Clattering carts, overly bright lights and frequent disruptions make hospitals a tough place to get a good night’s sleep. But now, hospitals across Connecticut are launching efforts to help patients sleep longer and better. At Yale-New Haven Hospital, researchers are expanding a pilot program that successfully reduced noise in the medical ICU and kept staff out of patient rooms overnight. At Hartford Hospital, where noise levels sometimes resembled airport runways, they’ve eliminated overhead paging on patient floors except in true emergencies. And Stamford Health’s new hospital building, slated to open in September, is designed with sleep in mind.
Lapses in cleanliness, infection-control procedures and in the treatment of patients with behavioral health problems were among the most common violations found in Connecticut hospitals inspected by the state health department in 2015, reports collected by C-HIT show. Inspection reports from the state Department of Public Health, spanning 2013 through 2015 – posted in C-HIT’s Data Mine section — show a mix of citations for poor physical conditions, such as mold and fungus in pharmacy preparation areas, and inadequate patient care, including improper evaluation and treatment of psychiatric patients and use of restraints. The state DPH inspects hospitals, which are all Medicare-certified through the federal government, once every four years. Inspections also occur when the DPH receives a complaint against a facility or is following up to ensure compliance with a corrective action plan. C-HIT’s database, based on DPH records through late 2015, includes reports on all 29 acute-care hospitals.
The high cost of insulin, which has risen by triple-digit percentages in the last five years, is endangering the lives of many diabetics who can’t afford the price tag, say Connecticut physicians who treat diabetics. The doctors say that the out-of-pocket costs for insulin, ranging from $25 to upwards of $600 a month, depending on insurance coverage, are forcing many of their low-income patients to choose between treatment and paying their bills. “Some of my patients have to make the choice between rent or insulin,” said Dr. Bismruta Misra, an endocrinologist with the Stamford Health Medical Group. “So they spread out taking insulin [injecting it less frequently than a doctor has prescribed] or don’t take it.”
Experts and recent studies point to drug companies’ long-standing patents and the lack of generic or “biosimilar” insulin as key reasons why the drug is so expensive. A study by Philip Clarke, a professor of health economics at the University of Melbourne in Australia, reported that the price of insulin has tripled from 2002-2013.
Eighteen Connecticut hospitals will lose 1 percent of their Medicare payments in 2016 as a penalty for comparatively high rates of avoidable infections and other complications, such as pressure sores and post-operative blood clots, according to new federal data. The Centers for Medicare & Medicaid Services (CMS) announced this month that 758 of the nation’s hospitals – about 23 percent of all eligible hospitals — would be penalized for patient safety lapses in the second year of the Hospital-Acquired Condition Reduction Program, which was mandated by federal health care reform. The penalties are based on rates of infections and other complications that occurred in hospitals between 2012 and 2014. The 18 hospitals in Connecticut include larger urban institutions, such as Yale-New Haven, Hartford and Bridgeport hospitals, and smaller hospitals, such as Manchester Memorial and Windham. They are among hospitals in the worst performing quartile nationally on patient-safety measures including the frequency of central-line and catheter-related infections, post-operative sepsis and accidental laceration.
Connecticut hospitals reported record numbers of patients killed or seriously injured by hospital errors in 2013, with large increases in the numbers of falls, medication mistakes and perforations during surgical procedures, a new state report shows. The report, covering 2013, marks the first time that the number of so-called “adverse events” in hospitals and other health care facilities has topped 500 – double the number in 2012, when 244 such incidents were reported. Much of the increase was due to an expansion of reporting on pressure ulcers, which added a new category with 233 “unstageable” ulcers that were not counted before. Even without that category, however, reports of adverse events climbed 20 percent over 2012. The most significant increases were in the numbers of patients harmed by foreign objects left in their bodies after procedures – doubling from 12 to 25 in one year — or those harmed by perforations during surgical procedures – 79, compared to 55 the previous year.
Connecticut’s acute-care hospitals saw gains from their operations tumble 35 percent in the last fiscal year, with seven of 29 hospitals reporting operating losses, according to a new state report. While hospitals still ended the year with $597 million in profits overall, the report by the state Office of Health Care Access (OHCA) raises concerns that non-operating revenue, such as income from investments, was masking the decline in operating revenue. “While hospitals’ operational financial performance weakened in FY 2013, they continued to generate significant non-operating gains, helping to keep overall hospital financial performance strong,” the report says. “However, a robust financial picture should rely more on patient and other operating revenues, and not on a less than reliable income source, such as investment performance.”
Hospitals’ profits from operations dropped to $333.6 million, from $513.5 million in the 2012 fiscal year. At the same time, hospitals earned $70 million more from investments, charitable contributions and other sources of revenue.
A simple blood test is transforming the world of prenatal screening, offering women a risk-free way to learn about fetal abnormalities early in pregnancy. Already, the new test has drastically reduced the demand for amniocentesis, an invasive procedure that diagnoses chromosomal disorders in mid-pregnancy and occasionally causes miscarriage. The blood test, which became available in late 2011, can analyze DNA to predict Down Syndrome and a few other genetic diseases as early as nine weeks in pregnancy, says Dr. Daniel Gottschall, medical director of Women’s Health Connecticut, a group practice with 80 offices around the state. “It’s almost like science fiction to see how they can do this with such a high level of accuracy,” says Leslie Ciarleglio, a genetics counselor at Hartford Hospital, where the number of amniocentesis procedures plummeted by more than 70 percent in just two years — from 112 in 2011 to 32 in 2013. “It’s far more accurate than any screening test we’ve had before.”
The test, which experts consider one of the most important clinical tools to emerge so far from the genomics revolution, can alleviate fear and suffering for pregnant women worried about birth defects. But the medical advance also raises disturbing questions about the future of screening — and whether the quest for the perfect baby could go too far. Currently, most women who get the blood tests are carrying high-risk pregnancies.
As the state works to improve its mental health system, new federal data show that hospitals in Connecticut restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average. In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 – indicating that thousands of patients may have left facilities without adequate treatment and medication plans. A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, show that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities – and is the third highest state in restraining patients 65 and older. Two psychiatric units – at Bridgeport Hospital and Masonicare Health Center in Wallingford – have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.
In more than half of Connecticut’s emergency rooms, the waiting time to see a health-care provider exceeds the national average of 28 minutes – a problem that experts say could get worse, as thousands more residents obtain health insurance. The average wait can stretch to an hour or more at Rockville General, Manchester Memorial, Bridgeport, Waterbury and Hartford hospitals, according to a C-HIT review of federal data. The statewide average waiting time is 30 minutes. The longest wait time is at Hartford Hospital, where patients were not seen for 82 minutes, on average; the shortest wait of 14 minutes is at Windham Hospital, the data compiled by the Centers for Medicare & Medicaid Services (CMS) through 2012 show. Officials at Hartford and Bridgeport hospitals claim shorter wait times than the federal data.
Twenty-four of Connecticut’s 31 hospitals will face Medicare penalties in the fiscal year starting in October, in the second round of the federal government’s push to reduce the number of patients readmitted within a month of discharge, new data shows.