Will Consolidations Reduce Infections?

It's unclear what impact health care consolidations will have on controlling infection outbreaks.

Expert opinions are mixed on what impact health care consolidation will have on the safety of outpatient clinics.

"My personal feeling is that that's part of the solution," said Dr. Joseph Perz of the Division of Healthcare Quality Promotion at the U.S. Centers for Disease Control and Prevention. "It means that pockets of health care delivery that had less attention are hopefully getting more attention. Basically, it's the rising tide that raises all ships."

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Todd Kerr, a managing director in the national Governance, Regulatory and Risk Strategies practice at Deloitte in Nashville, Tenn., said, "You will find that most large companies have very stringent policies and I think it's how well they push those policies out and how well they monitor those policies.

"It's not just policies," said Kerr, who previously worked as a chief health care compliance officer. "To me, over my career, I have found that it's monitoring those policies that creates the safest environment."

Russ Nassof, executive vice president of RiskNomics, an environmental and health care risk management consultancy in Scottsdale, Ariz., said he doubted consolidation would result in safer practices or that hospitals and larger organizations would be successful in promoting best practices to affiliated outpatient facilities.

He mentioned an inspection audit his company did recently at a Midwestern heath care organization and all of its facilities. He went to see one of its suburban ambulatory care facilities and found it had been closed for several months.

"The acute care facility that sent us there wasn't even aware of it," he said. "How well can they be monitoring what is going on at their facilities?"

Oversight and monitoring can be a challenge even inside a single facility, said Margaret Ramirez, director of physician services, AIG Casualty Loss Prevention Health Care.

It's too early, she said, to determine the impact of consolidation on infection control. One school of thought sees more resources being available to physician offices and clinics, leading to better policies, procedures and infrastructure to support safety.

The obverse, she said, is that emphasis on cost containment combined with providers seeing sicker patients will adversely affect quality of care.

"It's going to depend on the leadership and what kind of physicians they have put in place in the certain specialty areas to champion patient safety," Ramirez said.

--By Anne Freedman

March 1, 2013

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