From the April 2016 issue of HealthCare Business News magazine

• Sixty-seven percent of hospitals reported an SIR between zero and 1.0.
• Eight percent of hospitals had an SIR of above 1.0, with some 25 percent of hospitals having the group’s standard for urinary tract infection.

Through public reporting, The Leapfrog Group is credited with declining rates of CLABSI (hospitals reporting a CLABSI rate of zero increased to 25 percent in 2015, up from 18.8 percent in 2013), but at present, three-quarters of hospitals fail to meet Leapfrog’s standards, underscoring the need for increased quality improvement and transparency.


“This report highlights the risks associated with CLABSI and CAUTI infections, which can leave a patient susceptible to hospital readmission due to a hospital-borne infection, or sicker than when they arrived at the hospital,” says Kristin Torres Mowat, senior vice president of plan development and data operations at Castlight Health. “In our work with The Leapfrog Group, we strive to empower consumers with key quality and safety information to help them make informed health care decisions.”

A technological home run for CLABSI and pneumothorax reduction: ultrasound central line guidance
CLABSI and pneumothorax rank among the most expensive medical errors. According to the Centers for Disease Control (CDC), about 250,000 CLABSIs occur each year in the U.S. with estimated attributable mortality of 12 to 25 percent, and estimated cost of up to $56,000 per infection. Collapsed lung lengthens hospital stay by 4 to 7 days at an additional cost of up to $45,000 per case. The cost can soar far higher if the patient sues, with a recent study reporting malpractice payments of up to $6.9 million for central line-related injuries, such as pneumothorax, pulmonary artery rupture and air embolism.

Ultrasound-guided vascular access can help reduce — or even eliminate — dangerous complications of central-line placement. For example, a recent randomized study of 900 critical care patients reported that ultrasound-guided CVC lowered rates of pneumothorax to zero percent, compared to a rate of 2.4 percent for traditional landmark methods. The researchers also reported the following outcomes:

• A 100 percent success rate with ultrasound-guided CVC, compared to 94.4 percent in the landmark technique.
• A 1.1 percent rate of accidental carotid artery puncture with ultrasound, versus 10.6 percent with landmark methods.
• The ultrasound group also had significantly reduced blood-vessel access time, higher first-pass success and a 35 percent lower rate of CLABSI.

April 2016 Magazine

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