infections proves more difficult, Diaz said, because it involves patient preparation that occurs at home, and inter-operative and post-operative pieces among other things.
“Hard-wiring that success is a little more daunting,” he said. “We have periods when we’ve done much better and periods when we’ve slipped. We’re trying to improve in all areas, but that one in particular because we’ve had variable success there.”
He said the fine is calculated at about 1 percent of the Medicare reimbursement received; however, he said the hospital estimates it would be less than that since some procedures were not performed at the hospitals, but at outpatient centers. The fines are being assessed to hospitals in the bottom 25 percent in the country for preventing avoidable infections.
Figures from 2013 show seven infections resulting after 118 colon surgeries at the hospitals.
In 2014, 11 infections were reported from among 119 colon surgeries. Four infections were reported from among 67 of those procedures between January and September of this year.
In the same time period, the hospital has seen one avoidable infection reported each year during hysterectomy surgeries. It performed 111 hysterectomies in 2013, 142 hysterectomies in 2014, and 90 from January to September this year.
He said the hospital responds to a report of a hospital-acquired infection with a team review that checks to see if all best practices were followed.
In May, the hospital received a “C” rating for hospital safety from an independent rating agency, but at that time Diaz said the figures did not fully reflect the experience at the hospital which opened Nov. 9, 2013. He said that he anticipated improvement in that rating.
“Quality has so many facets, and they’re all important,” Diaz said.
Betty Adams — 621-5631
Twitter: @betadams
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