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May 22, 2018

Op ed: Stanford Health Care’s commitment to patient safety, quality and the most favorable patient outcomes

Norman Rizk, MD, is the Senior Associate Dean for Clinical Affairs at the Stanford School of Medicine and Chief Medical Officer at Stanford Health Care.

In a recent op-ed published in these pages, a Service Employees International Union-United Healthcare Workers West (SEIU – UHW) representative attacked nationally recognized hospital quality experts and questioned Stanford Health Care’s (SHC’s) commitment to patient and employee safety.

This was not the studied assessment of a medical or quality expert, but rather a tactic adopted by a labor union as a negotiating strategy. As a clinician who has day-to-day knowledge of the manner in which SHC provides care, I want to assure our community that patient safety is our priority, that we invest heavily in advancing it and that the results are clear. U.S. News and World Report, for example, ranked SHC 9th among all U.S. hospitals in its 2017-18 Best Hospitals Honor Roll. In fact, SHC has ranked consistently among the nation’s top hospitals for years in many ranking systems.

Academic medical centers (AMCs), and Stanford in particular, provide care for some of the sickest patients in the world. Our case mix index, a federal index of the resources required to treat patients and hence of their acuity of illness, is currently 2.53 — among the highest of all AMCs. These very ill patients are particularly prone to health care-associated infections, due to their frailty and vulnerability, and we continually seek to protect them by improving our already excellent infection control. Currently, we have more than 120 unique safety and quality initiatives, incorporating the expertise of clinicians, patients and infection control physicians.

Our commitment to quality initiatives is and will always be a major part of ensuring that SHC provides patients what they need and richly deserve: safe, effective, solicitous care. Let me cite just a few recent examples from our latest data sets:

  • Our most recent hospital-acquired infections are at very low rates.
  • In April, Stanford had zero bloodstream infections related to central intravenous lines in our ICUs and medical/surgical units, which is much better that the national average.
  • In addition, our urinary catheter related infections were lower than the national average by 30%.
  • Also during the first quarter (January – March 2018), Clostridium difficile infections were 38% below the predicted rate; this contrasts with the two-year-old statistics on Clostridium difficile cited by SEIU, which in part related to overly sensitive molecular monitoring tests used by Stanford at that time.
  • Data from Vizient, an independently recognized health care performance improvement organization, place SHC 14th out of 95 centers last quarter in safety among the most complex AMCs in the U.S.

Our ongoing goal and intention is to be the very best, and to continue to share our outcome data with the public. We are already transparent in this regard, sharing clinical data with federal, state, and local agencies and quality organizations. We have also developed a public website that we continue to update with the latest quality statistics and outcomes: https://stanfordhealthcarequality.com/commitment.html#quality.

Adversarial advertising and op-eds designed to advance collective bargaining positions should not be confused with current and real data collected and analyzed to assess and advance the quality of the Stanford Health Care system. Confusing advocacy positions with real information is a disservice to the physicians, nurses, housekeeping staff and many others who have dedicated themselves, above all else, to caring for our patients and serving the larger community. SHC always seeks to be the best, and to be the best at getting better. We are all very fortunate to have this resource in our community, and to be able to access its world-class care.