1. Surgical Care Measures
2. Heart Attack Care Measures
3. Pneumonia Care Measures
4. Heart Failure Care Measures
5. Asthma Care for Children
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1. How is the quality of surgical care measured?
Surgical care is the care you get before, during and after surgery. Medical experts have looked at the research about surgical care and agreed on seven things that should be happening for all patients who have surgery.
New! Patients already on blood pressure medication are kept on it before and after surgery
Many people who have heart problems or are at risk for heart problems take drugs called beta blockers to reduce the risk of future heart problems. This measure shows whether surgery patients who were already taking beta blockers before coming to the hospital were given beta blockers during the time period just before and after their surgery.
Antibiotics are given within one hour before surgery
This measures how often hospital teams give patients antibiotics within one hour before surgery. Research shows that surgery patients who get antibiotics within the hour before their operation are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, does not work as well.
The correct antibiotic drug is given
This measures how often patients get the right antibiotic drug, based on the type of surgery, to prevent a surgical wound infection. Certain antibiotics are recommended to help prevent infection for particular types of surgery. By following the guidelines for the correct antibiotic drugs, hospitals can reduce a patient's risk of getting a wound infection after surgery.
Antibiotics are stopped within 24 hours after surgery
This measures how often hospital teams stop giving antibiotics to patients within 24 hours after surgery. While antibiotics can lower the chances of infection after surgery, it is usually not necessary to continue the drugs for more than 24 hours after routine surgery, and doing so can increase the chances of side effects. Patients should talk with their doctors if they have questions about how long to take antibiotics after surgery.
Control of blood sugar after surgery
This measures the percentage of a hospital's heart surgery patients whose blood sugar is kept under good control in the days right after surgery. Treatment to control blood sugar in post-heart surgery patients can prevent major complications, such as heart attack, neurological, kidney, lung and gastrointestinal injury.
Safe hair removal prior to surgery
This measures the percentage of surgery patients needing hair removed from the surgical area before surgery, who had hair removed using a safer method (electric clippers or hair removal cream - not a razor).
Treatment to prevent blood clots is ordered
This measures how often doctors order treatments for patients to prevent blood clots from forming after certain surgeries. Treatment to prevent blood clots must be given at the right time to prevent blood clots from forming after selected surgeries. Such treatments may include blood thinning drugs, elastic support stockings, or mechanical air stockings that help blood circulation in the legs.
Treatment to prevent blood clots is given within 24 hours before and after surgery
This measures how often patients actually received treatment(s) to prevent blood clots within 24 hours (before or after) certain surgeries. Certain types of surgery can increase the risk of blood clots forming because patients do not move much during and, usually, after some surgeries. Treatments called 'prophylaxis' should be provided at the right time. Approaches may include blood thinning drugs, elastic support stockings, or mechanical air stockings that help circulation in the legs.
2. How is the quality of heart attack care measured?
A heart attack happens when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. It is important that blood begins flowing in the heart as quickly as possible after a heart attack to lessen damage to the heart muscle and improve the patient's chance of survival. Medical experts have looked at the research about heart attacks and agreed on seven things that should be happening for all patients who have heart attacks.
Aspirin is given at arrival to the hospital
This measures the percentage of patients given aspirin when they arrive at the hospital after a heart attack. Aspirin can help keep blood clots from forming and dissolve blood clots that may cause heart attacks.
Aspirin is given at discharge
This measures the percentage of patients who were given a prescription for aspirin when they were discharged from the hospital after being treated for a heart attack. Taking aspirin may help prevent further heart attacks. Talk to your health care provider before using aspirin on a regular basis to make sure it is safe for you.
Medicines given to improve heart function
This measures the percentage of a hospital's patients who were given special medicines after a heart attack. Specific medicines may lower blood pressure and reduce how hard the heart has to work by limiting the effects of a hormone that narrows blood vessels. Since these drugs work differently, the doctor will decide which one is most appropriate for the patient. Patients who have a heart attack should receive a prescription for a medicine to improve heart function before leaving the hospital.
Patients advised to stop smoking
This measures the percentage of a hospital's patients who, before they were discharged from the hospital, were advised or counseled to stop smoking. Smoking increases patients' chances of developing blood clots and heart disease that can result in a heart attack, heart failure or stroke. Quitting may help prevent another heart attack. It is important that patients receive information to help them quit smoking before leaving the hospital.
Blood pressure medicine is prescribed at discharge from the hospital
This measures the percentage of a hospital's patients who were given a prescription for blood pressure medicine when they were discharged after being treated for a heart attack. Blood pressure medicine relieves the stress on the heart by slowing the heart rate and reducing the force with which the heart muscles contract to pump blood. It also helps keep blood vessels from constricting in the heart, brain, and body. Patients who have a heart attack should receive a prescription for blood pressure medicine before leaving the hospital.
Procedure to open blocked blood vessels done within 90 minutes of arrival at hospital
This measures the percentage of heart attack patients who underwent a procedure to open blocked blood vessels within 90 minutes of arrival at the hospital. This procedure opens blocked blood vessels in the heart to increase blood flow. It is vital that blood flow is returned as quickly as possible after a heart attack to lessen damage to the heart muscle and improve the patient's chances of surviving the heart attack. Doctors may perform this procedure, or give medicine to open the blockage, and in some cases, may do both.
3. How is the quality of heart failure care measured?
Heart failure is a weakening of your heart's ability to pump blood. When heart failure occurs, your body does not get enough oxygen and nutrients to meet its needs. Medical experts have looked at the research about heart failure and agreed on four things that should be happening for all patients to get quality care.
Instructions are given when patient is released from the hospital
This measures the percentage of patients with heart failure who were given appropriate instructions when they were released from the hospital. Heart failure is a chronic condition that needs to be managed to reduce the chances of more complications. Hospital staff should provide information to patients to help them manage their heart failure symptoms after they leave the hospital.
Patient is given a test of how the heart is pumping
This measures the percentage of patients with heart failure who received a test of the heart's ability to pump blood. Heart failure occurs when the heart can't pump enough blood throughout the body. The right treatment for heart failure depends on the area of the heart affected. The test checks how the heart is pumping so health care providers can see if the heart is pumping properly.
Medicines given to improve heart function
This measures the percentage of a hospital's patients who were given special medicines to improve how the heart is pumping. These medicines can lower blood pressure and reduce the work the heart has to perform by limiting the effects of a hormone that narrows blood vessels. These medicines are particularly beneficial in patients with decreased function of the left side of the heart.
Patients advised to stop smoking
This measures the percentage of patients with heart failure who, before they were discharged from the hospital, were advised or counseled to stop smoking. Smoking increases the risk for developing blood clots and inhibits circulation, which can result in worsened heart failure, a heart attack or stroke.
4. How is the quality of pneumonia care measured?
Pneumonia is a serious lung infection that causes breathing trouble, fever, cough and tiredness. It is a leading cause of death among the elderly and people who have ongoing illnesses. Medical experts have looked at the research about pneumonia and agreed on seven things that should be happening for all patients with pneumonia.
Blood-oxygen level is measured
This measures the percentage of patients with pneumonia who have the level of oxygen in their blood measured. Pneumonia can lower the oxygen in a patient's blood because the air spaces in the lungs fill with mucus and block oxygen from going into the blood stream. It is important to measure the amount of oxygen in the patient's blood within 24 hours of arriving at the hospital to see if the patent needs oxygen therapy.
Pneumonia vaccine is given
This measures the percentage of patients with pneumonia who were checked for, and if appropriate, given a pneumonia vaccine. The vaccine for pneumonia may help prevent or lower the risk of problems from pneumonia caused by bacteria. Even patients who already have pneumonia should be asked if they have been vaccinated recently for pneumonia. If not, they should be given the vaccine.
Blood test is done before an antibiotic is given
This measures the percentage of patients who had a blood test before being given the first dose of antibiotics. A blood test can help doctors find out which bacteria may have caused the pneumonia. Different antibiotics work for different types of bacteria, so knowing the type of bacteria allows doctors to pick the right antibiotic for each patient.
Patients advised to stop smoking
This measures the percentage of patients with pneumonia who, before they were discharged from the hospital, were advised or counseled to stop smoking. Smoking increases patients' chances of getting pneumonia or lung diseases like emphysema and bronchitis. It is important for patients to get information before they leave the hospital to help them quit smoking. Quitting reduces patients' chances of getting pneumonia again.
Antibiotic is given within six hours of arrival to the hospital
This measures the percentage of patients with pneumonia who were given an antibiotic within six hours of arriving at the hospital. (Patients who come down with pneumonia while they are hospitalized are not counted in this measure). For people with pneumonia caused by bacteria, early treatment with antibiotics can cure the pneumonia and reduce the chance of complications.
Correct antibiotic drug is given
This measures how often patients get the right antibiotic drug, based on the type of bacteria that caused the pneumonia. If the patient's pneumonia is caused by bacteria, hospitals can treat the infection with antibiotics. Different bacteria are treated with different antibiotics.
Flu shot is given
This measures the percentage of patients with pneumonia who were checked for, and if appropriate, given a flu shot. Flu shots lower the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a hospital or community. Health care teams should make sure that patients with pneumonia, particularly those age 50 or older, get a flu shot during flu season to protect them from another lung infection and to help prevent the spread of influenza.
5. How is the quality of care for children's asthma measured?
Reliever medicine given while hospitalized for asthma
National guidelines recommend using reliever medication in the severe phase and gradually cutting down the dosage of medications to provide control of asthma symptoms. Relievers are medications that relax the bands of muscle surrounding the airways and are used to quickly make breathing easier.
Medicine given to reduce inflammation and control symptoms while hospitalized for asthma
National guidelines recommend using systemic corticosteroid medication (oral and IV medication that reduces inflammation and controls symptoms) in the severe phase and gradually cutting down the dosage of medications to provide control of the asthma symptoms. Systemic corticosteroids are a type of medication that work in the body as a whole. Systemic corticosteroids help control allergic reactions and reduce inflammation.
Home management plan given while hospitalized for asthma
The Home Management Plan of Care document includes arrangements for follow-up care. It will help children with asthma and their caregivers develop a plan to manage the child’s asthma symptoms and to know when to take action. The plan of care should clearly tell the child and their caregiver when and how to use medication.