GCHC Quality Trends

Greater Cincinnati Hospitals Improved on ALL Measures

Quality Trends
The following trend charts display Greater Cincinnati hospitals’ quality data for 2005 and 2006 for the quality measures related to heart attack and congestive heart failure. These measures assess how often recommended care (such as giving aspirin to heart attack patients) is delivered when it is appropriate. Comparisons are not presented for pneumonia because the data for that measure was included in the Hospital Quality Improvement Project in 2006 but not 2005. Only hospitals with two full years of data are included in the averages on the charts. For that reason, data from Atrium Medical Center and Margaret Mary Community Hospital are not included.

This performance score uses the "all or none" methodology to determine if patients received all of the recommended treatment for which they were eligible. For each condition on these charts (heart attack and heart failure), performance is determined at the patient level, summarized per hospital and them summarized for the Greater Cincinnati hospitals participating in this project.

A hospital’s process of care performance score is calculated with this formula (per condition):
Total # patients receiving all care measures/Total # patients qualifying for the care = % score

To download the Greater Cincinnati Hospital Quality Improvement Project (HQIP) written report with 2005 hospital performance data, click here.

Analysis
The Greater Cincinnati area average improved on ALL the measures related to heart attack and congestive heart failure from 2005 to 2006. The measure with the most significant improvement over the measured time period was associated with congestive heart failure; the Greater Cincinnati area hospitals improved their performance on the percentage of patients receiving discharge instructions from 59% in 2005 to 79% in 2006.

There were also several notable improvements on the measures related to heart attack. The percentage of patients receiving ACE inhibitors at discharge increased from 78% to 84% and the percentage of patients receiving PCI in less than 90 minutes improved from 37% in 2005 to 56% in 2006.

Click here for a glossary of terms.

Quality Trends: Charts

The charts below depict the Greater Cincinnati area hospitals' performance in the areas of heart attack and congestive heart failure from 2005 to 2006. The blue bar reflects all combined hospitals' 2005 performance, and the purple bar reflects all combined hospitals' 2006 performance. The gray horizontal line over the 2006 bar represents the average for the state of Ohio in 2006. The green bar reflects the national average in 2006.

Heart Attack
Heart Attack: Overall Performance 2005 - 2006 Greater Cincinnati Area Hospitals	Heart Attack: Aspirin Administered at Arrival, Within 24 Hours of Arrival, or Within 24 Hours Prior to Arrival 2005 - 2006 Greater Cincinnati Area Performance

Heart Attack: Aspirin Prescribed at Discharge 2005 - 2006 Greater Cincinnati Area Performance	Heart Attack: Patients Having Left Ventricular Ejection Fractions (LVEF) Below 40% that were Prescribed ACE Inhibitors at Discharge 2005 - 2006 Greater Cincinnati Area Performance

Heart Attack: Smoking Cessation Advice or Counseling Offered 2005 - 2006 Greater Cincinnati Area Performance	Heart Attack: Beta Blockers Prescribed at Discharge 2005 - 2006 Greater Cincinnati Area Performance

Heart Attack: Beta Blockers at Arrival 2005 - 2006 Greater Cincinnati Area Performance	Heart Attack: Fibrinolytic at Arrival 2005 - 2006 Greater Cincinnati Area Performance

Heart Attack: PCI - Rate Receiving PCI in Less than 90 Minutes 2005 - 2006 Greater Cincinnati Area Performance


Congestive Heart Failure
Congestive Heart Failure: Overall Performance 2005 - 2006 Greater Cincinnati Area Hospitals	Congestive Heart Failure: Patients with a Complete Set of Discharge Instructions in the Medical Record 2005 - 2006 Greater Cincinnati Area Performance

Congestive Heart Failure: Patients Receiving Left Ventricular Ejection Fraction (LVEF) Assessment 2005 - 2006 Greater Cincinnati Area Performance	Congestive Heart Failure: ACE Inhibitor Prescribed for Patients with CHF 2005 - 2006 Greater Cincinnati Area Performance

Congestive Heart Failure: Smoking Cessation Advice or Counseling Offered 2005 - 2006 Greater Cincinnati Area Performance

Glossary of Terms
ACE inhibitors, or inhibitors of Angiotensin-Converting Enzyme, are a group of medicines that are used primarily in treatment of hypertension and congestive heart failure, in some cases as the drugs of first choice.

Angina: Chest pain due to lack of oxygen supply.

Angiotensin Receptor Blockers (ARBs) are a group of medicines used in hypertension (high blood pressure), diabetic nephropathy (kidney damage due to diabetes) and congestive heart failure.

Arrhythmia is an irregular heart beat, faster or slower than normal.

Atherosclerosis: Commonly referred to as a "hardening" of the arteries. It is caused by the formation of multiple plaques within the arteries.

Beta Blockers (sometimes written as β-blockers) are a class of drugs used for various indications, but particularly for the management of hypertension and cardiac arrhythmias.

Cerebral Perfusion is the net supply of blood flow to the brain.

Chronic is long-lasting and recurrent or characterized by long suffering.

Colonoscopy is the internal examination of the lower intestine.

Endoscopy means looking inside and refers to looking inside the human body for medical reasons.

Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract.

Graft: A surgical procedure to transplant tissue without a blood supply.

Lamina: Surface.

Laminectomy: Surgical removal of part of a vertebra (back bone). Usually done to relieve pressure on a spinal nerve caused by a herniated disk or bony spur.

Left Ventricular Function (LVF) is the assessment of how well the left ventricle is working.

Left Ventricular Ejection Fraction (LVEF) is the fraction of blood pumped out of the left ventricle with each heartbeat.

Left Ventricular Systolic Dysfunction (LVSD): An abnormal performance of the left ventricle or the muscular chamber of the heart. LVSD may often occur in the period following a heart attack and greatly increases patients' risk for recurrent heart attacks, heart failure or other deadly events.

Mortality is the rate of death.

Percutaneous Coronary Interventions (PCI): Procedures done for diagnosis or therapy which reach the heart through major blood vessels instead of having to open the chest.

Proton Pump Inhibitors (or PPIs) are a group of drugs designed to bring forth pronounced and long-lasting reduction of gastric acid production.

Respiratory Tract is the part of the anatomy that has to do with the process of respiration or breathing.

Spinal Stenosis is a medical condition where the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the natural process of spinal degeneration that occurs with aging.

Thrombolysis is the breakdown (lysis) by pharmacological means, of blood clots. It is sometimes referred to as clot busting for this reason.

Thrombolytic is an agent that facilitates the breakdown of blood clots.

Tranexamic Acid is often prescribed for excessive bleeding.

Vasopressin Analogues are chemicals similar in function to desmopressin. Taking a desmopressin dose 30-45 minutes before sleeping results in concentrated urine production, and the urination reflex experienced when the bladder fills above a certain level is not triggered.