Hospital Quality Comparison Glossary

This Glossary explains the different care measures used to measure hospital quality.

ACE inhibitor for LVSD: Hospitals should make sure that any patient having a heart attack or heart failure should get an ACE (angiotensin-converting enzyme) inhibitor. ACE inhibitors are a type of medicine that can help reduce the risk of death from a heart attack. They must be given to the patient within 24 hours of the first symptoms of a heart attack. They work by stopping the body from producing a hormone that narrows blood vessels. Wider blood vessels help improve heart function and lower blood pressure. Continued use can help prevent heart failure. 

LVSD stands for left ventricular systolic dysfunction. The left ventricle is the main pumping section of the heart. If it is not working properly, it can cause a heart attack or heart failure.

Advising smokers to quit: It is important that you get information to help you quit smoking before you leave the hospital. Quitting may help prevent another heart attack. Smoking increases your risk for developing blood clots and heart disease that can result in a heart attack, heart failure or stroke. Smoking causes your arteries to thicken and your blood vessels to narrow. Fat and plaque stick to the walls of your arteries, which makes it harder for blood to flow. Reduced blood flow to your heart may result in chest pain, high blood pressure, and an increased heart rate. Smoking is also linked to lung disease and cancer, and can cause premature death.

Antibiotics stopped within 24 hours after surgery: Antibiotics prevent and treat infections. While infections are less likely when patients are given preventive antibiotics before surgery, taking antibiotics for more than 24 hours after routine surgery is usually not necessary and can increase the risk of side effects such as stomach aches, serious diarrhea, and antibiotic resistance (when antibiotics are used too much, they will not work anymore). There are exceptions when antibiotics must be taken for a longer time after surgery; talk with your doctor if you have questions about how long to take them.

Aspirin at arrival: If a patient has not already had an aspirin when he or she gets to the hospital, the hospital should give the patient one immediately. Taking an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of a heart attack. Aspirin acts as a blood thinner, so it can help prevent blood clots from forming and even help dissolve clots that have already formed. If the patient cannot take aspirin because he or she has an ulcer or allergy, the hospital should make sure the patient takes another medicine that will work the same way.

Aspirin at discharge: Following a heart attack, a patient should keep taking aspirin to help reduce the risk of another heart attack. Hospitals should make sure that patients are told to continue to take aspirin after leaving the hospital. If the patient cannot take aspirin because he or she has an ulcer or allergy, the hospital should make sure the patient takes another medicine that will work the same way.

Assessment of left ventricular function: If a patient has heart failure, hospitals should test a patient's left ventricle, the main pumping section of the heart, to find the cause. This includes listening to the heart and ordering tests like a chest x-ray, blood work, and an echocardiogram (ECG).

Beta blocker at arrival: Hospitals should make sure that patients with a heart attack or heart failure are given beta blockers within 24 hours of arriving at the hospital. Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain, and help prevent a heart attack.

Beta blocker at discharge:Hospitals should make sure that patients with a heart attack or heart failure are prescribed beta blockers when they leave the hospital. Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain, and help prevent further heart problems.

Blood culture prior to first antibiotic: Different types of bacteria can cause pneumonia. A blood culture is a test that lets the hospital know which bacteria may have caused a patient's pneumonia, which helps determine which antibiotic should be prescribed. It is best to do the blood culture within 24 hours of the patient's arrival at the hospital and before antibiotics are started.

Discharge instructions provided: Heart failure is a chronic condition. It results in symptoms such as shortness of breath, dizziness, and fatigue. Before you leave the hospital, the staff at the hospital should provide you with information to help you manage the symptoms after you get home and tell you what to do if your symptoms get worse.

Doctors ordered treatments to prevent blood clots: This measure tells how often surgery patients' doctors ordered treatment to prevent blood clots from forming in the veins after certain surgeries.

Evaluation of left ventricular systolic (LVS) function: The function of the left side of the heart must be evaluated to help determine the treatment plan for heart failure patients.

Fibrinolytic medication within 30 minutes of arrival: Blood clots can cause heart attacks. Doctors may give heart attack patients fibrinolytic (clot-dissolving) medicine, or perform a procedure to open the blockage. In some cases they may do both.

Influenza vaccination: An influenza shot can help prevent influenza in the future, even for patients who have been hospitalized for pneumonia.

Influenza vaccination status: Patients who are 50 or older and hospitalized for pneumonia October through February should be screened to find out if they've received a flu shot, and if not, should receive it before they're discharged from the hospital.

Initial antibiotic timing: Hospitals should make sure that patients with bacterial pneumonia get an antibiotic or combination of antibiotics as soon as possible. The information in the chart shows the percent of patients who were given their first dose of antibiotics within 4 hours of arrival at the hospital. Antibiotics attack bacteria, so early treatment with antibiotics can cure bacterial pneumonia and reduce the possibility of complications. If a patient is allergic to antibiotics, the hospital should give another medicine to treat pneumonia.

Most appropriate initial antibiotic: Pneumonia is a lung infection that is usually caused by bacteria or a virus. If pneumonia is caused by bacteria, hospitals will treat the infection with antibiotics; different antibiotics treat different bacteria.

Oxygenation assessment: Hospitals should test the amount of oxygen in a patient's blood (an "oxygenation assessment") within 24 hours of the patient's arrival. Pneumonia can lower the amount of oxygen in the blood. This is because the air spaces in the lungs fill with fluid. The blood gets oxygen from the air, so when there's less air in the lungs, there is usually less oxygen in the blood. There are two kinds of test that hospitals might use. One is called an ABG (arterial blood gas) test. The other is a pulse oximetry test, where electrodes are attached to a patient's finger, earlobe, or skin fold.

PCI within 120 min. of arrival: A Percutaneous Coronary Intervention (PCI) is a procedure that opens a blocked blood vessel, such as an angioplasty, stenting, or atherectomy. All these procedures involve a catheter (flexible tube), often inserted in the leg, that is guided through blood vessels to the blockage. The heart gets oxygen from blood vessels, so opening the blockage and increasing blood flow using a PCI is among the most effective ways to help prevent further heart muscle damage.

Pneumococcal vaccination status:  Hospitals should make sure to give all patients admitted with bacterial pneumonia a pneumonia vaccination. A pneumonia vaccine may help prevent or lower the risk of complications of bacterial pneumonia in the future.

Prophylactic (preventive) antibiotic received 1 hour before incision: Antibiotics prevent and treat infections. Research shows that surgery patients who get antibiotics within the hour before their operations are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective.

Prophylactic (preventive) antibiotics discontinued within 24 hours after surgery end time: Patients who are given antibiotics to help prevent surgical infections should have them discontinued within 24 hours after surgery (48 hours for coronary artery bypass graft surgery or other heart surgeries).

Received treatment to prevent blood clots within 24 hours before or after surgery: This measure tells how often surgery patients received treatment to prevent blood clots within 24 hours before or after certain surgeries.

Thrombolytic agents within 30 minutes:  Thrombolytics are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. You should get them within 30 minutes of arrival at the hospital.