Hospital Compare Measures and Conditions
 

Heart Attack

Every year, about one million people suffer a heart attack (acute myocardial infarction or AMI). AMI is among the leading causes of hospital admission for Medicare beneficiaries, age 65 and older.

Scientific evidence indicates that the following processes of care represent the best practices for the treatment of AMI. Higher scores are better.
  • Aspirin at arrival - Acute myocardial infarction (AMI) patients without aspirin contraindications who received aspirin within 24 hours before or after hospital arrival.
  • Aspirin at discharge - AMI patients without aspirin contraindications who were prescribed aspirin at hospital discharge.
  • ACE inhibitor or ARB for left ventricular systolic dysfunction - AMI patients with left ventricular systolic dysfunction (LVSD) and without angiotensin converting enzyme inhibitor (ACE inhibitor) contraindications or angiotensin receptor blocker (ARB) contraindications who are prescribed an ACE inhibitor or an ARB at hospital discharge.
  • Beta Blocker at arrival - AMI patients without beta-blocker contraindications who received a beta-blocker within 24 hours after hospital arrival.
  • Beta Blocker at discharge - AMI patients without beta-blocker contraindications who were prescribed a beta-blocker at hospital discharge.
  • Fibrinolytic medication received within 30 minutes of hospital arrival - AMI patients receiving fibrinolytic therapy during the hospital stay and having a time from hospital arrival to fibrinolysis of 30 minutes or less
  • PCI Received Within 90 Minutes Of Hospital Arrival - AMI patients receiving Percutaneous Coronary Intervention (PCI) during the hospital stay with a time from hospital arrival to PCI of 90 minutes or less.
  • Smoking cessation advice/counseling - AMI patients with a history of smoking cigarettes, who are given smoking cessation advice or counseling during a hospital stay.
Heart Failure

Heart failure is the most common hospital admission diagnosis in patients age 65 or older, accounting for more than 700,000 hospitalizations among Medicare beneficiaries every year. It is associated with severe functional impairments and high rates of mortality and morbidity.

Substantial scientific evidence indicates that the following processes of care represent the best practices for the treatment of heart failure. Higher scores are better.
  • Evaluation of left ventricular systolic (LVS) function  - Heart failure patients with documentation in the hospital record that an evaluation of the left ventricular systolic (LVS) function was performed before arrival, during hospitalization, or is planned for after discharge.
  • ACE inhibitor or ARB for left ventricular systolic dysfunction - Heart failure patients with left ventricular systolic dysfunction (LVSD) and without angiotensin converting enzyme inhibitor (ACE inhibitor) contraindications or angiotensin receptor blocker (ARB) contraindications who are prescribed an ACE inhibitor or an ARB at hospital discharge.
  • Discharge instructions - Heart failure patients discharged home with written instructions or educational material given to patient or care giver at discharge or during the hospital stay addressing all of the following: activity level, diet, discharge medications, follow-up appointment, weight monitoring, and what to do if symptoms worsen.
  • Smoking cessation advice/counseling - Heart failure patients with a history of smoking cigarettes, who are given smoking cessation advice or counseling during a hospital stay.
Pneumonia

Community acquired pneumonia is a major contributor to illness and mortality in the United States, causing 4 million episodes of illness and nearly one million hospital admissions each year.

Scientific evidence indicates that the following measures represent the best practices for the treatment of community-acquired pneumonia:
  • Oxygenation Assessment - Pneumonia inpatients who receive an oxygenation assessment, arterial blood gas (ABG), or pulse oximetry within 24 hours of hospital arrival.
  • Initial Antibiotic Timing - Pneumonia inpatients that receive within 4 hours after at the hospital. Evidence shows better outcomes for administration times less than four hours.
  • Pneumococcal Vaccination Status - Pneumonia inpatients age 65 and older who were screened for pneumococcal vaccine status and were administered the vaccine prior to discharge, if indicated.
  • Influenza Vaccination Status - Pneumonia patients age 50 years and older, hospitalized during October, November, December, January, or February who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated.
  • Blood Cultures Performed in the Emergency Department Prior to Initial Antibiotic Received in Hospital - Pneumonia patients whose initial hospital blood culture specimen was collected prior to first hospital dose of antibiotics
  • Appropriate Initial Antibiotic Selection - Immunocompetent patients with pneumonia who receive an initial antibiotic regimen that is consistent with current guidelines.
  • Smoking cessation advice/counseling - Pneumonia patients with a history of smoking cigarettes, who are given smoking cessation advice or counseling during a hospital stay.
Surgical Infection Prevention

Hospitals can reduce the risk of wound infection after surgery by providing the right medicines at the right time on the day of surgery. Studies show a strong association of reduced incidence of post-operative infection with administration of antibiotics within the one hour prior to surgery. After the incision is closed, however, studies show that prolonged administration of prophylaxis with antibiotics may increase the risk of certain other infections at no additional benefit to the surgical patient.

Scientific evidence indicates that the following processes of care represent the best practices for the prevention of infections after selected surgeries (colon surgery, hip and knee arthroplasty, abdominal and vaginal hysterectomy, cardiac surgery (including coronary artery bypass grafts (CABG)) and vascular surgery):
  • Prophylactic Antibiotic Received Within 1 Hour Prior to Surgical Incision - Surgical patients who received prophylactic antibiotics within 1 hour prior to surgical incision.
  • Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time - Surgical patients whose prophylactic antibiotics were discontinued within 24 hours after surgery end time.
  • Prophylactic Antibiotic Selection - Surgical patients who received the recommended antibiotics for their particular type of surgery.
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