A few patients over the last several weeks have asked us about the recently publicized “ health grade” WakeMed Raleigh got from the LeapFrog group. It got a “C” which, at first glance, is NOT what you want to see, right?This grade was due to some heavily weighted factors that for the most part have nothing to do with the maternity ward.The LeapFrog group was looking at the following:
- Central line infections: Central lines are essentially large IVs placed in very large veins used mainly for trauma and other life threatening situations to be able to give more fluids quickly.
- Catheter related infection: This is urinary tract infections related to bladder catheters that are usually in place for a longer duration.
- C-diff infection: This is bowel infection that is usually seen in patients who have been on antibiotics for other reasons and their colon gets weak and infected with C-diff.
- MRSA: This is methicillin-resistant staph infections
- Surgical Complications: Leapfrog was mainly looking at retained surgical foreign bodies.
We can assure you that while these things are EXTREMELY important and the goal is ZERO for all of them, the incidence is very low.
WakeMed has been taking initiatives successfully for the last couple of years to reduce the aforementioned infection rates. For example, in the timeframe Leapfrog was reviewing cases, there was 1 in 50,000 surgical case with a retained foreign body. One is too many, but the risk is still extremely low.
In addition, these indices above are not really OB related. They are mostly the incredibly ill trauma patients who are hospitalized for extended periods of time, in and out of the operating room many times, and in and out of the intensive care unit.
We, as a group not owned/operated by WakeMed, would never do business at WakeMed if we were not fully comfortable in the quality of care our patients can get there.
The local media failed to accentuate the positives about the obstetrical services provided at WakeMed by Leapfrog this year, so we would like to take a minute to highlight those areas.
Here is a comparison of maternity care for our area hospitals. (WakeMed North is not shown as they don’t deliver 2,000 or more babies a year.) You will clearly see that the OB care is top-notch.
Cesarean Sections
Cesarean sections (C-sections) carry increased risks of infection or blood clots, and some women experience longer recoveries and difficulty with future pregnancies. C-sections can also cause problems for babies, like breathing difficulties that need treatment in a newborn intensive care unit (NICU).
To measure a hospital’s rate of C-sections, Leapfrog uses one standardized, endorsed measure that reflects the percentage of first-time mothers giving birth to a single term baby in the head-down position.
For this measure, a lower rate is more desirable.
Leapfrog’s target for all hospitals is 23.9%. (Hospitals with a reported rate of 23.9% or less are better than target. Hospitals with a rate greater than 23.9% are worse than target.)
- WakeMed Raleigh hospital’s rate of Cesarean sections is: 15.4%
- Rex hospital’s rate of Cesarean sections is: 26.5%
- WakeMed Cary’s rate of Cesarean sections is: 27.3%
Episiotomy
An episiotomy is an incision made in the perineum (the birth canal) during childbirth. Although episiotomies were once routine in childbirth, medical guidelines today recommend an episiotomy only in a narrow set of cases. Episiotomies have been clearly linked with worse perineal tears, loss of bladder or bowel control, and pelvic floor defects.
For this measure, a lower rate is more desirable.
Leapfrog’s target for all hospitals is 5%. (Hospitals with a reported rate of 5% or less are better than target. Hospitals with a rate greater than 5% are worse than target.)
- WakeMed Raleigh hospital’s rate of episiotomies is: 0.6%
- Rex hospital’s rate of episiotomies is: 2.8%
- WakeMed Cary’s rate of episiotomies is: 6.1%
Early Elective Delivery
Data strongly demonstrates that early elective deliveries—scheduled cesarean sections or medical inductions performed prior to 39 weeks of gestation without medical necessity—carry risks to both babies and mothers. Early elective deliveries can result in neonatal intensive care unit (NICU) admissions, longer stays and higher costs to both patients and payers.
For this measure, a lower rate is more desirable.
Leapfrog’s target for all hospitals is 5%. (Hospitals with a reported rate of 5% or less are better than target. Hospitals with a rate greater than 5% are worse than target.)
- WakeMed Raleigh hospital’s rate of early elective deliveries is: 0.4%
- Rex hospital’s rate of early elective deliveries is: 0.0%
- WakeMed Cary’s rate of early elective deliveries is: 3.0%
