It may look harmless and even sexy when a surgical mask dangles from the neck of a hunky TV doctor, or his hair peeks out from under his surgical cap. But to Illinois infection control watchdogs, it looks like a pathway for deadly germs.
Exposed hair and dangling masks in sterile operating rooms were among shortcomings they observed in Illinois same-day surgery centers, according to state inspection reports.
The reports, obtained by The Associated Press through the Freedom of Information Act, describe other serious problems seen during the past year by inspectors trying to stop the spread of dangerous bacteria and viruses:
- A Chicago eye surgery center routinely skimped on sterilizing time for surgical instruments, cutting the recommended 10 minutes down to four minutes -- and sometimes -- just three minutes.
- A central Illinois center didn't investigate why one of its surgeons had a high rate of post-operative infections.
- A suburban Chicago center cleaned instruments in a sink that had no hot water.
The lapses at same-day surgery centers were found throughout the state as regulators continue a crackdown prompted by a 2008 hepatitis C outbreak in Las Vegas believed to be caused by unsafe clinic practices.
In Illinois, 36 surgical centers still have not been inspected using a new tougher approach required by federal health officials after the Las Vegas scare.
Surgery centers are a growing segment of the health care system. They perform procedures including cataract surgeries, colonoscopies and foot operations - often more cheaply than hospitals. Across the nation, the centers annually do more than 6 million procedures and collect $3 billion from Medicare.
Surgery centers face challenges that are different than hospitals. Turnaround times between surgeries are shorter, for example. But the centers are expected to uphold the same infection control standards as in hospitals, said Jan Davidson, a registered nurse and infection control expert at the Denver-based Association of periOperative Registered Nurses, a group that writes recommendations for infection control.
The person in charge of infection control at a surgery center is often a nurse who has other jobs too, Davidson said. In comparison, hospitals typically have one staff member who does nothing else but head the infection control program, she said.
In Illinois, no disease outbreaks have been linked to the centers, but there's no way to tell how many patients, if any, suffered infections because of the problems seen during the unannounced inspections.
The new scrutiny is meant to bring surgery center practices in line with what's enforced at hospitals. That makes it unlikely for a center to get a completely clean report, said Janis Licari, an executive with Midwest Surgical Management Group, which operates Midwest Center for Day Surgery, Downers Grove, which was cited for problems.
"With hospitals and surgery centers held to the same infection control practices, and the increased frequency and depth of (government) reviews, it is unlikely any provider will not receive some minimal recommendations for improvement," Licari said in an email.
The public can be reassured that regulators are watching with a sharper eye, said Bill Bell, division chief for Health Care Facilities and Programs for the Illinois Department of Public Health.
"We want people to know there is regulatory oversight of these types of facilities and that we are closely monitoring infection control," Bell said. Inspectors follow at least one patient through a surgery from start to finish, rather than basing their reports on a look at a facility's written policies, as in the past, he said.
Last year, The Associated Press examined reports in Illinois and found that nearly 76 percent of centers that were inspected were cited for infection-control problems.
"I hope that they get it under control," said Beth Durbin, 34, who had surgery in 2004 at Effingham Ambulatory Surgery Center in Effingham, which was cited in November 2010 for not looking into a surgeon's unusually high post-op infection rate and other problems. "I prefer going to the surgery centers. I prefer them over the hospital."
Durbin's surgery went well and she suffered no infection problems. Linda Meinhart, business manager for the surgery center, said in an email that the center welcomes reviews by state regulators and "works diligently to implement actions that will improve patient care."
Some of the situations discovered by Illinois inspectors during the past year could have led to patient infections.
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