Hospital Quality Reporting Website
Welcome to the Connecticut Hospital Association's Hospital Quality Reporting Website. This website is a resource for patients, their families, and the general public to begin looking at the quality of hospital care in Connecticut and to help you make good decisions about your healthcare. You should view this information as a starting point for educating yourself about the quality of hospital care, for talking to your doctors about choosing a hospital for medical care, and for asking questions while receiving care in the hospital. You may also want to review this information when considering a hospital visit for a scheduled procedure.
The information in this website shows well accepted measures of quality for four medical conditions: heart attack (acute myocardial infarction), heart failure, pneumonia, and surgery. For each medical condition, there are several measures that are scored. In these reports, "good quality" is viewed as the percentage of patients who receive the recommended care; the more patients that receive the treatment, the higher the percentage. It's important to note that these percentages only include patients whose history and condition indicate the treatment is appropriate. Talk to your doctor if you have questions about your treatment.
These measures are collected from hospitals four times per year by the Centers for Medicare and Medicaid Services (CMS) which administers Medicare, the health insurance program for people age 65 or older, some disabled people under age 65, and people with permanent kidney failure. While CMS collects the measures, the data include all patients in the hospitals.
If you are seeking information on a particular quality measure that you don't see reported here, ask your hospital about it. Just because the information is not included on CHA's Quality Reporting Website does not mean hospitals are not tracking it. Ask if there is a measure that pertains to your particular situation or procedure, and if so, ask if your hospital tracks it and what its results have been.
- Click on View Reports to navigate to the Report Selection page.
- First, choose a Medical Condition from the drop-down box located on the upper left corner of the screen. Select from one of the four medical conditions shown: heart attack, heart failure, pneumonia, and surgical care improvement project (SCIP).
- Next, choose a measure from the drop-down box located directly below Medical Condition. A description of the measure selected is provided in two places: at the bottom of the screen, and also when you click the yellow box to the right of the window. To close the descriptive box, click the box with the blue "X" which will return you to the selection screen.
- Then, choose a hospital from the drop-down box located on the right hand corner of the screen.
After selecting a medical condition, measure, and hospital, a graph with the hospital "score", the state average, and the national average will be shown. A note at the bottom of the graph will tell you whether a higher or lower percentage shows a better result.
Why is this important to you and your family?
It's important because scientific evidence shows that high quality care leads to fewer repeat hospitalizations, hospital-acquired infections and medical errors, making sure you get the best care possible.
There are a number of graphs available for you to use to review key measures of the quality and safety of hospitals in Connecticut. You can choose a graph using one of the following criteria – Medical Condition, Measure, and Hospital.
Heart failure is a disorder in which the heart loses its ability to pump blood efficiently. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly.
Left ventricular function assessment – Assessing the left ventricular function (LVF) of the heart helps evaluate the heart's ability to work efficiently. Without testing the function of the heart, a patient may not receive the care he or she needs to obtain the best function possible.
ACE inhibitor or ARB medication for left ventricular systolic dysfunction (LVSD) - Left ventricular systolic dysfunction (LVSD) occurs when the left ventricle, or chamber of the heart pumps less blood than it should. If a patient has heart failure because his or her left ventricle is not working properly, angiotension-converting enzyme inhibitors (ACE) or angiotension receptor blocking (ARB) inhibitor medications make it easier for the heart to pump.
Smoking Cessation Counseling – Smoking contributes to complications associated with congestive heart failure. Patients who are given advice on how to quit smoking by their health care provider during a hospitalization are more likely to stop smoking. Quitting smoking while in the hospital can also help the patient's recovery.
Discharge Instructions – Educating patients with heart failure and their families is critical to the home care of heart failure. Patients who do not understand and follow instructions from their health care providers are often re-hospitalized. Patients and their families should understand how to take prescribed medications, monitor their weight, exercise regularly and follow a healthy diet. In addition, patients should be seen by their health care provider for a follow-up appointment after they are hospitalized and know what to do if symptoms worsen.
Pneumonia is a condition caused by a bacterial infection of the respiratory system. Although not all patients that have pneumonia are admitted to the hospital, those with more severe cases or those who have a weakened immune system may require hospitalization so that they can receive antibiotics and other treatments more quickly.
Time to first antibiotic dose – There is growing evidence of an association between timely administration of antibiotics and improved survival for patients admitted to the hospital with pneumonia. Based on these studies, the Infectious Diseases Society of America and the American Thoracic Society suggest that the maximum time to the administration of the first antibiotic should be 8 hours.
Oxygen assessment – Inadequate oxygen in the blood is a common effect of pneumonia and is known to increase the chance of dying. Pneumonia patients should have their oxygen level checked within 24 hours of coming to the hospital. If the oxygen level is low, supplemental oxygen can be given to reduce the chance of dying.
Pneumococcal screening and/or vaccination – Pneumococcal vaccination is indicated for person age 65 and older because it is up to 75% effective in preventing pneumococcal bacteremia (bacteria in the blood) and meningitis (inflammation of the lining of the brain and spinal cord). It is also an important vaccine due to an increase in bacteria that are resistant to antibiotics. Patients that are admitted to the hospital with pneumonia should be asked if they have received a pneumococcal vaccine. If they have not received the vaccine, it should be given to the patient before they leave the hospital.
Smoking Cessation Counseling – Smoking cessation is essential for patients with pneumonia. Patients who are given advice on how to quit smoking by their health care provider during a hospitalization are more likely to quit smoking. Quitting smoking while in the hospital can also help the patient's recovery from pneumonia.
Antibiotics on Admission – Antibiotics are medicines that treat infection, and each one is different. Hospitals should provide the right antibiotic within 24 hours of admission.
Blood Culture – A blood culture tells what doctors what type of pneumonia a patient has. This information helps determine the antibiotics that will work best.
Error Prevention Goals
Over the past few years, hospitals and other health care providers have become more aware of the occurrence of errors in the health care delivery system. In response, they have developed safer processes to prevent the most common causes of error.
Procedure site marking – Marking the surgical site or the site of a procedure with a special marking pen can reduce the chance that an operation or procedure will be done on the wrong site when more than one option is available. For example, procedures that involve the left or right side of the body, or multiple structures like fingers and toes, should be marked prior to the surgery or procedure. When possible, the patient should be involved in marking the site since they know best where the surgery or procedure should occur.
Procedure verification process – Right before the start of a surgery or procedure, the members of the health care team should conduct a final verification process to be sure that they have the right patient, the right equipment, are planning to do the right procedure(s), on the right site(s). In many cases, the patient will not be aware that this is happening since they may already be sedated.
Eliminate dangerous medication abbreviations – Medication errors are frequently hard to detect but can occur for a number of reasons. One known cause of medication errors is the use of abbreviations, acronyms and symbols in medication orders that do not have common meaning, or can be misread by the pharmacist or person administering the medication. To reduce these errors, doctors and other health care professionals have identified the most common errors and are working to eliminate them through a variety of methods. For more information about medication errors, visit the Institute for Safety Medication Practices website at www.ismp.org.
Remove concentrated electrolytes – Concentrated electrolytes are solutions that are packaged in a concentrated form that requires that they be diluted before being given to a patient. Failure to dilute these solutions can lead to dangerous complications or even death. The most commonly used electrolytes are potassium chloride, potassium phosphate and sodium chloride. To prevent these concentrated solutions from being used, they should be removed from patient care area(s). In patient care areas where the concentrated form is required, access to the solution should be strictly controlled.
Medication Reconciliation - Research has shown that differences in the medications a patient is taking before coming to the hospital, and the medications ordered in the hospital can cause harm. The medication reconciliation process makes sure that all of the patient's current medications are reviewed when the patient is admitted to the hospital, is transferred to a different care unit, and is discharged to home or another care facility. Patients can help reduce the risk of this type of error by keeping an accurate list of current medications, and bringing this list to the hospital. This list should include the medication name, dose, when you take the medication and how you take the medication.
Surgical Infection Prevention
Timing of Antibiotics for Surgery - Research has shown that giving an antibiotic within one hour of making a surgical incision reduces surgical site infections.
Right Antibiotic for Surgery - Each surgery exposes the patient to infection caused by different bacteria. Receiving an antibiotic that kills bacteria most common for each surgery will reduce the chances of getting a surgical site infection.
Stopping the Antibiotic - Antibiotics to prevent a surgical site infection should be given to patients that have had surgery for no more than 24 hours after surgery. Antibiotics given for longer periods of time may increase the risk of the bacteria becoming resistant to antibiotics.
Inpatient Quality Indicators (IQI)
The Inpatient Quality Indicators include three distinct types of measures.
Volume measures examine the volume of inpatient procedures for which a link has been demonstrated between the number of procedures performed and outcomes such as mortality.
In-hospital mortality measures examine outcomes following procedures and for common medical conditions.
Utilization examines procedures for which questions have been raised about overuse, underuse, and misuse.
Agency for Health Care Research and Quality
The Employer Health Care Alliance Cooperative
HCAHPS Hospital Survey
Home Health Compare
The Joint Commission
The Joint Commission "Speak Up" Campaign
National Institutes of Health
Nursing Home Compare
"Top Ten" Most Useful Consumer Health Web Sites from the Medical Library Association
A list of the top 100 web sites based upon the recommendation of the Medical Library Association