UMMC

UMMC is making progress in dealing with a recent outbreak of Clostridium difficile, according to spokeswoman Colleen Flynn.

The number of patients being screened for potentially having C. diff has dropped from six last weekend to three.

And staff, using a sterilization machine designed to clean potentially contaminated surfaces, has learned how to use the equipment to exceed the manufacturer's standards for cleaning surfaces.

"We would really like the current cases to be the last cases," Flynn said. "We don't want any more hospital-acquired cases. We want to eradicate it all together."

Dealing with C. diff and other infectious bacteria is a concern for all hospitals, but the recent outbreak at UMMC brought the local hospital into the spotlight.

Flynn said staff noticed an uptick in C. diff cases before the news hit local media and began new procedures -- in consultation with the State Health Department -- to deal with the spike.

"We immediately took steps to see what else we could do," Flynn said.

When the weekend rolled around and the number of patients at the hospital (called the "census") dropped, staff was able to move patients out of some rooms and group patients together based on their treatment. The hospital also began extra sterilization procedures where necessary and increased staffing to stop the spread of the bacteria.

"We told the Department of Health what we would like to do and the Department of Health concurred that these were great steps," Flynn said.

From Feb. 28 to April 15, UMMC has reported 11 hospital-acquired cases of C. diff and six community-acquired cases (meaning the patients had C. diff before arriving at UMMC), according to Department of Health officials.

One patient who contracted C. diff died in March, but the cause of death has not been determined. The patient had other serious health issues and the cause of death may not have been due to C. diff.

Currently, there are five patients with C diff at UMMC. Four are being treated and one is in comfort care.

Every patient that displays C. diff symptoms -- particularly, diarrhea -- is tested for the bacteria.

Currently, only three patients are being screened, which Flynn said is a good sign the hospital's procedures are working.

"For what we usually see, this is a positive trend for where we want to be," Flynn said.

Tom Allocco, a spokesman for the Department of Health, said the spike in UMMC's numbers is not so great that it should cause public concern. When the department used the term "outbreak" in a previous statement, it merely signified an increase over previous reports of C. diff.

Flynn said UMMC went six straight months earlier in 2010 without a single case of C. diff and finished off 2010 with five straight months of no C. diff patients.

Flynn said the hospital recently purchased a machine designed to eliminate most C. diff bacteria on hard surfaces.

Staff followed the manufacturer's recommended cleaning solutions and procedures for sterilizing surfaces. Then, when scanned for the presence of live matter on the surfaces, the count came within the expected range.

However, that wasn't good enough for UMMC, Flynn said.

They tried again using extra friction and when they scanned again, there was no live matter at all on the surfaces.

"We learned something," Flynn said. "We learned, OK, use the solution mixture recommended by the manufacturer, but (by applying) more friction, we could bring the count down to zero."

In a follow up e-mail, Flynn provided this statement on UMMC's C. diff procedures.

Clostridium difficile precautions at UMMC:
If a patient is admitted with diarrhea, or develops it, while hospitalized and is being tested for C. diff, the patient is immediately placed on Contact Plus Precautions. This means that the STOP sign is placed under the room number so it can be seen before someone enters, and a Contact Plus Precautions sign is posted on the PPE caddy. It specifies that hands are to be washed with soap and water, to wash any spores that may have gotten on the hands of the person down the drain.

The recent outbreak of the potentially fatal bacteria commonly called C. diff at United Memorial Medical Center is having a ripple effect on the Genesee County Nursing Home.

Nursing Home Administrator Charles Rice told the legislature's Ways and Means Committee on Wednesday afternoon that "a lot of people are coming out of the hospital now" with C. diff.

After the meeting, Rice and the Nursing Home's Nursing Director Dawn Canale backed down from that statement. Rice and Canale said the Nursing Home has always been on alert for C. diff, but recent media reports about the C. diff outbreak at UMMC has the Nursing Home stepping up its infection control measures.

No Nursing Home residents have C. diff, Rice said, and Canale explained that any potential transfer patient from UMMC who tests positive for C. diff is not accepted as a resident at the Nursing Home.

Asked if there has been a spike recently in the number of potential transfers who test positive for C. diff, Canale said, "I don't want to say that," adding, "because two or three to me is a lot, but to you guys ..."  Canale's statement trailed off.

Canale said that every transfer from the hospital is screened and must have two negative tests for C. diff before becoming a resident at the Nursing Home.

"They always tell us (if a patient had C. diff) and we always make sure they’ve been treated and they're not contagious," Canale said.

If a person had C. diff but has recovered, the patient can be transferred, but the resident is either given a room with an other former C. diff patient or given a private room.

"We don't unnecessarily expose our fragile residents," Rice said. "Most of the time they've been treated, but we still keep a good eye on them."

Dealing with the outbreak of C. diff has been difficult, Rice said, because there is limited bed space in the Nursing Home and special precautions must be taken to separate potential C. diff carriers from other residents.

Rice also said that employees are given extra instructions on infection control and extra attention is given to disinfecting the facility.

Statement from Tom Allocco, New York Department of Health:

United Memorial Medical Center has properly reported its cases of Clostridium difficile (C. diff) to the State Health Department. The department has been working with United Memorial on the implementation of proper infection-control measures to help reduce the spread of illness. These include proper hand hygiene (simple, but probably the most important control measure), cleaning and disinfecting portions of the facility, and the separation of those who are infected from other patients. The department’s investigation of the outbreak continues. Once the investigation is finalized, the findings will be available. 

Additionally, the state health department has a public report on "Hospital Acquired Infections" that was released in late 2010 and covers data through 2009.

According to the report, in 2009, UMMC performed 28 colon procedures and of those, two patients contracted infections. That puts UMMC's infection rate at 7.1 (a number adjusted to calculate infections per 100 procedures to enable statewide comparisons). New York's infection rate for colon procedures in 2009 was 4.8.  

UMMC's rate of 7.1 is considered within the range of state average.

Strong Memorial's rate for 2009 was 5.5, also within the state average.

In 2008, UMMC's rate was 6.4, the state average was 4.4 and Strong was 4.8

In 2008, Strong performed 327 procedures and there were 16 infections. The following year, Strong performed 317 procedures and there were 17 infections.

Erie County Medical Center performed 86 colon procedures in 2008 and 98 in 2009 with three reported infections in each year. Numbers also fell within the statistical average at Highland Hospital in Rochester, while Women & Children's Hospital of Buffalo reported no infections, with about 50 procedures for each year. (For some reason, the report called W&C's zero-infection rate "statistically insignificant" and didn't give it a "blue star" on its report card).

For hip replacement surgery, UMMC's infection rate in 2008 was 3.1, and 2.5 in 2009. Both numbers fall within the range of the state average of 1.1. In 2008, UMMC performed 81 procedures with three infections and in 2009, 84 procedures with two infections. For the same procedure, Strong performed 50 operations in 2008 and 60 in 2009 with no infections.

A reporter from Rochester forwarded me this press release put out by Betsy McCaughey a couple of days ago. The message from the former Lt. Governor of New York and founder of the Committee to Reduce Infection Deaths seems particularly relevant and the information worth reading.

Hospital infections kill more Americans each year than AIDS, car accidents and breast cancer combined -- and researchers are searching for solutions. This week, a study of 153 Veterans Affairs hospitals shows that doing a simple swab test to identify and isolate the few patients carrying infection-causing bacteria can save lives. It's called screening, but even more important is cleaning. Studies are rolling in that hospitals need to be cleaner.

In fact, if you're visiting a friend or relative in the hospital, don't bring flowers or candy -- take gloves and a canister of bleach wipes.

Hospitals do an inadequate job of cleaning rooms -- so germs left behind by past patients are lying in wait. Patients are at far greater danger of infection when placed in a hospital room where a previous patient had an infection. Hospitals won't tell you who occupied the room before you.

Alarming research published in the Archives of Internal Medicine (March 28) demonstrates that a patient's risk of picking up the drug-resistant bug MRSA (methicillin-resistant Staphylococcus aureus) is much higher if the previous occupant of the hospital room had it.

Being placed in a room where the last patient had Clostridium difficile, or C. diff for short, more than doubles the risk of getting that dreaded infection, according to a new study in Infection Control and Hospital Epidemiology (March 2011). C. diff is the most common hospital infection in some parts of America.

Patients pick up invisible C. diff bacteria when they touch surfaces in their room, then eat a roll or cookie with their contaminated hands and swallow the bacteria along with the food.

C. diff causes life-threatening diarrhea -- wreaking havoc in your gastrointestinal system unless you have enough powerful "good" bacteria in your system to keep the C. diff under control. But patients on antibiotics often lack good bacteria. Some hospitals are treating desperately ill patients by giving them fecal enemas.

Pretty awful. Especially when it could be avoided by keeping the patient's room clean.

Dr. Robert Orenstein launched a cleanup campaign at the Mayo Clinic in Rochester, Minn. -- wiping the frequently touched surfaces around each patient's bed once a day with bleach-soaked wipes. The results: a 75- percent drop in C. diff infections.

Lax room-cleaning raises the risk of contracting other kinds of hospital infections, too. The No. 1 predictor of which patient picks up a drug-resistant bug called VRE (vancomycin-resistant Enterococcus) is who occupied the patient's room in the prior two weeks, according to Tufts University investigators. That two-week span could mean three or four patients ago.

A study of 36 hospitals from Boston to Washington, D.C., found that cleaners routinely overlook half the surfaces in patients' rooms. Toilet seats are cleaner than telephones and call buttons.

Doctors and nurses may clean their hands coming into the room -- but recontaminate them when they open the privacy curtain or rest their hands on the bedrail. Then they touch their patient, and germs enter the patient's body via an IV, urinary-tract catheter, wound or surgical incision.

For decades, hospital administrators and government agencies have shrugged off the notion that hospitals are dirty, saying, "germs are everywhere." They emphasize getting doctors and nurses to clean their hands -- which isn't enough.

The Joint Commission, which is responsible for accrediting most hospitals, just considers whether a hospital looks clean -- when infection-causing germs are invisible.

Food-processing plants routinely test surfaces for bacteria. Hospitals ought to meet at least the same standard.

www.HospitalInfection.org

An elderly member of one of Batavia's most prominent local families lies in a United Memorial Medical Center bed tonight gravely ill, and family members are fairly confident UMMC is responsible for her serious condition.

The aunt of local business woman Lois Gerace, and the great-aunt of Town of Batavia Board Member John Gerace, Margaret Wagner, 86, contracted clostridium difficile, more commonly called "C diff," after being treated for a fractured hip at UMMC.

She's been in the hospital for two weeks and medical personnel, according to Lois and John, have told the family she will likely succumb to the bacteria.  

"They have her in what's called 'comfort care,'" Lois said.

UMMC CEO Mark Schoell acknowledges that there has been a slight spike in the incidents of C diff at the hospital, but said it's a common infectious bacteria at hospitals and UMMC takes every standard precaution to prevent its spread.

"I believe our infection controls procedures and policies are excellent," Schoell said. "They comply with all of the standards of the industry and all of the requirements of the health department of New York State. In fact, when we saw the spike in our absolute numbers of C diff, we immediately got the health department involved in the effort to manage those cases."

C diff most commonly strikes elderly people while hospitalized, especially when they're on antibiotics, but according to the Mayo Clinic (link above), C diff can make even healthy people not on antibiotics ill. While it is treatable, C diff is potentially fatal for anybody who contracts it.

Annually, more than 480,000 people are diagnosed with C diff. Of those, 28,000 die as a result. Not quite half of those deaths occur after people contract C diff in a hospital. The majority of deaths occur in nursing homes.

Schoell said typically, UMMC  has a count of 40 to 45 patients and with that number of patients, at least two or three contract C diff.

The Geraces believe Wagner contracted C diff when, after her surgery, she was placed in a third floor recovery room with a C diff patient. At least, they say, that's what a nurse told them, though Lois admits they don't have lab tests or hospital records to support the assertion.

Recently, the hospital had 65 patients and currently has six C diff patients, Schoell said.

Up until yesterday, John Gerace said, his aunt was in a room on the third floor, but after he let a head nurse know that he had notified the media of the situation, the hospital removed all patients from the third floor and sterilized it from top to bottom.  

"Now, if there wasn’t a problem, or if I didn’t say anything, there would still be people up on that third floor," John said.

Schoell said the decision to vacate the third floor and clean it was made well before the media was contacted by Gerace. He said the hospital could only make the move after the number of patients dropped, which typically happens on a weekend, so beds could more easily be relocated and all the C diff patients could be consolidated in the same wing.

"We would have done that, taken the same actions whether there was media involvement or not," Schoell said. "It was the right thing to do."

Schoell said by consolidating C diff patients in one wing, hospital staff can do a better job of controlling who enters and who leaves rooms, but on Sunday evening, two reporters were able to walk right up to the second floor, ask for a family member of a C diff patient, and be escorted down the hall to the area of the room (though the reporters made no attempt to enter the room). No staff members offered any objections or warnings.

John Gerace also disputes the assertion that there are only six C diff patients at UMMC. He said he's counted at least a dozen of the red "stop" signs similar to one placed outside his aunt's room on the second floor. 

The Geraces are especially concerned for the sake of the community that there is no security on the second floor warning visitors that a potential lethal bacteria is present, nor are there adequate warning signs and information posted when you arrive on the floor warning of the danger.

"If you come in and you’re having a bad stomach day and your antacids aren’t kicking in, you’re done," said Robert Gerace. "In three or four days, you’re going to be in the same bed."

The Gerace's first learned of Margaret Wagner's condition when they came to visit her a few days after her hip surgery. They started toward her room, John said, and a nurse stopped them and said, "You don't want to go down there."

The nurse said they didn't know what was wrong with Wagner, but it was potentially communicable. Family members were eventually allowed into the room, but only after donning gowns and masks. They told Wagner they were dressed up for Halloween.

After visiting with Wagner a couple of times while wearing masks, another nurse pulled John aside and said the masks weren't necessary because C diff is not airborne.

All along the line, John said, communication from the hospital about how to protect themselves from C diff has been spotty and inconsistent.

"I'm leaving one day and a staffer says, 'Oh, by the way, you want to wash the bottom of your shoes off with chlorine and water,'" John said. "Nobody told us this before. You could be tracking it into your house with small children. Nobody is telling us this stuff. Why wouldn’t somebody come in and say, ‘oh, by the way, these are all the things you guys need to do'?"

Family members have been concerned about some of the sanitary practices they've observed over the past two weeks. They said they've seen janitors cleaning out contaminated rooms, sweep everything into the hall and then use ungloved hands to pick up the waste and put it in a trash can.

Lois's husband, Joe Gerace, is partners with her in Bob Harris Realty and he operates Gerace Hair Care (he's also chairman of the City of Batavia Republican Committee). She said she doesn't understand why the state requires barber shops and beauty salons to keep all trash in covered receptacles but all around the hospital, she's seen open containers used to dispose of potentially contaminated materials.

The Gerace family has a history of supporting UMMC and said one of the things they've valued about living in Batavia is that the city has a local, nearby hospital. Now all they want, each of them said, was to ensure that local residents get safe, quality care at their local hospital.

"I really don’t want to get into lawsuits and stuff like that," Lois said. "What I want to see is protection for the patients here."

This story produced in cooperation with The Batavian's news partner, WBTA.

Regular readers of The Batavian might recognize a couple of the pictures hanging on the wall here. As part of the decor in UMMC's new surgical wing, the hospital purchased 15 of my photos. Seven pictures are hanging in the waiting room and a barn shot is hanging across from the elevators. I'm not sure where the remaining seven photos are, but they're around somewhere.

Friday the ribbon was cut on a new $19.5 million surgical wing at United Memorial Medical Center.

More than 125 people attended the ceremony and toured the new facility, with more people taking advantage of the open house to see the state-of-art surgical wing.

The new facility includes five high-tech surgical suites and 19 recovery beds.

"Batavia in its history has had many pivotal moments, and this is certainly one of them," UMMC Board Chairman Tom Houseknecht said. "The entire community can be proud of this new surgery center."

UMMC Chief of Surgery, Dr. Matthew Landfried, said the entire staff is eager to begin working in the new 44,000-square-foot addition.

The first surgery is scheduled for Jan. 4.

Above, Mark Schoell, UMMC CEO, Tom Houseknecht, Dr. Matt Landfried and Bill Fritz, chair of the 2010 capital campaign, cut the red ribbon.

More pictures after the jump (to purchase pictures, click here):

Regular readers of The Batavian may recognize this picture -- first published on April 22. It's one of 15 photos of Genesee County by Howard Owens selected for display in the new wing. The other 14 photos will be hung some time in the coming week.

The public is invited to tour the new surgical wing at UMMC this afternoon from 3 to 7 p.m.

A free shuttle service from the Bank Street and Washington Street parking lot to the North Street location is available.

Officials at UMMC  have requested the fire department to go to 127 North St., Batavia, to investigate the smell of chemicals on the second floor of the building.

UPDATE 11:36 a.m.: Tim Yaeger, emergeny services coordinator, is on scene to assist city fire. We've heard no other updates. There's no indication from radio traffic that this is a serious situation.

UPDATE 1:14 p.m.: City fire units which responded are back in service.

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Here's a news release from The Jerome Foundation and the United Memorial Medical Center Foundation.

The 27th annual Health and Humanitarian Award of Genesee County will be presented to Ronald Burroughs on Friday, Dec. 3 at an awards luncheon at Terry Hills Restaurant.

The award is presented by The Jerome Foundation and United Memorial Medical Center Foundation and recognizes volunteer men and women of Genesee County who have helped promote emotional, physical and spiritual well-being of the area’s residents.

In naming Ronald Burroughs for this year’s award, the foundations recognize his volunteer efforts and leadership with Genesee County Habitat for Humanity. He has served as a board member of the local Habitat for Humanity affiliate, and has been a tireless volunteer -- building and rehabilitating houses so local families can live in clean, decent and stable housing.

Michael Seyfried and Nancy Platt, members of the local Habitat for Humanity Board of Directors, nominated Burroughs for the award, citing his zeal and skill in all phases of the building projects.

“Ron has provided leadership, equipment, professional contacts and 'sweat equity time' for a number of houses in our community, and his vision for such projects has enabled families to acquire affordable housing on their own," Seyfried noted in his nomination.

Platt credited Burroughs with inspiration and leadership in establishing Habitat’s ReStore resale outlet that sells reusable and surplus building materials to the public. Proceeds help the local affiliate fund construction of Habitat homes within Genesee County.

The Health and Humanitarian Award luncheon is open to the public. Reservations can be made by contacting United Memorial Medical Center Foundation at 344-5300. Seating will be limited so early reservations are encouraged.

Officials were on hand today at the new surgical wing of United Memorial Medical Center for the setting of the cornerstone.

Above, masons Ken Maurer, left,  and Jeff Crevier, set the cornerstone into place.

The expansion project represents a $19.5 million investment by the hospital. It will contain five new technologically advanced operating suites, a treatment room and 19 recovery beds. The project is scheduled to be finished by Dec. 15.

After the brief ceremony, guests were invited to tour the still-under-construction facility.

More pictures after the jump:

CEO Mark Schoell addresses the group on hand for the cornerstone setting.

Schnoell with Rev. Ken Comer watching Maure and Crevier place the cornerstone.

Brian and Michelle Trott are to the left in this picture with their children Brandon and Ashley. Michelle is the architect for the UMMC expansion. She was born at UMMC and her parents still reside in Bethany. Brian is the architect for Pembroke Central Schools.

Schoell called this "the big room." It's the biggest of the surgery suites.

(by WBTA News Intern Ashley Chiocco)


The Dr. Bruce A. Holm Upstate MedTech Centre has opened.

The ceremonial ribbon cutting took place yesterday (Friday) afternoon during the building’s grand-opening celebration on Assemblyman Stephen Hawley Drive.

The $7.2-million building will be home to GCC’s state-of-the-art nursing facilities, UMMC’s therapy programs, and provide space for emerging biotech companies.

GCC’s Nursing Program Director Kathy Polumbo tells how the new facilities will enhance the students’ learning experiences.

"We have all the latest technology in our classrooms," says Palumbo. "And I think the labs are the real 'piece de resistance.' We have a very realistic environment with our simulators.

"So what we're hoping is: We will make the sutdents better prepared for when they actually get their first job and they come into the real world."

The MedTech Centre is just the first building to be completed in GCEDC’s Upstate MedTech Park.

PHOTO: Area representatives, EDC officials and members of GCC pose at yesterday's ribbon-cutting ceremony.

There will be an open house for the new School of Nursing facilities at MedTech Park from 3 to 6:30 p.m. on Friday, Aug. 20.

Genesee Community College and Genesee County Economic Development Center (GCEDC) will jointly celebrate the opening of the Dr. Bruce A. Holm Upstate MedTech Centre.

It includes the college's new School of Nursing, the headquarters of GCEDC and the Physical Therapy Department of United Memorial Medical Center.

Community members are invited for the ribbon-cutting ceremony, tours and hands-on demonstrations of the brand-new classrooms and laboratories.

Genesee's School of Nursing occupies the entire second floor of the new MedTech Centre building. The new 20,000-square-foot-facility includes a lecture hall, conference rooms, and three state-of-the-art nursing labs for hands-on, experiential learning.

There's also a student and employee gathering room with tables, a vending area and lockers, which allow students and staff to study, relax or socialize between classes. Faculty and administrative offices also occupy the second floor.

"The college's nursing program recently increased its enrollment, helping address a nationwide demand for more registered nurses," said Kathy Palumbo, director of Genesee's Nursing program. "This new facility exemplifies both the college and business community's commitment to a stronger healthcare workforce.

"We are grateful to all the public officials, private citizens, supporters of the college as well as our dedicated students and faculty who helped make these state-of-the-art facilities a reality."

The open house will welcome Genesee's wide-reaching Nursing Program alumni as well as the nursing faculty and advisory council, Genesee's president, Stuart Steiner, Ed.D, board of trustee members, elected officials and representatives from the GDEDC (which occupies part of the first floor of the building).

"This is an exciting time for GCEDC and Genesee Community College," said Steven Hyde, president and CEO of the GCEDC. "We are not only welcoming the nurses of tomorrow to this brand-new facility, ... we look forward to working collaboratively with the college and other organizations to develop new jobs for our region in the burgeoning new field of medical technology."

The ribbon cutting and School of Nursing open house program includes:

3 p.m. -- Doors open for the Open House

4 p.m. -- Ribbon cutting and brief welcome and acknowledgments by MedTech and college officials

4:30-6:30 p.m. -- Facility tours, School of Nursing demonstrations

An assortment of refreshments will be provided at the reception, including the college's new bottled "Cougar Water."

For further information or to RSVP to the GCC School of Nursing open house and reception please call Patty Hume at 585-343-0055, ext. 6234.