Glossary

How patients rate the hospital overall. The percentage is the number of people who gave their hospital an overall ranking of 9 or 10 on a scale of 0 to 10, with 0 meaning the worst hospital possible and 10 being the best hospital possible. Higher is better.

Why This Matters
Research shows that hospitals with higher patient satisfaction are also safer.

Technical Description
How do patients rate the hospital overall? http://www.medicare.gov/hospitalcompare/Data/Overview.html

Patients reported how often their nurses communicated well with them during their hospital stay on a scale of never, sometimes, usually or always. ‘Communicated well’ means nurses explained things clearly, listened carefully to the patient and treated the patient with courtesy and respect. The percentages below represent the percent of patients who reported that their nurses ‘always’ communicated well.

Why This Matters
Patients and their families are an important part of the care team and nurses need to be communicating well with them to ensure they can take an active role in their care while they are in the hospital and once they return home.

Technical Description
How often did nurses communicate well with patients? http://www.medicare.gov/hospitalcompare/Data/Overview.html

Patients reported how often their doctors communicated well with them during their hospital stay on a scale of never, sometimes, usually, or always ‘Communicated well’ means doctors explained things clearly, listened carefully to the patient and treated the patient with courtesy and respect. The percentages below represent the percent of patients who reported that their doctors ‘always’ communicated well.

Why This Matters
Patients and their families are an important part of the care team and doctors need to be communicating well with them to ensure they can take an active role in their care while they are in the hospital and once they return home.

Technical Description
How often did doctors communicate well with patients? http://www.medicare.gov/hospitalcompare/Data/Overview.html

Heart attack patients with another hospital stay within 30 days of their last stay. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates for Heart Attack: http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Heart failure patients with another hospital stay within 30 days of their last stay. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates for Heart Failure: http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients with another hospital stay within 30 days of their stay for pneumonia. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates for Pneumonia: http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients who have to stay in the hospital again within 30 days of their hip or knee replacement surgery. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates after Hip/Knee Surgery: http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients with another hospital stay within 30 days of their last stay. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates after Discharge from Hospital (hospital-wide): http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients with another hospital stay within 30 days of their CABG surgery. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates after Discharge from Hospital:
http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients with another hospital stay within 30 days of their stay for COPD. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates after Discharge from Hospital:
http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

Patients with another hospital stay within 30 days of their stay for stroke. Lower is better.

Why This Matters
Going back to the hospital within 30 days of getting out of the hospital can mean people aren’t getting the right care after they leave the hospital.

Technical Description
Hospital 30-Day Readmission Rates after Discharge from Hospital:
http://www.medicare.gov/hospitalcompare/Data/30-day-measures.html

A blood infection caused by germs entering the body through a line placed in an intensive care unit patient’s vein to deliver medicine. Lower is better.

Why This Matters
Infections can be prevented if the right steps are taken. To learn how to prevent central line infections, visit: http://www.cdc.gov/hai/pdfs/bsi/BSI_tagged.pdf

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors.

The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facility’s SIR is:

Better than the U.S. National Benchmark
No Different than U.S. National Benchmark
Worse than the U.S. National Benchmark

A bladder infection caused by germs entering the body through a tube that drains urine from a patient’s bladder. Lower is better.

Why This Matters
Infections are added complications that can endanger patients. Infections can be prevented if the right steps are taken. To learn how to prevent catheter associated urinary tract infections, visit: http://www.cdc.gov/HAI/ca_uti/uti.html

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors. The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facility’s SIR is: Better than the U.S. National Benchmark No Different than U.S. National Benchmark Worse than the U.S. National Benchmark

Infections after surgery to remove the uterus through the stomach. Lower is better.

Why This Matters
Infections can be really bad for patients, creating the need for more surgery or other treatments. Infections can be prevented if proper precautions are taken.

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors.

The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facility’s SIR is:

Better than the U.S. National Benchmark
No Different than U.S. National Benchmark
Worse than the U.S. National Benchmark

Clostridium difficile is a germ that can cause diarrhea. Most cases of C. diff infection occur in patients taking antibiotics. The C. diff bacteria can survive for a long time outside the body on hard surfaces, so infections can spread in health care environments.

Why This Matters
Preventing Clostridium difficile infections is important because it is very hard to treat and can be debilitating to hospital patients who are already sick.

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors. The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facilities SIR is:

• Better than the U.S. National Benchmark
• No Different than U.S. National Benchmark
• Worse than the U.S. National Benchmark

Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by a bacteria that lives on the skin. When it gets into the body it can be tough to treat because it’s resistant to some commonly used antibiotics.

Why This Matters
Any infection is preventable. It is particularly important to prevent MRSA infections because they can be very hard to treat.

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors.

The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facilities SIR is:

Better than the U.S. National Benchmark
No Different than U.S. National Benchmark
Worse than the U.S. National Benchmark

Infections after colon surgery. Lower is better.

Why This Matters
Infections can be really bad for patients, creating the need for more surgery or other treatments. Infections can be prevented if proper precautions are taken.

Technical Description
Calculations for the HAI measures adjust for differences in the characteristics of hospitals and patients using a Standardized Infection Ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. The SIR may take into account the type of patient care location, number of patients admitted with MRSA or C. difficile infections, laboratory methods, hospital affiliation with a medical school, bed size of the hospital, patient age, and American Society of Anethesiologists’ (ASA) classification of physical health. It compares the actual number of HAIs in a facility or state to a national benchmark based on previous years of reported data and adjusts the data based on several factors. The calculation of the Standardized Infection Ratio and its 95% confidence intervals allows for determination of whether a facilities SIR is: Better than the U.S. National Benchmark No Different than U.S. National Benchmark Worse than the U.S. National Benchmark

Medicare is a health insurance program for people age 65 or older or people under 65 with certain disabilities or conditions. For Medicare, hospitals generally receive payment of only 86 cents for every dollar of actual cost of providing care. (Source: American Hospital Association)

Medicaid is a joint federal and state program that helps with medical costs for people with low incomes. For Medicaid, hospitals generally receive payment of only 89 cents for every dollar of actual cost of providing care. (Source: American Hospital Association)

Self-payment is when a patient pays for a health-related service when they don’t have insurance to cover their medical treatment or surgery. For patients who do not have insurance, hospitals typically have financial assistance programs for patients who qualify.

The amount a hospital sets for total services provided to the patient before any insurance discounts. Similar to a “sticker cost,” it is usually not the final amount paid.

The amount a patient pays to the hospital (for example, deductible or co-pay).

The amount Medicare or Medicaid pays to the hospital for inpatient stay.

The amount a patient pays to the hospital after reimbursement from commercial insurance provider (for example, deductible or co-pay).

The amount a commercial insurer pays to the hospital for inpatient stay from commercial insurance provider. Rates are negotiated between the insurance company and the hospital.

The amount a commercial insurer pays to the hospital for inpatient stay from commercial insurance provider. Rates are negotiated between the insurance company and the hospital.

Most hospitals are required by the Centers for Medicare & Medicaid Services (CMS) to report quality data. Because they have set out clear definitions and guidelines, all hospitals report the data in the same way, making it easy to compare among hospitals and even between states.

As hospitals throughout Indiana are located in varying communities with different patient outcomes, adjusting data is a common practice used to make quality data measures comparable. Adjusting data stems from the variety of patient factors found in different regions, such as average age, neighborhood poverty level or even precentage of existing illnesses. Putting these hospitals on even footing provides the patients with a better comparison.

You are getting emergency department services, observation services, outpatient surgery, lab tests or X-rays — or any other hospital services — and the doctor has not written an order to admit you to a hospital as an inpatient. In these cases, you’re an outpatient even if you spend the night in the hospital.

You are formally admitted to the hospital with a doctor’s order. An inpatient admission is generally appropriate when you’re expected to need two or more midnights of medically necessary hospital care, as ordered by your doctor.

Through the use of volunteer physicians and health care professionals, hospitals are able to provide low-cost or free health care to medically uninsured individuals. These healh care professionals donate their time, as long as the hospital incurs the cost of their salary; includes hospital subsidies such as grants, costs for staff time, equipment, overhead costs, lab and medication costs.