••• This story has been updated. The original version contained an error regarding MRSA (Methicillin-resistant Staphylococcus aureus) infections. T.J. Samson did score above the hospital average in this category.
GLASGOW — T.J. Samson Community Hospital in Glasgow has been given a grade of a C by The Leapfrog Group, a national nonprofit organization working to improve the quality and safety of health care, in its hospital safety grade report.
The organization scores general, acute-care hospitals nationwide on how safe they keep patients from errors, injuries, accidents and infections. Of the more than 2,600 hospitals that were graded, 32 percent earned an A, 26 percent earned a B, 36 percent earned a C, 6 percent earned a D and just under 1 percent got an F, said a press release on the organization's website.
Leapfrog assigns grades twice a year — in the spring and again in the fall.
T.J. Samson dropped to a C from a B in the fall of 2018.
“We dropped a tenth of a point,” said Dr. Eric Fisher, executive vice president of quality and director of hospitalist program for T.J. Samson. “It's like having a 90.0 and we got an 89.9 and went down from a B to a C. We are right on the cusp of being outside the B range.”
T.J. Samson scored below average in three areas — C. diff (Clostridium difficile) infections, urinary tract infections and surgical site infections.
Decreasing surgical site infections has been something T.J. Samson has been focusing on in the last three months.
The hospital has been working to standardize its procedure regarding antibiotics given to patients prior to surgery.
“You want to try to kill those bacteria as best as you can so that they are gone when you start making incisions and opening up a portal of entry for those bacteria,” Fisher said. “Anytime you don't have that standardization, you run the risk of somebody doing something not the way it was supposed to be done.”
T.J. Samson is tracking its performance regarding surgical site infections monthly and Fisher said that number is improving.
As for MRSA infections, he said the hospital is also working to improve its score there as well by making sure the hospital deals with those types of infections on the front end; knowing when people are going to be at high risk for developing an MRSA infection and then taking precautions to protect them.
“We've actually implemented some new protocols because it is always a fine line between having things put into place that are protective, but can also be a hindrance for everyone else who isn't at risk for MSRA,” he said.
Studies in the last few years have shown that when hospitals “... went over board with precautions and gowning up, we actually, in some settings … the care given to people wasn't as good because of all the time and energy spent gowning up. The patients didn't get enough attention. It's a fine balance there,” he said.
MRSA is a type of staph infection and Fisher said the measure looks at how many people are getting it who did not have it when they came to the hospital.
“Some of that, too, you have to identify that they had it when they got here so it and C. diff are sort of tricky measures because if you had it before you came in here, but you came in for something else and it kind of shows itself three days later, you probably had it when you came in,” he said. “We can't say that for sure so we have to take that one as it happened here when sometimes that's not necessarily the case.”
The hospital is trying to put procedures in place to make sure patients are screened for MRSA and C. diff infections and treated in an efficient manner if they have them.
“It's the same thing with pressure injuries,” he said. “It's the same challenge. Most pressure (injuries) don't start in the hospital. Most come from home.”
If T.J. Samson doesn't detect pressure injuries, such as bedsores, early on and they are documented, then the hospital gets cited for them occurring while the person is a patient there, he said.
Not all pressure injuries occur at home. Occasionally, a patient will develop a pressure injury at the hospital.
“I'm not going to deny that, but we work very hard to stop that from happening. Now we are really having to focus on making sure we get it all in the beginning so we don't end up getting low scores on measures like this,” Fisher said.
The same thing holds true for urinary tract infections.
“If they come in with it, especially if people already have catheters in at home, that's the big risk there,” he said. “The reality there is urinary tract infections are a problem across the board in the nation because people come in, they are sick, they can't get out of bed, they don't want to get out of bed if they are that sick. The tendency has been in the past to put those Foley catheters in or leave them in too long.”
The hospital is decreasing the number of patients developing urinary tract infections by not giving them catheters, but if a patient does require one, then the hospital will put one in for a short period of time, he said.
It is also looking at using catheters that wick moisture away, eliminating a pathway for bacteria to cause a urinary tract infection.
If there is one thing Fisher said he wants people to know about T.J. Samson's score, it is that the grade is not reflective of where the hospital is now regarding those areas. The hospital has been working to make improvements in those areas and others and that T.J. Samson is committed to always being better.