**HOSPITAL QUALITY MODEL REPORT: health topics**

**SPONSOR HOME PAGE**

*This page would be the normal home page of whatever group is releasing
the report in a particular state or community. The group might be, for
example, the State Health Department. The page would have a direct link
to the **Report Home Page**. We are thinking about using the following
language to introduce the Report. Note that throughout this document we
will refer to the entire template as "the Report" but it is presumed
that the name of the report will be chosen by the sponsor.*

**Announcing!**

(sponsor name) is proud to introduce a new tool to help the people and
hospitals of (insert location) learn about and improve the quality of
health care in our (community/state). The Report provides information
that lets you compare how well our hospitals perform when they take care
of patients with a wide range of health problems.

Whether you are choosing a hospital for yourself or a loved one, or just
want to see where a particular hospital performs well and how it might
improve its care, take advantage of this new resource. **[Go to Report
Home Page]{.underline}** *Note: this can be a "tab" on the website in
addition to having a link here*

National experts in medicine and hospital quality, led by the federal
government's lead agency for health care quality, provided the building
blocks for this tool. They identified the most readily available
information that can give an accurate picture of the quality and safety
of care at different hospitals. **[Click here to get Technical Details
about the Quality Information in the Report]{.underline}** *Note: this
can be a "tab" on the website in addition to having a link here*

They also asked people like you if this was information they would like
to have, and their answer was "yes!"

We hope you find this tool valuable. If you have questions, or want to
share your feedback on the tool, please email us at **[(insert email
address or provide link to feedback form]{.underline}).**

+-----------+----------+-----------+----------+----------+-----------+
| # [       | #        | #         | # [Thin  | #        | # [Ot     |
| Compare H |  [What i | [How shou | gs to Ke | [Technic | her Resou |
| ospital S | s Hospit | ld you us | ep in Mi | al Detai | rces]{.un |
| cores]{.u | al Quali | e this Re | nd]{.und | ls]{.und | derline}  |
| nderline} | ty?]{.un | port?]{.u | erline}  | erline}  |           |
|           | derline} | nderline} |          |          |           |
+-----------+----------+-----------+----------+----------+-----------+

**Report on Hospital Quality in** \[*community/state*\]

Quality in health care, including in hospitals, can be described as
"doing the right thing, at the right time, in the right way \-- and
having the best possible results."

This report provides information on how well all the hospitals in
(insert location) care for patients with a wide range of health
problems. It can:

-   help you choose a hospital for yourself,

-   provide useful information for your loved ones if they need hospital
    care,

-   encourage hospitals to improve their quality, and

-   help everyone learn more about hospital quality.

**Why should you look at this information?**

Don't people get good care in any hospital their doctor recommends? Here
are the facts:

-   All hospitals do not provide the same quality of care. Some
    hospitals are better than others.

-   A particular hospital might do a very good job on some health
    problems and not such a good job on other health problems.

-   Whenever anyone goes to the hospital, they risk getting a new health
    problem while getting medical care for an existing problem.
    Hospitals vary in how well they protect patients from these risks.

-   Your doctor, or the specialist or surgeon he or she recommends, may
    be highly skilled, but hospital quality also depends on how well
    **all** the hospital staff, such as the nurses, take care of you,
    and on how well the hospital is organized.

Given those facts, our goal is to give you information you can use to
increase your chances of getting the best possible hospital care when
you need it.

**What Information is available in the Report?**

There are three types of information in this Report:

-   how often patients had various medical complications while in the
    hospital

-   how often patients died while in the hospital for certain health
    conditions and operations

-   the number of times certain operations were done the way experts
    think they should be done.

This information is provided about \[insert #\] hospitals to help you
compare them to each other.

There are many ways to judge hospital quality. We are reporting this
information because experience shows it is accurate, easily available
for most hospitals from their administrative records, and of interest to
members of the public

**[Click here to start comparing hospitals' results]{.underline}**

**Getting Started...**

The information in this Report is organized into \[insert number\]
topics that relate to different types of health problems. We have
information on how well \[insert number\] hospitals performed on these
indicators. **Let's get started!**

**Step One: Choose one or more hospitals to compare**

*Sponsors: This is where you set up a search function through which
users will be able to enter information, such as a zip code or
city/state, and then view a list of the hospitals in your area which are
included in the report.*

**[Go to Health Topics Selection Page]{.underline}**

**HEALTH TOPICS SELECTION PAGE**

**Step Two: Pick the health care quality topic you want to learn
about.**

Quality information is available for ten topics. Some of the topics will
be interesting to many people; others will be interesting only to some.
For example, if you or a loved has a heart problem, you will probably be
interested in the "Heart Conditions" topic. On the other hand, anyone
facing a hospital stay should be interested in the topic "Medical
complications of all patients" since it discusses problems that can
occur for any hospital patient. With the exception of "Medical care for
children" and some information in "Childbirth," all information refers
to adult patients.

Within each topic we have information on several different *quality
indicators*. A quality indicator is a piece of information, usually a
number, that shows how often patients had a particular experience when
they received medical care. These experiences reflect a particular
aspect of hospital quality. Each health topic is briefly described
below, with examples of quality indicators for that topic. To learn
about all the indicators we present for each topic, click on the link at
the end of the topic description. You can return to this page and pick
another topic whenever you like.

-   ***Heart conditions:*** This section includes items such as how many
    patients died while hospitalized for heart attacks, and how often a
    hospital performs certain heart-related surgeries or procedures.
    **[Click here to see Quality Indicators for Heart
    Conditions]{.underline}**

-   ***Operations for cancer of the esophagus and pancreas**:* This
    section includes items related to cancer of the esophagus (the tube
    leading from the throat to the stomach) and the pancreas (a
    digestive organ). **[Click here to see Quality Indicators for Cancer
    of the Esophagus and Pancreas]{.underline}**

-   ***Brain and nervous system:*** This section includes indicators of
    how many patients died while hospitalized for a stroke, and how
    often hospitals did an operation to remove blockage in the arteries
    leading to the brain. **[Click here to see Quality Indicators for
    the Brain and Nervous System]{.underline}**

-   ***Childbirth:*** This section includes items such as how often a
    birth-related injury occurs to either the mother or the infant.
    **[Click here to see Quality Indicators for
    Childbirth]{.underline}**

-   ***Hip replacement and hip fracture:*** This section includes how
    many patients died in the hospital following hip replacement surgery
    or a hip fracture. **[Click here to see Quality Indicators for Hip
    Replacement and Hip Fracture]{.underline}**

-   ***Other surgeries:*** This section includes how many patients died
    when getting a repair of an abnormally enlarged artery supplying
    blood to lower half of the body, and how often the hospital performs
    this and selected other surgeries. **[Click here to see Quality
    Indicators for Other Surgeries]{.underline}**

-   ***Other health conditions:*** This section includes items such as
    how many patients died while hospitalized for pneumonia, and how
    often patients died after they came in with heavy bleeding in their
    stomach or intestines. **[Click here to see Quality Indicators for
    Other Health Conditions]{.underline}**

-   ***Medical complications of patients having an operation:*** This
    section discusses problems or complications patients can face after
    surgery. Examples are complications from anesthesia, and how often
    patients were infected following surgery. **[Click here to see
    Quality Indicators for Safety of Patients having
    Surgery]{.underline}**

-   ***Medical complications of all patients:*** This section includes
    items related to problems or complications that can be experienced
    by any hospital patient. Examples are how often patients get bed
    sores and how often patients die after developing a complication
    that should have been identified and treated. **[Click here to see
    Quality Indicators for Safety of All Patients]{.underline}**

-   ***Medical care for children:*** This section includes items such as
    how often children under the age of 18 have problems breathing after
    surgery, have a bad reaction to transfused blood or die after heart
    surgery. **[Click here to see Quality Indicators for Children's
    Medical Care.]{.underline}**

**Quality of care for heart conditions**

Information is available in the Report about five indicators of quality
of care for heart conditions. Definitions of each of the indicators are
provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for heart attack patients**

> Deaths in the hospital of patients who came in because they had a
> heart attack (which is called an *acute myocardial infarction*).

**□ Death rate for patients with congestive heart failure**

> Deaths in the hospital of patients who came in because they had heart
> failure (which is called *congestive heart failure*).

**□ Death rate for patient having a coronary artery bypass graft
(CABG)**

> Deaths in the hospital following an operation (called a *coronary
> artery bypass graft*, or *CABG*), which is designed to provide a way
> around clogged arteries in the heart.

**□ Death rate for patient having a percutaneous transluminal coronary
angioplasty (PTCA)**

> Deaths in the hospital following a procedure (called a *percutaneous
> transluminal coronary angioplasty*, or *PTCA*) in which clogged
> arteries of the heart are opened up, and then kept open using wire
> mesh tubes or "stents."

**□ Rate of cardiac catheterization procedures on both sides of the
heart**

> Many patients undergo a "cardiac catheterization" to learn how well
> the heart is working. Usually, this is done by putting tubes in the
> arteries on one side of the heart. This indicator shows how many
> patients getting this procedure have tubes put into the arteries on
> both sides of the heart (called a *bi-lateral cardiac
> catheterization*), which experts believe puts them at greater risk for
> complications.
>
> **Additional information: Number of operations**
>
> Information is also available about the number of times coronary
> artery bypass grafts (CABG) and percutaneous transluminal coronary
> angioplasties (PTCA) were done at individual hospitals. Research shows
> that, in general, when hospitals do these operations frequently, they
> are more likely to have good results. However, experts do not always
> agree on the minimum number needed to achieve high quality. You will
> find graphs for these indicators on the same page as the death rate.

**Compare Hospital Scores**

**Compare hospital scores on heart conditions**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names to see detailed results on how each
hospital performed.**

+-------------------------+--------------------------------------------+
| **Death rate** is the   | **A hospital's score is calculated in      |
| percent of patients who | comparison to the average of hospitals     |
| were treated for a      | across the state.**                        |
| particular illness or   |                                            |
| had a particular        | Average is about the same as the average   |
| procedure who died      | of hospitals across the state.             |
| while in each hospital  |                                            |
| during \[insert year\]. | **Better than average** is better than the |
|                         | average of hospitals across the state.     |
| **Rate** is the percent |                                            |
| of patients having a    | **Worse than average** is worse than the   |
| particular procedure    | average of hospitals across the state.     |
| who had it done in one  |                                            |
| way rather than         |                                            |
| another.                |                                            |
+-------------------------+--------------------------------------------+

+--------------------------+---------+---------+----------+---------+
| **Heart Conditions**     | **H     | **H     | **       | **H     |
|                          | ospital | ospital | Hospital | ospital |
|                          | A**     | B**     | C**      | D**     |
+--------------------------+---------+---------+----------+---------+
| [Death rate for heart    | **B     | Average | *        | **B     |
| attack                   | etter** |         | *Worse** | etter** |
| patients]{.underline}    |         |         |          |         |
|                          | **Than  |         | **than   | **than  |
| The average rate of      | av      |         | a        | av      |
| death for hospitals      | erage** |         | verage** | erage** |
| across the state is      |         |         |          |         |
| **[9]{.underline}** for  |         |         |          |         |
| every **100** patients.  |         |         |          |         |
+--------------------------+---------+---------+----------+---------+
| [Death rate for patients | **B     | **      | Average  | **B     |
| with congestive heart    | etter** | Worse** |          | etter** |
| failure]{.underline}     |         |         |          |         |
|                          | **Than  | **Than  |          | **than  |
| The average rate of      | av      | av      |          | av      |
| death for hospitals      | erage** | erage** |          | erage** |
| across the state is      |         |         |          |         |
| **[4]{.underline}** for  |         |         |          |         |
| every **100** patients.  |         |         |          |         |
+--------------------------+---------+---------+----------+---------+
| [Death rate for patients | Average | **      | Average  | **B     |
| having CABG (coronary    |         | Worse** |          | etter** |
| artery bypass            |         |         |          |         |
| graft)]{.underline}      |         | **Than  |          | **than  |
|                          |         | av      |          | av      |
| The average rate of      |         | erage** |          | erage** |
| death for hospitals      |         |         |          |         |
| across the state is      |         |         |          |         |
| [**3**]{.underline} for  |         |         |          |         |
| every **100** patients.  |         |         |          |         |
+--------------------------+---------+---------+----------+---------+
| [Death rate for patients | **B     | **      | **       | Average |
| having                   | etter** | Worse** | Better** |         |
| PTCA (percutaneous       |         |         |          |         |
| transluminal coronary    | **Than  | **Than  | **Than   |         |
| a                        | av      | av      | a        |         |
| ngioplasty)]{.underline} | erage** | erage** | verage** |         |
|                          |         |         |          |         |
| The average rate of      |         |         |          |         |
| death for hospitals      |         |         |          |         |
| across the state is      |         |         |          |         |
| **[10]{.underline}** for |         |         |          |         |
| every **1,000**          |         |         |          |         |
| patients.                |         |         |          |         |
+--------------------------+---------+---------+----------+---------+
| [Rate of patients having | **B     | **B     | *        | Average |
| cardiac catheterization  | etter** | etter** | *Worse** |         |
| procedures on both sides |         |         |          |         |
| of the                   | **Than  | **Than  | **Than   |         |
| heart]{.underline}       | av      | av      | a        |         |
|                          | erage** | erage** | verage** |         |
| The average rate of      |         |         |          |         |
| death for hospitals      |         |         |          |         |
| across the state is      |         |         |          |         |
| **[7]{.underline}** for  |         |         |          |         |
| every **100** patients.  |         |         |          |         |
+--------------------------+---------+---------+----------+---------+

**Death rate for heart attack patients**

This graph shows you the percent of patients admitted to each hospital
after having a heart attack (called an *acute myocardial infarction*),
who died during their hospital stay. This information is for patients
admitted during \[insert year\].

When you are choosing a hospital, you should look for the hospital that
has a lower number of deaths. A **[lower]{.underline}** number is shown
by a **[shorter]{.underline}** bar on the graph below.

![](media/image1.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
who died after having a heart attack, in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Death rate of patients with congestive heart failure**

This graph shows you the percent of patients who were admitted to a
hospital because they had heart failure (called *congestive heart
failure*), who died during their hospital stay. This information is for
patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
lower number of deaths. A **[lower]{.underline}** number is shown by a
**[shorter]{.underline}** bar on the graph below.

![](media/image2.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
who died after being admitted because they had congestive heart failure
in hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Coronary artery bypass graft (CABG) -- death rate and number of
operations**

The two graphs on this page show you the quality of hospital care
related to coronary artery bypass grafts (CABG), a procedure designed to
restore the natural flow of blood in the heart. This information is for
patients admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
patients died after they had a CABG. The graph on the
[right]{.underline} shows you the number of times a hospital performed a
CABG. Research shows that, in general, when hospitals do these
procedures frequently, they are more likely to have good results. Often,
but not always, a hospital that has a higher number of operations (right
graph) will have lower death rates (left graph).

+-----------------------------------+-----------------------------------+
| **Death rate for coronary artery  | **Number of coronary artery       |
| bypass graft**                    | bypass grafts**                   |
+-----------------------------------+-----------------------------------+
| When choosing a hospital, look    | > When choosing a hospital, look  |
| for the hospital that has a       | > for the hospital that has a     |
| **[lower]{.underline}** number of | > **[higher]{.underline}** number |
| deaths. A **[lower]{.underline}** | > of operations. A                |
| number is shown by a              | > **[higher]{.underline}** number |
| **[shorter]{.underline}** bar on  | > is shown by a                   |
| the graph below.                  | > **[longer]{.underline}** bar on |
|                                   | > the graph below.                |
+-----------------------------------+-----------------------------------+
| ![](media/image3                  | ![](media/image4                  |
| .wmf){width="5.048611111111111in" | .wmf){width="5.045833333333333in" |
| height="3.515972222222222in"}     | height="3.5055555555555555in"}    |
+-----------------------------------+-----------------------------------+
| **Average of hospitals across the | **Average of hospitals across the |
| state:** The average rate of      | state:** The average number of    |
| patients who died after this      | operations done by hospitals      |
| operation in hospitals across     | across your state. This number is |
| your state. This number is        | included so you have a better     |
| included so you have:             | idea of what is typical for your  |
|                                   | state.                            |
| -   a better idea of what is      |                                   |
|     typical for your state.       |                                   |
|                                   |                                   |
| -   a basis for comparing         |                                   |
|     individual hospitals'         |                                   |
|     performance.                  |                                   |
+-----------------------------------+-----------------------------------+

**Percutaneous transluminal coronary angioplasty (PTCA) -- death rate
and number of procedures**

The two graphs on this page show you the quality of hospital care
related to percutaneous transluminal coronary angioplasty (PTCA), a
procedure in which clogged arteries of the heart are opened up, and then
kept open using wire mesh tubes or "stents." This information is for
patients admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
patients died after having a PTCA. The graph on the [right]{.underline}
shows you the number of times a hospital performed this procedure.
Research shows that, in general, when hospitals do these procedures
frequently, they are more likely to have good results. Often, but not
always, a hospital that has a higher number of procedures (right graph)
will have lower death rates (left graph).

+-----------------------------------+----------------------------------+
| **Death rate for percutaneous     | **Number of percutaneous         |
| transluminal coronary             | transluminal coronary            |
| angioplasty**                     | angioplasties**                  |
+-----------------------------------+----------------------------------+
| > When choosing a hospital, you   | > When choosing a hospital, you  |
| > should look for the hospital    | > should look for the hospital   |
| > that has a                      | > that has a                     |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > of deaths. A                    | > number of operations. A        |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > is shown by a                   | > number is shown by a           |
| > **[shorter]{.underline}** bar   | > **[longer]{.underline}** bar   |
| > on the graph below.             | > on the graph below.            |
+-----------------------------------+----------------------------------+
| ![](media/image5                  | ![](media/image6.                |
| .wmf){width="4.979166666666667in" | wmf){width="5.024305555555555in" |
| height="3.4680555555555554in"}    | height="3.4902777777777776in"}   |
+-----------------------------------+----------------------------------+
| **Average of hospitals across the | > **Average of hospitals across  |
| state:** The average rate of      | > the state:** The average       |
| patients who died after this      | > number of procedures done by   |
| procedure in hospitals across     | > hospitals across your state.   |
| your state. This number is        | > This number is included so you |
| included so you have:             | > have a better idea of what is  |
|                                   | > typical for your state.        |
| -   a better idea of what is      |                                  |
|     typical for your state.       |                                  |
|                                   |                                  |
| -   a basis for comparing         |                                  |
|     individual hospitals'         |                                  |
|     performance.                  |                                  |
+-----------------------------------+----------------------------------+

**Rate of cardiac catheterization procedures on both sides of the
heart**

This graph shows you how often each hospital performs a "cardiac
catheterization" to measure how well the heart is working, by putting
tubes in the arteries on both sides of the heart rather than on just one
side. (This is called a *bi-lateral cardiac catheterization*.) Most
experts believe that it is better to put tubes only on one side of the
heart (a *uni-lateral catheterization*), so they would look for low
scores on this indicator. This information is for patients admitted
during \[insert year\].

When you are choosing a hospital, look for the hospital that has a lower
rate of bilateral cardiac catheterization. A **[lower]{.underline}**
rate is shown by a **[shorter]{.underline}** bar on the graph below.

![](media/image7.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state**: The average rate of patients
who had cardiac catheterization procedures on both sides of the heart,
in hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

# Quality of care for operations for cancer of the esophagus & pancreas

Information is available in the Report about two quality indicators for
cancers of the esophagus and the pancreas. Definitions of each of the
indicators are provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for operations to remove part or all of the esophagus**

> How often patients died in the hospital after an operation to remove
> part or all of their esophagus (the tube leading from the throat to
> the stomach). (This is called *esophageal resection*.)

**□ Death rate for operations to remove part or all of the pancreas**

> How often patients died in the hospital after an operation to remove
> part or all of their pancreas (a digestive organ). (This is called
> *pancreatic resection*.)
>
> **Additional information: Number of operations**
>
> Information is also available about the number of times these
> operations were done at individual hospitals. Research shows that, in
> general, when hospitals do these operations frequently, they are more
> likely to have good results. However, experts do not always agree on
> the minimum number needed to achieve high quality.
>
> You will find graphs for these indicators on the same page as the
> death rate.

**Compare Hospital Scores**

**Compare hospital scores on operations for cancer of the esophagus &
pancreas**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+----------------+-----------------------------------------------------+
| **Death rate** | **A hospital's score is calculated in comparison to |
| is the percent | the average of hospitals across the state.**        |
| of patients    |                                                     |
| who had a      | Average is about the same as the average of         |
| particular     | hospitals across the state.                         |
| procedure who  |                                                     |
| died while in  | **Better than average** is better than the average  |
| each hospital  | of hospitals across the state.                      |
| during         |                                                     |
| \[insert       | **Worse than average** is worse than the average of |
| year\].        | hospitals across the state.                         |
+----------------+-----------------------------------------------------+

+--------------------------+----------+----------+----------+----------+
| **Operations for cancer  | **       | **       | **       | **       |
| of the esophagus &       | Hospital | Hospital | Hospital | Hospital |
| pancreas**               | A**      | B**      | C**      | D**      |
+--------------------------+----------+----------+----------+----------+
| [Death rate for          | **       | *        | **       | average  |
| operations to remove     | Better** | *Worse** | Better** |          |
| part or all of the       |          |          |          |          |
| esophagus]{.underline}   | **than   | **than   | **than   |          |
|                          | a        | a        | a        |          |
| The average rate of      | verage** | verage** | verage** |          |
| death for hospitals      |          |          |          |          |
| across the state is      |          |          |          |          |
| [**9**]{.underline} for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Death rate for          | average  | *        | **       | average  |
| operations to remove     |          | *Worse** | Better** |          |
| part or all of the       |          |          |          |          |
| pancreas]{.underline}    |          | **than   | **than   |          |
|                          |          | a        | a        |          |
| The average rate of      |          | verage** | verage** |          |
| death for hospitals      |          |          |          |          |
| across the state is      |          |          |          |          |
| [**7**]{.underline} for  |          |          |          |          |
| every **100** patients.  |          |          |          |          |
+--------------------------+----------+----------+----------+----------+

**Removal of part or all of the esophagus -- death rate and number of
operations**

The two graphs on this page show you the quality of hospital care for
operations to remove part of the esophagus (the tube leading from the
throat to the stomach), usually because of cancer. This information is
for patients admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows how often
patients died following this operation. The graph on the
[right]{.underline} side of the page shows the number of times a
hospital performed this operation. This is a rare procedure. Research
shows that, in general, when hospitals do these procedures frequently,
they are more likely to have good results. Often, but not always, a
hospital that has a higher number of operations (right graph) will have
lower death rates (left graph).

+-----------------------------------+----------------------------------+
| **Death rate for operations to    | **Number of operations to remove |
| remove part or all of the         | part or all of the esophagus**   |
| esophagus**                       |                                  |
+-----------------------------------+----------------------------------+
| > When choosing a hospital, you   | > When choosing a hospital, you  |
| > should look for the hospital    | > should look for the hospital   |
| > that has a                      | > that has a                     |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > of deaths. A                    | > number of operations. A        |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > is shown by a                   | > number is shown by a           |
| > **[shorter]{.underline}** bar   | > **[longer]{.underline}** bar   |
| > on the graph below.             | > on the graph below.            |
+-----------------------------------+----------------------------------+
| ![](me                            | ![](media/image9.                |
| dia/image8.wmf){width="4.91875in" | wmf){width="4.949305555555555in" |
| height="3.623611111111111in"}     | height="3.5708333333333333in"}   |
| Error: Reference source not found |                                  |
+-----------------------------------+----------------------------------+
| **Average of hospitals across the | > **Average of hospitals across  |
| state:** The average rate of      | > the state:** The average       |
| patients who died following this  | > number of operations done by   |
| operation in hospitals across     | > hospitals across your state.   |
| your state. This number is        | > This number is                 |
| included so you have:             | >                                |
|                                   | > included so you have a better  |
| -   a better idea of what is      | > idea of what is typical for    |
|     typical for your state.       | > your state.                    |
|                                   |                                  |
| -   a basis for comparing         |                                  |
|     individual hospitals'         |                                  |
|     performance.                  |                                  |
+-----------------------------------+----------------------------------+

**Removal of part of the pancreas -- death rate and number of
operations**

The two graphs on this page show you the quality of hospital care for
operations to remove part of the pancreas (a digestive organ), usually
because of cancer. This information is for patients admitted during
\[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
patients died following this surgery. The graph on the
[right]{.underline} side of the page shows you the number of times a
hospital performed this operation. This is a rare procedure. Research
shows that, in general, when hospitals do these procedures frequently,
they are more likely to have good results. Often, but not always, a
hospital that has a higher number of operations (right graph) will have
lower death rates (left graph).

+-----------------------------------+----------------------------------+
| **Death rate for operations to    | **Number of operations to remove |
| remove part or all of the         | part or all of the pancreas**    |
| pancreas**                        |                                  |
+-----------------------------------+----------------------------------+
| > When choosing a hospital, you   | > When choosing a hospital, you  |
| > should look for the hospital    | > should look for the hospital   |
| > that has a                      | > that has a                     |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > of deaths. A                    | > number of operations. A        |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > is shown by a                   | > number is shown by a           |
| > **[shorter]{.underline}** bar   | > **[longer]{.underline}** bar   |
| > on the graph below.             | > on the graph below.            |
+-----------------------------------+----------------------------------+
| ![](media/image10.                | ![](media/image11.               |
| wmf){width="5.2131944444444445in" | wmf){width="4.969444444444444in" |
| height="3.6375in"}                | height="3.654861111111111in"}    |
+-----------------------------------+----------------------------------+
| **Average of hospitals across the | -   **Average of hospitals       |
| state:** The average rate of      |     across the state:** The      |
| patients who died following this  |     average number of operations |
| operation in hospitals across     |     done in hospitals across     |
| your state. This number is        |     your state. This number is   |
| included so you have:             |     included so you have a       |
|                                   |     better idea of what is       |
| -   a better idea of what is      |     typical for your state.      |
|     typical for your state.       |                                  |
|                                   |                                  |
| -   a basis for comparing         |                                  |
|     individual hospitals'         |                                  |
|     performance.                  |                                  |
+-----------------------------------+----------------------------------+

**Quality in care of the brain and nervous system**

Information is available in the Report about three indicators related to
quality of care for conditions relating to the brain and nervous system.
Definitions of each of the indicators are provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for an operation to remove blockage arteries to the
brain**

> How often patients died in the hospital after an operation to remove
> blockage in the arteries leading to the brain. (This is called
> *carotid endarterectomy*).

**□ Death rate for brain surgery**

> How often patients died in the hospital following brain surgery. (This
> is called a *craniotomy*).

**□ Death rate for stroke**

> How often patients died in the hospital who came in after having a
> stroke.
>
> **Additional information: Number of operations**
>
> Information is also available about the number of times the operation
> to remove blockage in brain arteries was done at individual hospitals.
> Research shows that, in general, when hospitals do these operations
> frequently, they are more likely to have good results. However,
> experts do not always agree on the minimum number needed to achieve
> high quality.
>
> You will find a graph for this indicator on the same page as the death
> rate.

**Compare Hospital Scores**

**Compare hospital scores on the brain and nervous system**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+----------------+-----------------------------------------------------+
| **Death rate** | **A hospital's score is calculated in comparison to |
| is the percent | the average of hospitals across the state.**        |
| of patients    |                                                     |
| who were       | Average is about the same as the average of         |
| treated for a  | hospitals across the state.                         |
| particular     |                                                     |
| illness or had | **Better than average** is better than the average  |
| a particular   | of hospitals across the state.                      |
| procedure who  |                                                     |
| died while in  | **Worse than average** is worse than the average of |
| each hospital  | hospitals across the state.                         |
| during         |                                                     |
| \[insert       |                                                     |
| year\].        |                                                     |
+----------------+-----------------------------------------------------+

+--------------------------+----------+----------+----------+----------+
| **Brain and nervous      | ## Ho    | **       | **       | **       |
| system**                 | spital A | Hospital | Hospital | Hospital |
|                          |          | B**      | C**      | D**      |
+--------------------------+----------+----------+----------+----------+
| [Death rate for          | **       | *        | average  | *        |
| operation to remove      | Better** | *Worse** |          | *Worse** |
| blockage in arteries to  |          |          |          |          |
| the brain]{.underline}   | **than   | **than   |          | **than   |
|                          | a        | a        |          | a        |
| The average rate of      | verage** | verage** |          | verage** |
| death for hospitals      |          |          |          |          |
| across the state is      |          |          |          |          |
| [**7**]{.underline} for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Death rate for brain    | average  | **       | *        | *        |
| surgery]{.underline}     |          | Better** | *Worse** | *Worse** |
|                          |          |          |          |          |
| The average rate of      |          | **than   | **than   | **than   |
| death for hospitals      |          | a        | a        | a        |
| across the state is      |          | verage** | verage** | verage** |
| [**6**]{.underline} for  |          |          |          |          |
| every **100** patients.  |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Death rate for          | **       | average  | *        | **       |
| stroke]{.underline}      | Better** |          | *Worse** | Better** |
|                          |          |          |          |          |
| The average rate of      | **than   |          | **than   | **than   |
| death for hospitals      | a        |          | a        | a        |
| across the state is      | verage** |          | verage** | verage** |
| **[10]{.underline}** for |          |          |          |          |
| every **100** patients.  |          |          |          |          |
+--------------------------+----------+----------+----------+----------+

**Removal of blockage in arteries to the brain-- death rate and number
of operations**

The two graphs on this page show you the quality of hospital care
related to an operation to remove blockage of the arteries leading to
the brain, called a *carotid endarterectomy*. This information is for
patients admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
patients died after having this operation. The graph on the
[right]{.underline} shows you the number of times a hospital performed
this operation. Research shows that, in general, when hospitals do these
procedures frequently, they are more likely to have good results. Often,
but not always, a hospital that has a higher number of operations (right
graph) will have lower death rates (left graph).

+-----------------------------------+----------------------------------+
| **Death rate for an operation to  | **Number of operations to remove |
| remove blockage in arteries to    | blockage in arteries**           |
| the brain**                       |                                  |
|                                   | **to the brain**                 |
+-----------------------------------+----------------------------------+
| > When you are choosing a         | > When you are choosing a        |
| > hospital, you should look for   | > hospital, you should look for  |
| > the hospital that has a         | > the hospital that has a        |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > of deaths. A                    | > number of operations. A        |
| > **[lower]{.underline}** number  | > **[higher]{.underline}**       |
| > is shown by a                   | > number is shown by a           |
| > **[shorter]{.underline}** bar   | > **[longer]{.underline}** bar   |
| > on the graph below.             | > on the graph below.            |
+-----------------------------------+----------------------------------+
| ![](med                           | ![](                             |
| ia/image12.wmf){width="5.13125in" | media/image13.wmf){width="5.1in" |
| height="3.564583333333333in"}     | height="3.5395833333333333in"}   |
+-----------------------------------+----------------------------------+
| **Average of hospitals across the | **Average of hospitals across    |
| state:** The average rate of      | the state:** The average number  |
| patients who died following this  | of operations performed in       |
| operation in hospitals across     | hospitals across your state.     |
| your state This number is         | This number is included so you   |
| included so you have:             | have a better idea of what is    |
|                                   | typical for your state.          |
| -   a better idea of what is      |                                  |
|     typical for your state.       |                                  |
|                                   |                                  |
| -   a basis for comparing         |                                  |
|     individual hospitals'         |                                  |
|     performance.                  |                                  |
+-----------------------------------+----------------------------------+

**Death rate for brain surgery**

This graph shows you the percent of patients who died after brain
surgery (called a *craniotomy*). This information is for patients
admitted during \[insert year\].

When you are choosing a hospital, you should look for the hospital that
has a **[lower]{.underline}** number of deaths for this operation. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image14.wmf){width="5.34375in" height="3.71875in"}

**Average of hospitals across the state:** The average rate of patients
who died in the hospital after brain surgery, across your state. This
number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

# Death rate for stroke patients

This graph shows you the percent of patients who died after being
admitted to the hospital because they had a stroke. This information is
for patients admitted during \[insert year\].

When you are choosing a hospital, you should look for the hospital that
has a **[lower]{.underline}** number of deaths. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image15.wmf){width="5.333333333333333in"
height="3.7083333333333335in"}

**Average of hospitals across the state:** The average rate of patients
who died after being admitted because they had a stroke, in hospitals
across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Quality of childbirth**

Information is available in the Report about four indicators of
childbirth quality and safety. Definitions of each of the indicators are
provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

-   **Rate of birth injury or infection to newborn**

> How often a newborn infant experiences a problem during the birth
> process (labor or delivery) such as a broken collarbone, an infection,
> or a head injury.

-   **Rate of obstetric tearing -- vaginal delivery with medical
    instruments**

> How often a woman experiences a tear (trauma) to her perineum -- the
> area between her vagina and rectum -- while giving birth, when a
> health care provider is helping to deliver her baby using a forceps or
> other medical instrument. Such tears are often preventable.

-   **Rate of obstetric tearing -- vaginal delivery without medical
    instruments**

> How often a woman experiences a tear (trauma) to her perineum -- the
> area between her vagina and rectum -- while giving birth. Such tears,
> which can happen even when medical instruments are not used, are often
> preventable.

-   **Rate of obstetric tearing -- Cesarean delivery**

> How often a woman experiences a tear (trauma) in her perineum -- the
> area between her vagina an rectum -- or to any of the birth-related
> organs inside her body, during a Cesarean (surgical) delivery of a
> baby. Such tears are often preventable.

**Compare Hospital Scores**

**Utilization rates for Cesarean section and vaginal birth after
Cesarean (VBAC)**

Information is also available about the proportion of deliveries in a
hospital that are performed by Cesarean section, which involves surgery,
and the proportion of deliveries in which a woman who previously had a
Cesarean section give birth normally (vaginally). **These are not
quality indicators**, but if you are interested in learning about these
rates, **[Click here for Utilization Rates.]{.underline}**

**Compare hospital scores on childbirth**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+---------------+------------------------------------------------------+
| **Rate** is   | **A hospital's score is calculated in comparison to  |
| the percent   | the average of hospitals across the state.**         |
| of mothers or |                                                      |
| babies who    | Average is about the same as the average of          |
| experienced a | hospitals across the state.                          |
| particular    |                                                      |
| problem       | **Better than average** is better than the average   |
| during        | of hospitals across the state.                       |
| childbirth    |                                                      |
| during        | **Worse than average** is worse than the average of  |
| \[insert      | hospitals across the state.                          |
| year\].       |                                                      |
+---------------+------------------------------------------------------+

+--------------------------+----------+----------+----------+----------+
| **Childbirth**           | **       | **       | **       | **       |
|                          | Hospital | Hospital | Hospital | Hospital |
|                          | A**      | B**      | C**      | D**      |
+--------------------------+----------+----------+----------+----------+
| [Rate of birth injury or | Average  | **       | **       | **       |
| infection in             |          | Better** | Better** | Better** |
| newborns]{.underline}    |          |          |          |          |
|                          |          | **than   | **than   | **than   |
| The average rate for     |          | a        | a        | a        |
| hospitals across the     |          | verage** | verage** | verage** |
| state is                 |          |          |          |          |
| **[6]{.underline}** for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of obstetric       | **Worse  | Average  | **       | Average  |
| tearing, vaginal         | than     |          | Better** |          |
| delivery, without        | A        |          |          |          |
| instruments]{.underline} | verage** |          | **than   |          |
|                          |          |          | a        |          |
| The average rate for     |          |          | verage** |          |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[46]{.underline}** for |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of obstetric       | **Worse  | Average  | **       | **       |
| tearing, vaginal         | than     |          | Better** | Better** |
| delivery, with           | A        |          |          |          |
| instruments]{.underline} | verage** |          | **than   | **than   |
|                          |          |          | a        | a        |
| The average rate for     |          |          | verage** | verage** |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[191]{.underline}**    |          |          |          |          |
| for every **1,000**      |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of obstetric       | **       | **       | Average  | Average  |
| tearing, Cesarean        | Better** | Better** |          |          |
| section]{.underline}     |          |          |          |          |
|                          | **than   | **than   |          |          |
| The average rate for     | a        | a        |          |          |
| hospitals across the     | verage** | verage** |          |          |
| state is                 |          |          |          |          |
| [**4**]{.underline} for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+

**Rate of birth injury or infection in newborns**

This graph shows you the percent of newborn babies who experienced an
injury or other problem during the birth process (labor or delivery)
such as a broken collarbone or head injury. This information is for
newborns delivered in hospitals in \[insert year\].

When choosing a hospital, look for the hospital that has lower numbers
for this indicator. A **[lower]{.underline}** number is shown by a
**[shorter]{.underline}** bar on the graph below.

![](media/image16.wmf){width="4.645833333333333in"
height="3.8229166666666665in"}

**Average of hospitals across the state:** The average rate of birth
injuries or infections in newborns in hospitals across your state.

This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of obstetric tearing - vaginal delivery with medical instrument**

This graph shows you the percent of women who experienced a tear in
their pelvic area or pelvic organ (*obstetric trauma*) while giving
birth, when a health care provider was helping to deliver the baby using
a forceps or other medical instrument. This information is for patients
admitted to a hospital in \[insert year\].

When choosing a hospital, you should look for the hospital that has
lower numbers for this indicator. A **[lower]{.underline}** number is
shown by a **[shorter]{.underline}** bar on the graph below.

![](media/image17.wmf){width="4.65625in" height="3.8333333333333335in"}

**Average of hospitals across the state:** The average rate of obstetric
tearing, in vaginal deliveries using medical instruments, in hospitals
across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of obstetric tearing -- vaginal delivery without medical
instrument**

This graph shows you the percent of women who experienced a tear in
their pelvic area or pelvic organ (*obstetric trauma*) while giving
birth, even though no forceps or other medical instruments were used.
This information is for patients admitted to a hospital in 2004.

When choosing a hospital, you should look for a hospital that has lower
numbers on this indicator. A **[lower]{.underline}** number is shown by
a **[shorter]{.underline}** bar on the graph below.

![](media/image18.wmf){width="4.666666666666667in" height="3.84375in"}

**Average of hospitals across the state:** The average rate of obstetric
tearing, in vaginal deliveries without using medical instruments, in
hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of obstetric tearing -- Cesarean delivery**

This graph shows you the percent of women who experienced a tear in
their pelvic area or any of the birth-related organs inside her body
(*obstetric trauma*), during a Cesarean (surgical) delivery of a baby.

When choosing a hospital, you should look for a hospital that has lower
numbers for this indicator. A **[lower]{.underline}** number is shown by
a **[shorter]{.underline}** bar on the graph below.

![](media/image19.wmf){width="5.15625in" height="3.8541666666666665in"}

**Average of hospitals across the state:** The average rate of obstetric
tearing during Cesarean deliveries, in hospitals across your state. This
number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Additional information on childbirth:**

**Utilization rates\* for Cesarean section**

The following information relates to Cesarean section (childbirth
involving an operation). These are not indicators of quality, since
health experts don't know which utilization rates are better or worse
for these procedures. However, if a woman has a strong preference either
for having or avoiding a Cesarean section, and her doctor confirms that
her preference is safe for her, these utilization rates may provide some
useful information.

**\***The **utilization rate** is the number of times a hospital did a
particular medical procedure during \[insert year\].

**Please check the box next to each utilization rate you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Utilization Rates**

-   **Utilization rate for Cesarean section delivery**

> How often babies in the hospital are delivered using Cesarean section,
> which involves an operation, instead of by normal/vaginal delivery.

-   **Utilization rate for Cesarean section delivery, first birth**

> How often babies in the hospital are delivered using Cesarean section,
> which involves an operation, instead of by normal/vaginal delivery --
> where this is the mother's first birth.

-   **Rate of vaginal birth after Cesarean (VBAC) among women at low
    risk of needing a Cesarean section**

> How often babies in the hospital are delivered normally -- meaning
> with a vaginal birth -- when the mother previously delivered by
> Cesarean section (involving an operation), and she is not facing a
> high risk of needing another Cesarean for other medical reasons.

-   **Rate of vaginal birth after Cesarean (VBAC), all**

> How often babies in the hospital are delivered normally -- meaning
> with a vaginal birth -- where the mother has previously delivered by
> Cesarean section (involving an operation). The difference between this
> indicator and the one above it is that this one counts
> [all]{.underline} VBACs, no matter how much the mother was at risk of
> needing another Cesarean.

*Note to sponsor: Choose only one of the two VBAC rates to report, not
both.*

**Compare Utilization Rates**

**Utilization rate for Cesarean section delivery**

This graph shows you the percent of babies in each hospital who were
delivered using Cesarean section, which involves an operation, instead
of by normal (vaginal) delivery. This information is for patients
admitted to a hospital during \[insert year\].

![](media/image20.wmf){width="4.645833333333333in"
height="3.8229166666666665in"}

**Average of hospitals across the state:** The average rate of babies
delivered using Cesarean section across your state. This number is
included so you have a better idea of what is typical for your state.

**Rate for Cesarean section delivery, first birth**

This graph shows you the percent of babies in each hospital delivered
using Cesarean section, which involves an operation, instead of by
normal (vaginal) delivery -- where this is the mother's first (primary)
birth. This information is for patients admitted to a hospital during
\[insert year\].

![](media/image21.wmf){width="4.65625in" height="3.8333333333333335in"}

**Average of hospitals across the state:** The average number of babies
delivered by Cesarean section, where this is the mother's first birth,
across your state. This number is included so you have a better idea of
what is typical for your state.

**Rate of vaginal birth after Cesarean (VBAC) among women at low risk of
needing a Cesarean section**

This graph shows you the percent of babies in each hospital who were
delivered normally -- meaning with a vaginal birth -- when the mother
delivered an earlier baby by Cesarean section (involving an operation),
and she is not facing a high risk of needing another Cesarean for other
reasons. This information is for patients admitted to a hospital during
\[insert year\].

![](media/image22.wmf){width="4.885416666666667in"
height="3.8541666666666665in"}

**Average of hospitals across the state:** The average rate of
uncomplicated vaginal births after a Cesarean section, across your
state. This number is included so you have a better idea of what is
typical for your state.

**Rate of vaginal birth after Cesarean (VBAC), all**

This graph shows you the percent of babies who were delivered normally
-- meaning with a vaginal birth -- where the mother previously delivered
by Cesarean section (involving an operation). The difference between
this indicator and the previous one is that this one counts all VBACs,
even those where a complication occurred during childbirth. This
information is for patients admitted to a hospital during \[insert
year\].

![](media/image23.wmf){width="4.666666666666667in" height="3.84375in"}

**Average of hospitals across the state:** The average rate of vaginal
births after a Cesarean section, across your state. This number is
included so you have a better idea of what is typical for your state.

**Quality of care for hip replacement and hip fracture**

Information is available in the Report about two indicators for care for
hip replacement and hip fracture. Definitions of each of the indicators
are provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for patients with a broken hip**

> How often patients died in the hospital who came in with a broken hip
> (hip fracture).

**□ Death rate for hip replacement surgery**

> How often patients died in the hospital after an operation to replace
> a bad hip.

**Compare Hospital Scores**

**Compare hospital scores** **for hip replacement and hip fracture**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+-----------------+----------------------------------------------------+
| **Death rate**  | **A hospital's score is calculated in comparison   |
| is the percent  | to the average of hospitals across the state.**    |
| of patients who |                                                    |
| were treated    | Average is about the same as the average of        |
| for a           | hospitals across the state.                        |
| particular      |                                                    |
| illness or had  | **Better than average** is better than the average |
| a particular    | of hospitals across the state.                     |
| procedure who   |                                                    |
| died while in   | **Worse than average** is worse than the average   |
| each hospital   | of hospitals across the state.                     |
| during \[insert |                                                    |
| year\].         |                                                    |
+-----------------+----------------------------------------------------+

+---------------------------+----------+---------+---------+---------+
| **Hip replacement and hip | **       | **H     | **H     | **H     |
| fracture**                | Hospital | ospital | ospital | ospital |
|                           | A**      | B**     | C**     | D**     |
+---------------------------+----------+---------+---------+---------+
| [Death rate for patients  | **       | **      | average | average |
| with a broken             | Better** | Worse** |         |         |
| hip]{.underline}          |          |         |         |         |
|                           | **than   | **than  |         |         |
| The average rate of death | a        | av      |         |         |
| for hospitals across the  | verage** | erage** |         |         |
| state is                  |          |         |         |         |
| **[3]{.underline}** for   |          |         |         |         |
| every **100** patients.   |          |         |         |         |
+---------------------------+----------+---------+---------+---------+
| [Death rate for hip       | **       | **      | average | average |
| replacement               | Better** | Worse** |         |         |
| surgery]{.underline}      |          |         |         |         |
|                           | **than   | **than  |         |         |
| The average rate of death | a        | av      |         |         |
| for hospitals across the  | verage** | erage** |         |         |
| state is                  |          |         |         |         |
| **[3]{.underline}** for   |          |         |         |         |
| every **1,000** patients. |          |         |         |         |
+---------------------------+----------+---------+---------+---------+

**Death rate for patients with a broken hip**

This graph shows you the percent of patients who died in the hospital,
who came in with a broken hip (hip fracture). This information is for
patients admitted during \[insert year\].

Deaths due to a broken hip are very rare. When choosing a hospital, you
should look for the hospital with a **[lower]{.underline}** number for
this condition. A **[lower]{.underline}** number is shown by a
**[shorter]{.underline}** bar on the graph below.

![](media/image24.wmf){width="5.364583333333333in"
height="3.7395833333333335in"}

**Average of hospitals across the state:** The average rate of patients
who died after being admitted with a broken hip, in hospitals across
your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Death rate for hip replacement surgery**

This graph shows you the percent of patients who died after surgery to
replace a bad hip. This is a fairly common operation that is not usually
complicated. Death rates should be extremely low. This information is
for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
[**lower**]{.underline} number of deaths. A **[lower]{.underline}**
number is shown by a **[shorter]{.underline}** bar on the graph below.

![](media/image25.wmf){width="5.375in" height="3.75in"}

**Average of hospitals across the state:** The average rate of patients
who died in the hospital after hip replacement surgery, across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Quality of care for other surgeries**

Information is available in the Report about three indicators of quality
related to other surgical procedures. Definitions of each of the
indicators are provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for surgical repair of an aortic aneurysm**

> How often patients died in the hospital after an operation (called an
> *abdominal aortic aneurysm repair*) to repair an enlarged blood vessel
> supplying blood to the lower half of the body.

**□ Rate of gallbladder removal using minimally-invasive (laparoscopic)
surgery**

> How often a hospital did an operation to remove a patient's
> gallbladder using a "laparoscopic" approach. (This is called a
> *laparoscopic cholecystectomy*.) This approach involves less cutting
> and is considered a better choice where possible, since it results in
> fewer complications and a faster and less painful recovery.

**□ Rate of healthy appendix removal in the elderly**

> How often a healthy appendix was removed from an elderly person in the
> hospital, during an operation for another medical problem. (This is
> called an *incidental appendectomy*). Health experts believe this
> should be avoided, but some surgeons still do it.
>
> **Additional information: Number of operations**
>
> Information is also available about the number of times operations to
> repair an enlarged blood vessel supplying blood to the lower half of
> the body were done at individual hospitals. Research shows that, in
> general, when hospitals do these operations frequently, they are more
> likely to have good results. However, experts do not always agree on
> the minimum number needed to achieve high quality.
>
> You will find a graph for this indicator on the same page as the death
> rate.

**Compare Hospital Scores**

**Compare hospital scores for other surgeries**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+-------------------------+--------------------------------------------+
| **Death rate** is the   | **A hospital's score is calculated in      |
| percent of patients who | comparison to the average of hospitals     |
| had a particular        | across the state.**                        |
| procedure who died      |                                            |
| while in each hospital  | Average is about the same as the average   |
| during \[insert year\]. | of hospitals across the state.             |
|                         |                                            |
| **Rate** is the percent | **Better than average** is better than the |
| of patients having a    | average of hospitals across the state.     |
| particular kind of      |                                            |
| surgery during \[insert | **Worse than average** is worse than the   |
| year\], who were        | average of hospitals across the state.     |
| operated on using one   |                                            |
| approach to the surgery |                                            |
| rather than another.    |                                            |
+-------------------------+--------------------------------------------+

+-------------------------+-----------+-----------+---------+---------+
| **Other Surgeries**     | *         | *         | **H     | **H     |
|                         | *Hospital | *Hospital | ospital | ospital |
|                         | A**       | B**       | C**     | D**     |
+-------------------------+-----------+-----------+---------+---------+
| [Death rate for         | *         | Average   | Average | **B     |
| surgical repair of an   | *Better** |           |         | etter** |
| aortic                  |           |           |         |         |
| aneurysm]{.underline}   | **than    |           |         | **than  |
|                         | average** |           |         | av      |
| The average rate of     |           |           |         | erage** |
| death for hospitals     |           |           |         |         |
| across the state is     |           |           |         |         |
| **[10]{.underline}**    |           |           |         |         |
| for every **100**       |           |           |         |         |
| patients.               |           |           |         |         |
+-------------------------+-----------+-----------+---------+---------+
| [Rate of gallbladder    | *         | *         | **      | **      |
| removal using           | *Better** | *Better** | Worse** | Worse** |
| minimally-invasive      |           |           |         |         |
| (laparoscopic),         | **than    | **than    | **than  | **than  |
| surgery]{.underline}    | average** | average** | av      | av      |
|                         |           |           | erage** | erage** |
| The average rate for    |           |           |         |         |
| hospitals across the    |           |           |         |         |
| state is                |           |           |         |         |
| **[76]{.underline}**    |           |           |         |         |
| for every **100**       |           |           |         |         |
| patients.               |           |           |         |         |
+-------------------------+-----------+-----------+---------+---------+
| [Rate of healthy        | *         | **Worse** | Average | **      |
| appendix removal in the | *Better** |           |         | Worse** |
| elderly]{.underline}    |           | **than    |         |         |
|                         | **than    | average** |         | **than  |
| The average rate for    | average** |           |         | av      |
| hospitals across the    |           |           |         | erage** |
| state is                |           |           |         |         |
| **[2]{.underline}** for |           |           |         |         |
| every **100** patients. |           |           |         |         |
+-------------------------+-----------+-----------+---------+---------+

**Surgical repair of an aortic aneurysm -- death rate and number of
operations**

The two graphs on this page show you the quality of hospital care
related to the surgical repair of an enlarged artery or vein supplying
blood to the lower half of the body. This is sometimes called an
*abdominal aortic aneurysm repair.* This information is for patients
admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
patients died after having this operation. The graph on the
[right]{.underline} shows you the number of times a hospital performed
this operation. This procedure is somewhat rare. Research shows that, in
general, when hospitals do these procedures frequently, they are more
likely to have good results. Often, but not always, a hospital that has
a higher number of operations (right graph) will have lower death rates
(left graph).

+---------------------------------+------------------------------------+
| **Death rate for surgical       | **Number of surgical repairs of an |
| repair of an aortic aneurysm**  | aortic aneurysm**                  |
+---------------------------------+------------------------------------+
| > When you are choosing a       | > When you are choosing a          |
| > hospital, you should look for | > hospital, you should look for    |
| > the hospital that has a       | > the hospital that has a          |
| > **[lower]{.underline}**       | > **[higher]{.underline}** number  |
| > number of deaths. A           | > of operations. A                 |
| > **[lower]{.underline}**       | > **[higher]{.underline}** number  |
| > number is shown by a          | > is shown by a                    |
| > **[shorter]{.underline}** bar | > **[longer]{.underline}** bar on  |
| > on the graph below.           | > the graph below.                 |
+---------------------------------+------------------------------------+
| ![](media/image26.w             | ![](media/image34.wmf)             |
| mf){width="4.811805555555556in" |                                    |
| height="3.342361111111111in"}   |                                    |
+---------------------------------+------------------------------------+
| **Average of hospitals across   | **Average of hospitals across the  |
| the state:** The average number | state:** The average number of     |
| of deaths following this        | operations performed in hospitals  |
| operation in hospitals across   | across your state. This number is  |
| your state. This number is      | included so you have a better idea |
| included so you have:           | of what is typical for your state. |
|                                 |                                    |
| -   a better idea of what is    |                                    |
|     typical for your state.     |                                    |
|                                 |                                    |
| -   a basis for comparing       |                                    |
|     individual hospitals'       |                                    |
|     performance.                |                                    |
+---------------------------------+------------------------------------+

**Rate of gallbladder removal using minimally-invasive (laparoscopic)
surgery**

This graph shows you the number of times a hospital did an operation to
remove a patient's gallbladder, using a "laparoscopic" approach. (This
is called a *laparoscopic cholecystectomy.)* This information is for
patients admitted during \[insert year\].

A laparoscopic approach involves smaller incisions and a quicker healing
time. Most experts believe that if at all possible, the laparoscopic
approach is better for the patient. Therefore, when choosing a hospital,
you should look for the hospital with a **[higher]{.underline}** number
for this indicator. A **[higher]{.underline}** number is shown by a
**[longer]{.underline}** bar on the graph below.

![](media/image35.wmf){width="5.34375in" height="3.71875in"}

**Average of hospitals across the state:** The average number of
gallbladder removals done using laparoscopy, in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of healthy appendix removal in the elderly**

This graph shows you the number of times a hospital removed a healthy
appendix from an elderly person, during an operation for another medical
problem (called an *incidental appendectomy*). This information is for
patients admitted during \[insert year\].

A healthy appendix is removed when an adult is having some other kind of
abdominal surgery, to prevent future problems with the appendix or to
make sure the appendix is not a source of abdominal pain. However, this
additional procedure is [not]{.underline} recommended for people aged 65
and older. Therefore, when choosing a hospital, you should look for the
hospital with a **[lower]{.underline}** number for this indicator. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image42.wmf)

**Average of hospitals across the state:** The average number of healthy
appendix removals in the elderly done in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Quality of care for other health conditions**

Information is available in the Report about two quality indicators for
other health conditions. Definitions of each indicator are provided
below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

**□ Death rate for pneumonia**

Deaths in the hospital of patients who came in with pneumonia.

-   **Death rate for patients with GI (gastrointestinal) bleeding**

> How often patients died after they came in with heavy bleeding in
> their stomach or intestines (called *gastrointestinal bleeding*).

**Compare Hospital Scores**

**Compare hospital scores on other health conditions**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+-----------------+----------------------------------------------------+
| **Death rate**  | A hospital's score is calculated in comparison to  |
| is the percent  | the average of hospitals across the state.         |
| of patients who |                                                    |
| were treated    | **Average** is about the same as the average of    |
| for a           | hospitals across the state.                        |
| particular      |                                                    |
| illness who     | **Better than average** is better than the average |
| died while in   | of hospitals across the state.                     |
| each hospital   |                                                    |
| during \[insert | **Worse than average** is worse than the average   |
| year\].         | of hospitals across the state.                     |
+-----------------+----------------------------------------------------+

+---------------------------+----------+----------+---------+---------+
| **Other Health            | **       | **       | **H     | **H     |
| Conditions**              | Hospital | Hospital | ospital | ospital |
|                           | A**      | B**      | C**     | D**     |
+---------------------------+----------+----------+---------+---------+
| [Death rate for pneumonia | **       | *        | Average | **B     |
| patients]{.underline}     | Better** | *Worse** |         | etter** |
|                           |          |          |         |         |
| The average rate of death | **than   | **than   |         | **than  |
| for hospitals across the  | a        | a        |         | av      |
| state is                  | verage** | verage** |         | erage** |
| **[8]{.underline}** for   |          |          |         |         |
| every **100** patients.   |          |          |         |         |
+---------------------------+----------+----------+---------+---------+
| [Death rate for patients  | Average  | **       | **      | **      |
| with GI                   |          | Better** | Worse** | Worse** |
| (gastrointestinal)        |          |          |         |         |
| bleeding]{.underline}     |          | **than   | **than  | **than  |
|                           |          | a        | av      | av      |
| The average rate of death |          | verage** | erage** | erage** |
| for hospitals across the  |          |          |         |         |
| state is                  |          |          |         |         |
| **[3]{.underline}** for   |          |          |         |         |
| every **100** patients.   |          |          |         |         |
+---------------------------+----------+----------+---------+---------+

**Death rate for pneumonia patients**

This graph shows you the percent of patients admitted to a hospital
because they had pneumonia, who died during their hospital stay. This
information is for patients who were admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
[**lower**]{.underline} number for this condition. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image43.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with pneumonia who died in hospitals across your state. This number is
included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Death rate for patients with GI bleeding**

This graph shows you the percent of patients who died after being
admitted to the hospital because of bleeding into their stomach or
intestines (which is called *gastrointestinal, or GI, bleeding*). This
information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate of deaths for this condition. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image44.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
who died after being admitted with GI bleeding, in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Medical complications for patients having operations**

This Report includes ten indicators showing how often patients
experienced a complication or problem as a result of having an
operation. These complications can be serious, even fatal. Each of them
can be prevented if steps are taken to make care safer. Definitions of
each indicator are provided below.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

-   **Rate of complications of anesthesia**

> How often patients experienced problems as a result of having
> anesthesia, i.e. being "put to sleep" before having an operation or
> procedure.

-   **Rate of hip fracture after an operation**

> How often hospital patients broke a hip bone from a fall following any
> kind of operation.

-   **Rate of too much bleeding or blood clots after an operation**

> How often patients bled too much (called *hemorrhaging*) or developed
> a large blood clot after an operation (which is called a *hematoma*).

-   **Rate of abnormal changes in body functions after an operation**

> How often hospital patients experienced problems with blood sugar
> control (if they have diabetes) or kidney failure (if they did not
> have previous kidney trouble) after having an operation (these
> problems are called *postoperative physiologic and metabolic
> derangements)*.

-   **Rate of breathing failure after an operation**

> How often patients became unable to breathe on their own following an
> operation, and needed a ventilator (a machine that helps someone
> breathe), at least temporarily. (This is called *postoperative
> respiratory failure*.)

-   **Rate of blood clots in the lung or a large vein, after an
    operation**

> How often hospital patients developed a blood clot that ends up in the
> lungs (which is called a *pulmonary embolism*) or in a large vein
> (which is called *deep vein thrombosis*), after an operation.

-   **Rate of bloodstream infection following an operation**

> How often hospital patients got a serious bloodstream infection
> following an operation (which is called *postoperative sepsis*).

-   **Rate of splitting open of a surgical wound after an operation on
    the stomach or pelvis**

> How often a surgical wound in the stomach or pelvic area split open
> after an operation. (This is called *postoperative wound dehiscence in
> abdominopelvic surgical patients*.)

-   **Rate of surgical instrument or tool accidentally left in a
    patient's body**

> How often a surgical instrument or tool (called a *foreign body*),
> such as a scalpel or a sponge, was accidentally left in a patient's
> body during an operation.

**□ Rate of patients having air leaking out of their lung**

> How often air leaks out of the patient's lung because someone
> accidentally punctured during a medical procedure or operation (a
> complication called *iatrogenic pneumothorax)*.

**Compare Hospital Scores**

**Compare hospital scores on medical complications for patients having
operations**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+---------------+------------------------------------------------------+
| **Rate** is   | **A hospital's score is calculated in comparison to  |
| the percent   | the average of hospitals across the state.**         |
| of surgical   |                                                      |
| patients who  | Average is about the same as the average of          |
| experienced a | hospitals across the state.                          |
| particular    |                                                      |
| problem       | **Better than average** is better than the average   |
| following     | of hospitals across the state.                       |
| their         |                                                      |
| operation     | **Worse than average** is worse than the average of  |
| during        | hospitals across the state.                          |
| \[insert      |                                                      |
| year\].       |                                                      |
+---------------+------------------------------------------------------+

+--------------------------+----------+----------+----------+----------+
| **Medical Complications  | **       | **       | **       | **       |
| for Patients Having      | Hospital | Hospital | Hospital | Hospital |
| Operations**             | A**      | B**      | C**      | D**      |
+--------------------------+----------+----------+----------+----------+
| [Rate of complications   | **       | Average  | **Worse  | **       |
| of                       | Better** |          | than     | Better** |
| anesthesia]{.underline}  |          |          | a        |          |
|                          | **than   |          | verage** | **than   |
| The average rate for     | a        |          |          | a        |
| hospitals across the     | verage** |          |          | verage** |
| state is                 |          |          |          |          |
| **[8]{.underline}** for  |          |          |          |          |
| every **10,000**         |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of hip fracture    | **       | **Worse  | Average  | Average  |
| after an                 | Better** | than     |          |          |
| operation]{.underline}   |          | a        |          |          |
|                          | **than   | verage** |          |          |
| The average rate for     | a        |          |          |          |
| hospitals across the     | verage** |          |          |          |
| state is                 |          |          |          |          |
| **[3]{.underline}** for  |          |          |          |          |
| every **10,000**         |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of too much        | **       | **Worse  | Average  | Average  |
| bleeding or blood clots  | Better** | than     |          |          |
| after an                 |          | a        |          |          |
| operation]{.underline}   | **than   | verage** |          |          |
|                          | a        |          |          |          |
| The average rate for     | verage** |          |          |          |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[2]{.underline}** for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of abnormal        | **       | **       | Average  | **       |
| changes in body function | Better** | Better** |          | Better** |
| after an                 |          |          |          |          |
| operation]{.underline}   | **than   | **than   |          | **than   |
|                          | a        | a        |          | a        |
| The average rate for     | verage** | verage** |          | verage** |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[10]{.underline}** for |          |          |          |          |
| every **10,000**         |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of breathing       | **Worse  | Average  | **Worse  | **       |
| failure after an         | than     |          | than     | Better** |
| operation]{.underline}   | a        |          | a        |          |
|                          | verage** |          | verage** | **than   |
| The average rate for     |          |          |          | a        |
| hospitals across the     |          |          |          | verage** |
| state is                 |          |          |          |          |
| **[9]{.underline}** for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of blood clots in  | Average  | Average  | Average  | **       |
| the lung or large vein,  |          |          |          | Better** |
| after an                 |          |          |          |          |
| operation]{.underline}   |          |          |          | **than   |
|                          |          |          |          | a        |
| The average rate for     |          |          |          | verage** |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[10]{.underline}** for |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of bloodstream     | **       | **Worse  | **       | **Worse  |
| infection following an   | Better** | than     | Better** | than     |
| operation]{.underline}   |          | a        |          | a        |
|                          | **than   | verage** | **than   | verage** |
| The average rate for     | a        |          | a        |          |
| hospitals across the     | verage** |          | verage** |          |
| state is                 |          |          |          |          |
| **[11]{.underline}** for |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of splitting open  | **       | **Worse  | **       | Average  |
| of a surgical wound      | Better** | than     | Better** |          |
| after an operation on    |          | a        |          |          |
| the stomach or pelvic    | **than   | verage** | **than   |          |
| area]{.underline}        | a        |          | a        |          |
|                          | verage** |          | verage** |          |
| The average rate for     |          |          |          |          |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[11]{.underline}** for |          |          |          |          |
| every **10,000**         |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of surgical        | **       | **       | **Worse  | **       |
| instrument or tool       | Better** | Better** | than     | Better** |
| accidentally left in a   |          |          | a        |          |
| patient's                | **than   | **than   | verage** | **than   |
| body]{.underline}        | a        | a        |          | a        |
|                          | verage** | verage** |          | verage** |
| The average rate for     |          |          |          |          |
| hospitals across the     |          |          |          |          |
| state is                 |          |          |          |          |
| **[3]{.underline}** for  |          |          |          |          |
| every **100,000**        |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of patients having | **       | **Worse  | Average  | **       |
| air leaking out of the   | Better** | than     |          | Better** |
| lung]{.underline}        |          | a        |          |          |
|                          | **than   | verage** |          | **than   |
| The average rate for     | a        |          |          | a        |
| hospitals across the     | verage** |          |          | verage** |
| state is                 |          |          |          |          |
| **[9]{.underline}** for  |          |          |          |          |
| every **10,000**         |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+

**Rate of complications of anesthesia**

This graph shows you the percent of patients who experienced problems as
a result of having anesthesia, meaning being "put to sleep" before
having an operation or medical procedure. This information is for
patients admitted during \[insert year\]. **Please note: this is a very
rare event.**

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate of complications from anesthesia. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image45.wmf){width="5.34375in" height="3.71875in"}

**Average of hospitals across the state:** The average rate of
complications from anesthesia of patients in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of hip fracture after an operation**

This graph shows you the percent of patients who broke a hip from a fall
following any kind of operation. A fall can happen for different
reasons, such as being given too much pain medication, or having too
little supervision when trying to walk after an operation. Or, it may
just happen. This information is for patients admitted during \[insert
year\]. **Please note that this is a very rare event**.

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate of postoperative hip fractures. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image46.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with hip fractures after an operation, in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of too much bleeding or blood clots after an operation**

This graph shows you how often patients bled too much (called
*hemorrhaging*) or developed a large blood clot (called a *hematoma*)
after an operation. All of these complications involved another
operation to stop the bleeding or remove the blood clots. This
information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** rate is shown by a **[shorter]{.underline}** bar
on the graph below.

![](media/image47.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
who had too much bleeding, or blood clots after an operation, in
hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of abnormal changes in body functioning after an operation**

This graph shows you the percent of patients experienced problems with
blood sugar control (if they have diabetes) or kidney failure (if they
did not have previous kidney trouble) after having an operation (these
complications are called *postoperative physiologic and metabolic
derangements)* This information is for patients admitted during \[insert
year\]. **Please note that this is a very rare event**.

When you are choosing a hospital, you should look for the hospital that
has a **[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image48.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with abnormal changes in body functioning, in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of breathing failure after an operation**

This graph shows you the percent of patients who became unable to
breathe on their own following an operation, and who needed a
ventilator, which is a machine that helps someone breathe, at least
temporarily (which is called *postoperative respiratory failure*). This
information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image49.wmf){width="5.322916666666667in"
height="3.6979166666666665in"}

**Average of hospitals across the state:** The average rate of patients
with breathing failure after an operation, in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of blood clots in the lung or large veins after an operation**

This graph shows you the percent of patients who developed a blood clot
in the lungs (which is called a *pulmonary embolism*) or in a large vein
(which is called *deep vein thrombosis*) following an operation. This
information is for patients admitted during \[insert year\].

These clots can be life-threatening. When you are choosing a hospital,
you should look for the hospital that has **[lower]{.underline}** rates
for this complication. A **[lower]{.underline}** number is shown by a
**[shorter]{.underline}** bar on the graph below.

![](media/image50.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with blood clots in the lung or large veins after an operation, in
hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of bloodstream infection following an operation**

This graph shows you the percent of patients who got a bloodstream
infection following an operation (which is called *postoperative
sepsis*). This information is for patients admitted during \[insert
year\].

When you are choosing a hospital, you should look for the hospital that
has **[lower]{.underline}** rates for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image51.wmf){width="5.322916666666667in"
height="3.6979166666666665in"}

**Average of hospitals across the state:** The average rate of patients
with bloodstream infections following an operation, in hospitals across
your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of splitting open of a surgical wound after an operation on the
stomach or pelvic area**

This graph shows you the percent of patients having an operation in
their stomach or pelvic area whose wound split open after an operation
(which is called *postoperative wound dehiscence*). All of these
complications were treated with another major operation to fix the
wound. This information is for patients admitted during \[insert year\].
**Please note that this is a very rare event**.

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image52.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with splitting open of a surgical wound after an operation on the
stomach or pelvis splitting, in hospitals across your state. This number
is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of surgical instrument or tool accidentally left in a patient's
body**

This graph shows you how often a surgical instrument or tool (called a
*foreign body*), such as a scalpel or sponge, was accidentally left in a
patient's body after an operation. This information is for patients
admitted during \[insert year\]. **Please note: this is a very rare
event.**

Even though a patient may not feel anything, having a surgical
instrument or tool left behind can cause infection or cuts and be very
dangerous. When choosing a hospital, you should look for the hospital
that has **[lower]{.underline}** rates for this indicator. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image53.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate at which
surgical tools were accidentally left in a patient's body, in hospitals
across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of patients having air leaking out of the lung**

This graph shows you how often air leaks out of the lung because someone
accidentally punctured it as a result of a medical procedure (called
*iatrogenic pneumothorax*). Iatrogenic pneumothorax sometimes requires
putting a tube into a patient's chest to remove the extra air. This
information is for patients who were admitted during \[insert year\].
**Please note that this is a very rare event**.

When choosing a hospital, look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** rate is shown by a **[shorter]{.underline}** bar
on the graph below.

![](media/image54.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with this complication in hospitals across your state. This number is
included so you have:

-   a better idea of what is normal for your state.

-   a basis for comparing individual hospitals' performance.

**Medical complications in the hospital, for adult patients**

This Report includes nine indicators showing how often **adult**
hospital patients experienced a medical complication or problem during a
hospital stay. These complications can be serious, even fatal. Each of
them can be potentially prevented if steps are taken to make care safer.

**Please check the box next to each indicator you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

**Select All Indicators**

-   **Death rate from failure to identify and treat a serious
    complication**

> How often patients died after developing a complication that should
> have been identified quickly and treated (called *failure to rescue*).

-   **Death rate for patients with health problems that rarely result in
    death**

> How often patients died in the hospital when they had been admitted
> for a health problem that rarely results in death. (This is called
> *death in low mortality DRGs,* i.e. **d**iagnosis-**r**elated
> **g**roups.)

-   **Rate of infections due to medical care**

> How often patients got certain types of infections as a result of the
> care they received in the hospital.

-   **Rate of patients with bed sores**

> How often patients developed a bed sore (called a *decubitus ulcer*),
> which is a sore or wound on the skin. This can occur because people
> are lying in one position for too long.

-   **Rate of blood transfusion reaction**

> How often patients in the hospital had a reaction because they
> received the wrong type of blood. (This is called a *transfusion
> reaction*).

-   **Rate of accidental cuts and tears**

> How often patients were accidentally cut, making an unnecessary or
> dangerous hole or tear in an organ of the body (called an *accidental
> puncture and laceration*), while receiving medical care in the
> hospital.

**Compare Hospital Scores**

**Compare hospital scores on medical complications, for adult patients**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

**Click on the indicator names for detailed results on how each hospital
performed.**

+-----------------------+----------------------------------------------+
| **Death rate** is the | **A hospital's score is calculated in        |
| percent of patients   | comparison to the average of hospitals       |
| who were treated for  | across the state.**                          |
| a particular illness  |                                              |
| or had a particular   | Average is about the same as the average of  |
| procedure who died    | hospitals across the state.                  |
| while in each         |                                              |
| hospital during       | **Better than average** is better than the   |
| \[insert year\].      | average of hospitals across the state.       |
|                       |                                              |
| **Rate** is the       | **Worse than average** is worse than the     |
| percent of patients   | average of hospitals across the state.       |
| who experienced a     |                                              |
| particular problem    |                                              |
| while in the hospital |                                              |
| during \[insert       |                                              |
| year\].               |                                              |
+-----------------------+----------------------------------------------+

+--------------------------+----------+----------+----------+----------+
| **Medical complications, | **       | **       | **       | **       |
| for adult patients**     | Hospital | Hospital | Hospital | Hospital |
|                          | A**      | B**      | C**      | D**      |
+--------------------------+----------+----------+----------+----------+
| [Death rate from failure | **       | Average  | **Worse  | **       |
| to identify and treat a  | Better** |          | than     | Better** |
| serious                  |          |          | a        |          |
| c                        | **than   |          | verage** | **than   |
| omplication]{.underline} | a        |          |          | a        |
|                          | verage** |          |          | verage** |
| The average rate of      |          |          |          |          |
| death for hospitals      |          |          |          |          |
| across the state is      |          |          |          |          |
| **[12]{.underline}** for |          |          |          |          |
| every **100** patients.  |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Death rate for patients | **       | **Worse  | **Worse  | **Worse  |
| with health problems     | Better** | than     | than     | than     |
| that rarely result in    |          | a        | a        | a        |
| death]{.underline}       | **than   | verage** | verage** | verage** |
|                          | a        |          |          |          |
| The average rate of      | verage** |          |          |          |
| death for hospitals      |          |          |          |          |
| across the state is      |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of patients with   | **       | Average  | **Worse  | **       |
| bed sores]{.underline}   | Better** |          | than     | Better** |
|                          |          |          | a        |          |
| The average rate for     | **than   |          | verage** | **than   |
| hospitals across the     | a        |          |          | a        |
| state is                 | verage** |          |          | verage** |
| **[3]{.underline}** for  |          |          |          |          |
| every **100** patients.  |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of infections due  | **       | **Worse  | Average  | **       |
| to medical               | Better** | than     |          | Better** |
| care]{.underline}        |          | a        |          |          |
|                          | **than   | verage** |          | **than   |
| The average rate for     | a        |          |          | average  |
| hospitals across the     | verage** |          |          | e**      |
| state is                 |          |          |          |          |
| **[3]{.underline}** for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of blood           | **       | **       | Average  | **Worse  |
| transfusion              | Better** | Better** |          | than     |
| reaction]{.underline}    |          |          |          | a        |
|                          | **than   | **than   |          | verage** |
| The average rate for     | a        | a        |          |          |
| hospitals across the     | verage** | verage** |          |          |
| state is                 |          |          |          |          |
| **[5]{.underline}** for  |          |          |          |          |
| every **1,000,000**      |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+
| [Rate of accidental cuts | Average  | **       | **Worse  | Average  |
| and tears]{.underline}   |          | Better** | than     |          |
|                          |          |          | a        |          |
| The average rate for     |          | **than   | verage** |          |
| hospitals across the     |          | a        |          |          |
| state is                 |          | verage** |          |          |
| **[3]{.underline}** for  |          |          |          |          |
| every **1,000**          |          |          |          |          |
| patients.                |          |          |          |          |
+--------------------------+----------+----------+----------+----------+

**Death rate from failure to identify and treat a serious complication**

This graph shows you the percent of patients who died because they
developed a complication that should have been identified quickly and
treated by hospital staff (which is called *failure to rescue*). This
information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** death rates for this indicator. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image55.wmf){width="5.333333333333333in"
height="3.7083333333333335in"}

**Average of hospitals across the state:** The average rate of patients
who died from failure to identify and treat a serious complication, in
hospitals across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Death rate for patients with health problems that rarely result in
death**

This graph shows you how often patients died in the hospital when they
were admitted for a health problem or condition that rarely results in
death. (This is called *death in low mortality DRGs*.) This information
is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate of deaths for this indicator. A
**[lower]{.underline}** rate is shown by a **[shorter]{.underline}** bar
on the graph below.

![](media/image56.wmf){width="5.322916666666667in"
height="3.6979166666666665in"}

**Average of hospitals across the state:** The average rate of deaths
for patients admitted to the hospital with health problems that rarely
result in death in hospitals across your state. This number is included
so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of patients with bed sores**

This graph shows you the percent of patients who developed bed sores,
which are sores or wounds on the skin (called a *decubitus ulcer*),
during their hospital stay. Usually this happens when patients are lying
in one position for too long and can often be prevented. This
information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image57.wmf){width="5.333333333333333in" height="3.71875in"}

**Average of hospitals across the state:** The average rate of patients
with bed sores in hospitals across your state. This number is included
so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of infections due to medical care**

This graph shows you the percent of patients who got certain types of
infections as a result of care they received while in the hospital.
These include infections related to intravenous tubes and fluids,
treatment of kidney failure, transfusions, and other types of shots.
This information is for patients admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate for this topic. A **[lower]{.underline}**
number is shown by a **[shorter]{.underline}** bar on the graph below.

![](media/image58.wmf){width="5.34375in" height="3.7083333333333335in"}

**Average of hospitals across the state:** The average rate of patients
with certain types of infections due to medical care, in hospitals
across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of blood transfusion reaction**

This graph shows you the percent of patients who had a reaction because
they received the wrong type of blood (which is called a *transfusion
reaction*). This situation can largely be avoided if the blood is tested
correctly beforehand and the right blood is given to the right patient.
This information is for patients admitted during \[insert year\].
**Please note this is a very rare event.**

A blood transfusion reaction can be very serious. When choosing a
hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this indicator. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image59.wmf){width="5.34375in" height="3.71875in"}

**Average of hospitals across the state:** The average rate of patients
who had a blood transfusion reaction, in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of accidental cuts and tears**

This graph shows you the percent of patients who were accidentally cut
or injured, making a hole or tear in an organ of the body, while
receiving medical care (which is called *accidental puncture and
laceration*). This information is for patients admitted during \[insert
year\].

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image60.wmf){width="5.3125in" height="3.6875in"}

**Average of hospitals across the state:** The average rate of patients
who had accidental cuts and tears, in hospitals across your state. This
number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Quality of medical care, for children**

Information is available in the Report about eight indicators of the
quality of care for **children** in the hospital. The information does
**not** cover what happens to anyone over the age of 18. Definitions of
each of the indicators are provided below.

**Please check the box next to each topic you care about.**

You can return to this page and pick another overall score whenever you
like, using the tabs on the (top/left)

.

**Select All Indicators**

-   **Rate of breathing failure among children after an operation**

> How often children became unable to breathe on their own following an
> operation, and needed a ventilator (a machine that helps someone
> breathe), at least temporarily (which is called *postoperative
> respiratory failure*.)

-   **Rate of splitting open of a surgical wound among children after an
    operation on the stomach or pelvis**

> How often a surgical wound in the stomach or pelvic area of a child
> split open after an operation (which is called *postoperative wound
> dehiscence in abdominopelvic surgical patients*.)

-   **Rate of too much bleeding or blood clots after an operation, among
    children**

> How often children bled too much (called *hemorrhaging*), or developed
> a large blood clot (called a *hematoma*) after an operation.

-   **Rate of bed sores in hospitalized children**

> How often children in the hospital developed a bed sore (called a
> *decubitus ulcer*), which is a sore or wound on the skin. This can
> occur because children are lying in one position for too long.

-   **Rate of blood transfusion reaction in hospitalized children**

> How often children in the hospital had a reaction because they
> received the wrong type of blood (which is called a *transfusion
> reaction*).

-   **Rate of surgical instrument or tool accidentally left in a child's
    body**

> How often a surgical instrument or tool (called a *foreign body*),
> such as a scalpel or a sponge, was accidentally left in a child's body
> during an operation.

-   **Rate of children other than newborns having air leaking out of
    their lung**

> How often air leaked out of a child's lung because someone
> accidentally punctured it as a result of a medical procedure (which is
> called *iatrogenic pneumothorax)*. This rate is for children other
> than newborns.

-   **Death rate of children having heart operations**

> How often children died in the hospital following heart operations.
>
> **Additional information: Number of operations**
>
> Information is also available about the number of times heart
> operations on children were done at individual hospitals. Research
> shows that, in general, when hospitals do these operations frequently,
> they are more likely to have good results. However, experts do not
> always agree on the minimum number needed to achieve high quality.
>
> You will find a graph for this indicator on the same page as the death
> rate.

**Compare Hospital Scores**

**Compare hospital scores on medical care for children**

When you are choosing a hospital, you should look for the hospital that
does **Better than average** on the topics that are most important to
you, or on as many items as possible.

Click on any of the indicators to see details on how each hospital
performed on that particular indicator.

+-------------------------+--------------------------------------------+
| **Rate** is the percent | **A hospital's score is calculated in      |
| of children who         | comparison to the average of hospitals     |
| experienced a           | across the state.**                        |
| particular medical      |                                            |
| problem as a result of  | Average is about the same as the average   |
| the care they received  | of hospitals across the state.             |
| in each hospital during |                                            |
| \[insert year\].        | **Better than average** is better than the |
|                         | average of hospitals across the state.     |
| **Death rate** is the   |                                            |
| percent of children who | **Worse than average** is worse than the   |
| had a particular        | average of hospitals across the state.     |
| procedure and who died  |                                            |
| while in each hospital  |                                            |
| during \[insert year\]. |                                            |
+-------------------------+--------------------------------------------+

+---------------------------+----------+----------+----------+---------+
| **Medical care for        | **       | **       | **       | **H     |
| children**                | Hospital | Hospital | Hospital | ospital |
|                           | A**      | B**      | C**      | D**     |
+===========================+==========+==========+==========+=========+
| [Rate of breathing        | **       | **       | **Worse  | **Worse |
| failure in children       | Better** | Better** | than     | than    |
| following an              |          |          | a        | av      |
| operation]{.underline}    | **than   | **than   | verage** | erage** |
|                           | a        | a        |          |         |
| The average rate for      | verage** | verage** |          |         |
| hospitals across the      |          |          |          |         |
| state is                  |          |          |          |         |
| **[14]{.underline}** for  |          |          |          |         |
| every                     |          |          |          |         |
| **[1,000]{.underline}**   |          |          |          |         |
| child patients.           |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of splitting open   | **Worse  | **       | Average  | **B     |
| of a surgical wound after | than     | Better** |          | etter** |
| an operation on the       | a        |          |          |         |
| stomach or pelvis of a    | verage** | **than   |          | **than  |
| child]{.underline}        |          | a        |          | av      |
|                           |          | verage** |          | erage** |
| The average rate for      |          |          |          |         |
| hospitals across the      |          |          |          |         |
| state is                  |          |          |          |         |
| **[8]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[10,000]{.underline}**  |          |          |          |         |
| child patients.           |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of too much         | **       | **Worse  | Average  | Average |
| bleeding or blood clots   | Better** | than     |          |         |
| in children following an  |          | a        |          |         |
| operation]{.underline}    | **than   | verage** |          |         |
|                           | a        |          |          |         |
| The average rate for      | verage** |          |          |         |
| hospitals across the      |          |          |          |         |
| state is                  |          |          |          |         |
| **[2]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[1,000]{.underline}**   |          |          |          |         |
| child patients            |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of bed sores in     | **       | **Worse  | Average  | **B     |
| hospitalized              | Better** | than     |          | etter** |
| children]{.underline}     |          | a        |          |         |
|                           | **than   | verage** |          | **than  |
| The average rate for      | a        |          |          | av      |
| hospitals across the      | verage** |          |          | erage** |
| state is                  |          |          |          |         |
| **[3]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[1,000]{.underline}**   |          |          |          |         |
| child patients            |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of blood            | **Worse  | **       | Average  | **B     |
| transfusion reaction in   | than     | Better** |          | etter** |
| hospitalized              | a        |          |          |         |
| children]{.underline}     | verage** | **than   |          | **than  |
|                           |          | a        |          | av      |
| The average rate for      |          | verage** |          | erage** |
| hospitals across the      |          |          |          |         |
| state is                  |          |          |          |         |
| **[2]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **                        |          |          |          |         |
| [1,000,000]{.underline}** |          |          |          |         |
| child patients            |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of surgical         | **Worse  | Average  | **Worse  | **B     |
| instrument or tool        | than     |          | than     | etter** |
| accidentally left in      | a        |          | a        |         |
| child's body]{.underline} | verage** |          | verage** | **than  |
|                           |          |          |          | av      |
| The average rate for      |          |          |          | erage** |
| hospitals across the      |          |          |          |         |
| state is                  |          |          |          |         |
| **[3]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[100,000]{.underline}** |          |          |          |         |
| child patients            |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Rate of children having  | **       | Average  | **Worse  | **B     |
| air leaking out of their  | Better** |          | than     | etter** |
| lung]{.underline}         |          |          | a        |         |
|                           | **than   |          | verage** | **than  |
| The average rate for      | a        |          |          | av      |
| hospitals across the      | verage** |          |          | erage** |
| state is                  |          |          |          |         |
| **[2]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[10,000]{.underline}**  |          |          |          |         |
| child patients            |          |          |          |         |
+---------------------------+----------+----------+----------+---------+
| [Death rate for children  | **       | **       | **Worse  | **B     |
| having heart              | Better** | Better** | than     | etter** |
| operations]{.underline}   |          |          | a        |         |
|                           | **than   | **than   | verage** | **than  |
| The average rate of death | a        | a        |          | av      |
| for hospitals across the  | verage** | verage** |          | erage** |
| state is                  |          |          |          |         |
| **[5]{.underline}** for   |          |          |          |         |
| every                     |          |          |          |         |
| **[100]{.underline}**     |          |          |          |         |
| child patients.           |          |          |          |         |
+---------------------------+----------+----------+----------+---------+

**Rate of breathing failure among children after an operation**

This graph shows you how often children having any kind of operation
became unable to breathe on their own right afterwards, and needed a
ventilator, which is a machine that helps someone breathe, at least
temporarily (a complication that is called *postoperative respiratory
failure*). This information is for patients under 18 admitted during
\[insert year\].

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this topic. A **[lower]{.underline}**
number is shown by a **[shorter]{.underline}** bar on the graph below.

![](media/image61.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of children
with breathing failure after an operation, in hospitals across your
state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of splitting open of a surgical wound after an operation on the
stomach or pelvic area among children**

This graph shows you the percent of children having an operation in
their stomach or pelvic area whose wound split open after an operation
(which is called *postoperative wound dehiscence*). All of these
complications were treated with another major operation to fix the
wound. This information is for patients admitted during \[insert year\].
**Please note that this is a very rare event**.

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image62.wmf){width="5.375in" height="3.75in"}

**Average of hospitals across the state:** The average rate of children
who had surgical wounds in the stomach or pelvis split open after an
operation, in hospitals across your state. This number is included so
you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of too much bleeding or blood clots after an operation, among
children**

This graph shows you how often children bled too much (called
*hemorrhaging*) or developed a large blood clot (called *hematoma*)
after an operation. All of these complications involved another
operation to stop the bleeding or remove the blood clots. This
information is for patients under 18 admitted during \[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** rate is shown by a **[shorter]{.underline}** bar
on the graph below.

![](media/image63.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of children
with too much bleeding or blood clots in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance

**Rate of hospitalized children with bed sores**

This graph shows you how often children in the hospital developed a bed
sore (which is called a *decubitus ulcer*), which is a sore or wound on
the skin. This can occur because children are lying in one position for
too long. This information is for patients under 18 admitted during
\[insert year\].

When choosing a hospital, you should look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image64.wmf){width="5.364583333333333in"
height="3.7395833333333335in"}

**Average of hospitals across the state:** The average rate of children
with bed sores in hospitals across your state. This number is included
so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance

**Rate of blood transfusion reaction among children**

This graph shows you how often children in the hospital had a reaction
because they received the wrong type of blood. (This is called a
*transfusion reaction*.) This situation can largely be avoided if the
blood is tested correctly and the right blood is given to the right
patient. A blood transfusion reaction can be very serious. This
information is for patients under 18 admitted during \[insert year\].
**Please note this is a very rare event.**

When choosing a hospital, you should look for the hospital that has
**[lower]{.underline}** rates for this indicator. A
**[lower]{.underline}** number is shown by a **[shorter]{.underline}**
bar on the graph below.

![](media/image65.wmf){width="5.5625in" height="3.75in"}

**Average of hospitals across the state:** The average rate of children
who had a blood transfusion reaction, in hospitals across your state.
This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of surgical instrument or tool accidentally left in a child's
body**

This graph shows you how often a surgical instrument or tool (called a
*foreign body*), such as a scalpel or a sponge, was accidentally left in
a child's body during an operation. This information is for patients
under 18 admitted during \[insert year\]. **Please note: this is a very
rare event.**

Having a surgical instrument or tool left behind can cause infection or
cuts and be very dangerous. When choosing a hospital, you should look
for the hospital that has **[lower]{.underline}** rates for this
indicator. A **[lower]{.underline}** number is shown by a
**[shorter]{.underline}** bar on the graph below.

![](media/image66.wmf){width="5.364583333333333in"
height="3.7395833333333335in"}

**Average of hospitals across the state:** The average rate at which
surgical tools were accidentally left in a child's body, in hospitals
across your state. This number is included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Rate of children (other than newborns) having air leaking out**

**of their lung**

This graph shows you how often air leaks out of a child's lung because
someone accidentally punctured it during a medical procedure (a
complication which is called *iatrogenic pneumothorax*). Iatrogenic
pneumothorax sometimes requires putting a tube into a child's chest to
remove the extra air. This information is for patients under 18, other
than newborns, who were admitted during \[insert year\]. **Please note
that this is a very rare event**.

When choosing a hospital, look for the hospital that has a
**[lower]{.underline}** rate for this complication. A
**[lower]{.underline}** rate is shown by a **[shorter]{.underline}** bar
on the graph below.

![](media/image67.wmf){width="5.354166666666667in"
height="3.7291666666666665in"}

**Average of hospitals across the state:** The average rate of patients
with this complication in hospitals across your state. This number is
included so you have:

-   a better idea of what is typical for your state.

-   a basis for comparing individual hospitals' performance.

**Heart operations performed on children -- Death rate and number of
operations**

The two graphs on this page show you the quality of hospital care
related to heart operations performed on children. This information is
for patients under 18 admitted during \[insert year\].

The graph on the [left]{.underline} side of the page shows you how often
children died following this operation. The graph on the
[right]{.underline} shows the number of times a hospital performed this
operation. Research shows that, in general, when hospitals do these
procedures frequently, they are more likely to have good results. Often,
but not always, a hospital that has a higher number of operations (right
graph) will have lower death rates (left graph).

+-----------------------------------+-----------------------------------+
| ### Death rate of                 | **Number of heart operations      |
| children having heart operations  | performed on children**           |
+-----------------------------------+-----------------------------------+
| When choosing a hospital, look    | When choosing a hospital, look    |
| for the hospital that has a       | for the hospital that has a       |
| **[lower]{.underline}** number of | **[higher]{.underline}** number   |
| deaths. A **[lower]{.underline}** | of operations. A                  |
| number is shown by a              | **[higher]{.underline}** number   |
| **[shorter]{.underline}** bar on  | is shown by a                     |
| the graph below.                  | **[longer]{.underline}** bar on   |
|                                   | the graph below.                  |
+-----------------------------------+-----------------------------------+
| ![](media/image68.                | ![](media/image69                 |
| wmf){width="4.9631944444444445in" | .wmf){width="4.965972222222222in" |
| height="3.45625in"}               | height="3.45in"}                  |
+-----------------------------------+-----------------------------------+
| **Average of hospitals across the | > **Average of hospitals across   |
| state:** The average number of    | > the state:** The average number |
| deaths in children following this | > of operations performed on      |
| operation in the hospitals across | > children in hospitals across    |
| the state. This number is         | > the state. This number is       |
| included so you have:             | > included so you have a better   |
|                                   | > idea of what is typical for     |
| -   a better idea of what is      | > your state.                     |
|     typical for your state.       |                                   |
|                                   |                                   |
| -   a basis for comparing         |                                   |
|     individual hospitals'         |                                   |
|     performance.                  |                                   |
+-----------------------------------+-----------------------------------+

**How should you use the Report?**

How can this information help you? First and foremost, if you or someone
you care about expects to be admitted to a hospital in the near future,
you can use this information to **help you choose a hospital**. The
information can help you **rule out certain hospitals** because the
information indicates they do not perform well. It can help you **find a
hospital that is especially good** at treating the conditions you face,
or especially good at avoiding complications. The report can also help
you **make a final choice** between two or three hospitals with good
reputations.

The best way to use this particular report is also to **look for
patterns in the scores**. Some hospitals may do very well across the
board; others may do well in some areas and not in others; still others
may really show problems in a wide range of areas. Look carefully for
these patterns. At the same time, if there is a particular surgery, or
medical condition, or complication that is of particular concern to you,
you will want to give more weight to information related to those
concerns.

Several factors go into making a hospital choice. For example, you may
have to **use the specific hospitals in the "network"** **of your health
plan.** If you have to go to a hospital in the network whose scores in
this report are troubling to you, **bring the information to your
doctor** to discuss it. You may want to ask your doctor to be especially
vigilant to ensure that certain problems that are worrying you are
avoided.

Second, you can only be admitted to a hospital by a doctor, and doctors
typically have "admitting privileges," the right to admit patients, at
one or a few hospitals. So when you choose a doctor, and especially
**when you choose a specialist, you may actually be choosing a
hospital** at the same time. So when your regular doctor refers you to a
specialist, ask the question "Where can this specialist admit patients?"
Then, **before committing yourself to a particular specialist, check out
their hospital** in this report. Again, if the information troubles you,
bring it back to your doctor and see if you can be referred to a
specialist who practices at a hospital that performs well on the topics
that are important to you.

**Remember, it's your life, and your health**. Most physicians and
hospitals are happy to talk with patients about information from
reliable sources, and they care about your preferences. You certainly
have the right to raise issues with them and get answers to your
questions.

**A few things to keep in mind as you use the Report**

This Report is a starting point for looking at the quality of care at a
particular hospital. The overall scores and specific topic results are
not the final word. There are a few things to keep in mind when looking
at this report.

-   **Neither the summary scores nor the specific topics cover all
    health conditions or surgeries.**

> As new information becomes available, this report may be updated.

-   **The Report doesn't address all aspects of quality.**

> For example, this report does not include information on what patients
> say about their care in the hospital, or information on whether
> hospitals consistently follow steps known to lead to better results.
> Information like this is available for many American hospitals on a
> federal government website called Hospital Compare. **[Click here to
> go to the Hospital Compare website.]{.underline}**
>
> The Report also does not include information on the specific services
> provided by a hospital. That information is best obtained directly
> from the hospital itself. **[Click here for a list of hospitals
> included in this Report and how to contact them.]{.underline}**

-   **Don't presume that because a hospital does well (or poorly) in one
    area of health care, that it will do well (or poorly) in all
    areas.**

> Hospitals can have strengths and weaknesses in providing different
> types of care. For example, there are many different kinds of cancers,
> each of which is treated differently. A hospital that has good scores
> on surgery involving cancer of the pancreas may not do so well with a
> different type of cancer.

-   **In some cases, the specific topics track serious failures in a
    hospital's performance which happen only once in a great while.**

> You have to be careful when comparing hospitals on these very rare
> events. The numbers are so small that it is hard to know when a
> difference means something or just happens by chance. An example would
> be a reaction to a blood transfusion, which happens in only a handful
> of cases out of a million people each year.

-   **Don't give too much weight to small differences between
    hospitals.**

> Even on more common events, be careful not to give too much weight to
> small differences. If in one hospital, 25 people out of a thousand had
> too much bleeding after surgery, and in another hospital, 26 people
> out of a thousand did, that's a really small difference and you
> shouldn't worry about it.

-   **Some differences in scores may reflect the age of patients or how
    sick patients are rather than the care provided by the hospital.**

> Hospitals vary in quality, but they also vary in terms of their
> patients. Their patients can be differ in terms of their age***,*** or
> in terms of how sick they are.
>
> If one hospital takes care of people who happen to be older, or
> sicker, that hospital's patients are more likely to die or have
> certain complications, no matter how good the hospital is.
>
> **We want to show you differences that relate to how hospitals
> actually perform**, rather than differences that relate to how old or
> sick their patients are. So to the extent possible, the information in
> this Report takes account of differences between hospitals in the age
> of their patients, and how sick they are. The scores in this report
> have been calculated to try to take account of these differences. For
> details about how the scores in this report were developed, **[Click
> here for Technical Details about the Quality Information in this
> Report]{.underline}**

**Hospital Quality: What is it? Where can I find learn more about it?**

Quality in health care, including in hospitals, can be described as
"doing the right thing, at the right time, in the right way \-- and
having the best possible results."

The Institute of Medicine recently stated that high quality health care
is:

-   ***Effective:*** Treatment uses scientific knowledge and medical
    experience to increase the chances of getting the best results, and
    decrease the chance of getting bad results, including death.

-   ***Safe:*** Treatment does not result in medical complications or
    cause harm to the patient that can be prevented.

-   ***Patient-centered:*** Doctors, nurses, and other medical staff
    treat patients with respect, dignity and compassion, and are
    responsive to patients' needs, values, and preferences.

-   ***Timely:*** Patients get the care they need without harmful
    delays.

-   ***Efficient:*** Treatment does not waste doctors' or patients' time
    or money.

-   ***Equitable:*** The same level of care is available to everyone,
    including men, women and children of all cultures, incomes,
    education level, social status or any other characteristic.

# Where to learn more about Hospital Quality

The information in this Report deals with the first two aspects of
hospital quality described above -- effective care and safe care. If you
are interested in other aspects of quality care, here are some resources
that can help. We also list websites with materials to help you think
through the process of choosing a hospital.

**Hospital Compare -- Department of Health and Human Services**

-   *Hospital Compare* is a website with quality information on almost
    all hospitals in the US. Current information includes measures of
    timely and effective care for three conditions: heart attack, heart
    failure and pneumonia. There is also a measure of safe care, the
    surgical infection prevention rate.

> In the next year or so, the website will add two kinds of new
> information: information similar to this report about death rates for
> patients admitted for different operations and medical conditions, and
> information about patients' experiences in hospitals, such as how well
> doctors and nurses communicate with patients and how responsive
> hospital staff are to patient needs. Go to
> **[www.hospitalcompare.hhs.gov]{.underline}**.
>
> In addition, the *Hospital Compare* website provides a *Hospital
> Checklist* that you can use to think through a range of issues to
> consider in choosing a hospital. Go to
> **[http://www.hospitalcompare.hhs.gov/Hospital/Static/About-HospChecklist.asp]{.underline}**

**Agency for Healthcare Research & Quality (AHRQ)**

-   *Quick Checks for Quality: Choosing Quality Health Care*, an
    information sheet by AHRQ, from
    **[http://www.ahrq.gov/consumer/quick.htm]{.underline}**.

-   AHRQ's *Your Guide to Choosing Quality Health Care*, from
    **[http://www.ahrq.gov/consumer/qnt]{.underline}**

-   *Be an Active Health Care Consumer*
    (**[http://www.ahrq.gov/path/beactive.htm]{.underline}**), an AHRQ
    web page that includes a list of quality tools and information for
    people who want to take an active role in their health care. Among
    the resources is a booklet, ***Guide to Health Care Quality: How to
    Know it When You See It***

To contact AHRQ by mail write to:

Agency for Healthcare Research and Quality\
Office of Communications and Knowledge Transfer\
540 Gaither Road, Suite 2000\
Rockville, MD 20850.

To reach them by phone, call (301) 427-1364

**Joint Commission on the Accreditation of Healthcare Organizations**

This organization (JCAHO) is the primary group that reviews and
accredits hospitals in the United States.

-   *Quality Check*
    (**[http://www.qualitycheck.org/consumer/searchQCR.aspx]{.underline}**),
    a site of the Joint Commission on the Accreditation of Healthcare
    Organizations, on which you can look up hospitals that meet this
    organization's patient safety and quality standards.

To reach JCAHO with a general question, call 630-792-5000.

To order JCAHO publications, call 877-223-6866

**If you have concerns and complaints about your care**

If you have a complaint about the quality of the medical care you or a
loved one received at a hospital, first contact the hospital's patient
advocate. You can usually reach the patient advocate through the
hospital's telephone operator.

If you still need help, there are two agencies in every state that work
on hospital quality.

-   *The Quality Improvement Organization or QIO.* This is the
    organization to contact if you are not satisfied after calling the
    hospital's patient advocate.

-   *The State Survey Agency.* This is the organization to call if you
    have other complaints about a health care facility.

The phone numbers for the State Survey Agency and the Quality
Improvement Organization in your state can be found at
**[www.medicare.gov/Contacts/Home.asp]{.underline}** Additional
information about hospitals may be found on websites of these state
agencies.

You can also contact the Complaint Hotline at the Joint Commission on
the Accreditation of Healthcare Organizations (JCAHO).

Phone: 1-800-994-6610

E-mail: <complaint@jointcommission.org>.

**Technical details about the quality information in this Report**

The quality indicator scores in this report are based on standardized
information that all hospitals in our state are required to submit to
(insert name of state agency). Hospitals have to demonstrate that the
information they provide is accurate and complete. The (agency) actually
calculates the scores, not the hospitals.

The specific indicators in this report were developed by the Agency for
Healthcare Research and Quality (AHRQ), and are called the AHRQ Quality
Indicators. AHRQ is a federal government agency whose mission is to
improve the quality and safety of health care in the United States.

AHRQ saw a need for a set of hospital quality indicators that could be
collected easily, based on information that was gathered in exactly the
same way from hospital to hospital. Dozens of experts in health services
research, internal medicine and pediatrics, statistics, and health care
quality measurement worked together to develop and test these indicators
to make sure they were medically meaningful, accurate and reliable. The
indicators are regularly reviewed and updated. **[Click here for
detailed information about the AHRQ Quality Indicators]{.underline}**

AHRQ has developed several kinds of indicators. The ones in this Report
include what are called Inpatient Quality Indicators, Patient Safety
Indicators, and Pediatric Quality Indicators. Both of these sets of
indicators relate primarily to the *results* of hospital care for
patients.

**[Click here for detailed information about the AHRQ Inpatient Quality
Indicators]{.underline}**

**[Click here for detailed information about the AHRQ Patient Safety
Indicators]{.underline}**

**[Click here for detailed information about the AHRQ Pediatric Quality
Indicators]{.underline}**

**How we analyzed the data and calculated scores**

*In this section of the website, the sponsor should present information
about the methods they used in analyzing the data and calculating
scores. For example, this is the place to explain how some hospitals
were identified as being "better" or "worse" than average, additional
details about risk-adjustment methods, and whether or not the data were
smoothed, or combined for several years.*