Once-troubled Madigan hospital is better now after poor report on infections, leaders say

Madigan Army Medical Center at Joint Base-Lewis McChord.
Madigan Army Medical Center at Joint Base-Lewis McChord. Madigan Army Medical Center

Five years after a study showed Madigan Army Medical Center had the worst post-surgery infection rate of any large military hospital, top staff members say things have dramatically improved.

“We definitely had a lot of problems, but we have turned that around in a big, big way,” said Peter Kreishman, deputy chief of surgery at Madigan.

A spring report by the American College of Surgeons ranking 700 civilian and military hospitals, including Madigan, for their quality of care showed marked improvements in an array of Madigan’s surgical services and handling of complications.

Also, a military-specific evaluation of inpatient satisfaction this summer showed Madigan has risen from the 35th percentile to the 95th in three years’ time.

“We’re very proud of where we’ve come, and the data certainly reflects that,” said Vicki Odegaard, chief of quality services at the hospital at Joint Base Lewis-McChord.

The improvements track back to statistical analyses that pinpointed where the hospital was failing patients, staffers said. An analysis of which post-surgery complications usually were the most frequent at Madigan led doctors to draw up specific plans to solve the problems.

The hospital sees 4,700 patients per day, a spokesman said.

To get the infection rate down, surgeons across multiple disciplines standardized how patients were prepared for surgery and how antibiotics were administered.

Pneumonia cases and urinary tract infections received specific targeting and showed similar improvements, Kreishman said.

“We are now sitting right on the national average for overall morbidity, so (that is) our overall complication rate,” he said.

In evaluations this year, Madigan has ranked among the top 10 percent of all surveyed hospitals for 17 categories, including orthopedic, colorectal and obstetric procedures, Kreishman said.

The hospital’s improvements have not been universal.

More patients are making return trips to the operating room for unplanned follow-up procedures than desired, Kreishman said.

And despite adding nine public-health nurses three years ago to help manage widespread health issues, the rate of diabetes screenings among susceptible populations has increased but lags behind the rate of well-child doctor visits.

Hospital officials said the turnaround remains ongoing. One current effort: a renovation project in the maternity area so all new mothers can go to private single-patient rooms.

Derrick Nunnally: 253-597-8693, @dcnunnally