Is McDonald’s Really the Big Problem in Hospitals? Or Preventable Infections and Healthcare Quality Problems?


It hasn't quite reached the level of hysteria as “pink slime,” but I've seen an inordinate amount of attention being given to the issue of McDonald's being located inside hospitals. A group of physicians have encouraged hospitals, especially children's hospitals, to boot the fast food giant: “Children's Hospitals Urged to Show McDonald's the Door.”

It might seem strange to have food generally labeled as unhealthy to be inside a healthcare facility. But, are we focused on the highest-impact problem with this hype?

Hospital cafeterias are often full of unhealthy options. I could, if I wanted, just as easily get fried foods, sweets, and hamburgers there. One hospital client of mine had a new cafeteria chef who tried introducing healthier options, but parents complained that they wanted mashed potatoes and other comfort foods when their kids were sick and in the hospital. So, in the name of patient/family satisfaction, the hospital caved in.

Either way, the issue isn't just McDonald's.

As mentioned on one cable news talk fest, the problem of hospital-acquired infections is a FAR more serious issue, as approximately 100,000 hospital patients die every year due to infections that are increasingly seen as preventable.

See the data on the scale of the quality and patient safety problem  in the United States and around the world.

99,000  patients die as a result of hospital-acquired infections (HAI) each year (AHRQ, 2009). The most common HAI agent is methicillin-resistant Staphylococcus aureus (MRSA) (AHRQ, 2008).

90,000  die as a result of nosocomial (HAI) infections (CDC)

NOTE: Total deaths from errors and infections would be quoted as 99,000 plus one of the top three estimates.Hospital errors rank between the  fifth and eighth  leading cause of death, killing more Americans than breast cancer, traffic accidents or AIDS (IOM).Just one type of error—preventable adverse drug events—caused  one out of five injuries or deaths  per year to patients in the hospitals that were studied (AHRQ, 2000).

See collected results of hospitals that are dramatically reducing infections and other quality and patient safety problems. We have pockets of success, but the industry, as a whole, is not improving quickly enough.

Organization:  Allegheny General Hospital  (PA)

  • (Central Line Associated Bloodstream Infections)  CLABIs  were nearly eliminated, falling 76 percent from 49 infections in 37 patients (5.1 per 1,000 line days) in the year before the intervention to six infections in six patients (1.2 per 1,000 line days) during the intervention year (Figure 11). Among patients with CLABs, the number of deaths decreased 95 percent and the death rate decreased 69 percent, from 19 of 37 patients (51%) to 1 of 6 patients (16%). Of the six CLABs that occurred, four were attributed to failures to follow specific guidelines.

Where is the outrage over healthcare quality and safety?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Mark-interesting post. While I don’t work in health care, this illustrates an issue that can be seen in all industries. We need to be focused on the real priorities and avoid being distracted by lesser issues.

  2. Wow – Mark. I’d venture to say because most people don’t see these numbers. I work on the employer side of offering benefits. Employers are saturated with wellness information and how unhealthy Americans are. No one is stepping in to tell us how hospital practices are affecting our claims experience and we’re not telling health insurance members how the hospital they choose can impact the care they receive.

    Recently, my dad went in for surgery and was shocked when his surgeon admitted that he was more worried about my dad acquiring MRSA then he was about complications from the surgery. As he said it “we got the surgery side down, it’s the rest of it that…concerns us”.

    This blog, reading the IHI website and other doctor authors have been an insight to me of what even happens on the other side. As a bonus, my mom has been a nurse for 30 years and I like to think I heard it all through here. Because of her experience, we have an unofficial house rule – never let anyone go to a hospital without a family advocate.

    Unless you follow blogs like yours or have had family members in healthcare, I think its unfortunately easy to completely miss this information. Thank you for being the continued advocate – showing both what happens AND that there’s ways to fix it.


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