Heart Attack

A heart attack is a life-threatening situation that occurs when a blood vessel to the heart is blocked by a clot or plaque. When this occurs, heart muscle is deprived of oxygen and the damage causes pain, and reduces the heart's ability to pump blood. Without prompt treatment through the use of drugs like aspirin or a "clot buster" medication, or interventions to open the vessel, patients can become disabled or even die. Our goal is to quickly restore blood flow to the heart to prevent more damage and prevent future heart attacks by reducing blood pressure, maintaining heart rate/beats, and preventing clots.

We measure six quality indicators:

• Was an aspirin given on arrival at the hospital?
• How quickly (within 90 minutes of arrival at the hospital) was cardiac catheterization (PCI) performed on appropriate patients?
• Were appropriate medications (aspirin, beta-blocker, ACEI/ARB, and statin) prescribed at discharge?

Heart Failure

Heart failure, also known as congestive heart failure, is a chronic condition caused by the inability of the heart (specifically, the ventricle) to pump as much blood as the body needs. When the heart is unable to pump blood, fluid backs up and affects patients’ lungs and other organs. Heart failure is one of the most common reasons for hospitalization. Our goal is to correctly identify the degree of heart failure, help the heart pump more effectively, and reduce the strain on the heart through medications and dietary modifications that can reduce fluid.

We measure three quality indicators:

• Was left ventricular (LV) function assessed?
• Were written instructions given at discharge?
• Was an appropriate medication (ACEI/ARB) prescribed at discharge?

Pneumonia

Pneumonia is an infection of the lungs that can range from mild to severe. It is usually due to bacteria or viruses. Pneumonia causes more deaths worldwide than any other type of infection. Making sure that we provide appropriate treatment to those who develop this infection is the goal of these quality indicators.

We measure two quality indicators:

• Were blood cultures done before the first dose of antibiotic was given?
• Was the appropriate antibiotic(s) prescribed, according to national guidelines, for "community-acquired" pneumonia?

Surgical Care Improvement Measures

Postoperative wound infection is a significant complication of surgery, and the use of antibiotics before surgery can prevent such infections. In addition, practices such as hair removal help prevent infection, and assessing risk of blood clots and administering medication to prevent clots are very important to preventing complications of surgery. The measures reported here examine when antibiotics are given and whether we have followed national guidelines in administering them.
We measure ten quality indicators:
- Were antibiotics administered within 1 hour prior to incision?
- Was the appropriate antibiotic(s) prescribed, according to national guidelines, for infection prevention?
- Were antibiotics discontinued within 24 hours after surgery?
- Was the blood sugar well controlled for cardiac surgery patients?
- Was hair removal done appropriately prior to surgery?
- Was the appropriate therapy to prevent blood clots ordered?
- Was the appropriate therapy to prevent blood clots given at the appropriate time?
- Was beta-blocker therapy continued for approprate patients?
- Was the urinary catheter removed within 2 days after surgery?
- Was the patient's temperature well controlled during surgery?