How to Give Your Hospital a Check-Up
If you or a family member is hospitalized for a serious medical condition, you are likely to count on your doctor and/or other medical personnel to know the best way to treat the problem.
Latest resource: By consulting a Web site known as Hospital Compare (www.hospital compare.hhs.gov), you can learn how conditions that often land people in the hospital should be treated-and how more than 4,000 US hospitals (about 95% of the nation's total) measure up in administering this care.*
Created by the US Department of Health and Human Services in partnership with the Hospital Quality Alliance (a public-private collaboration to improve hospital care), the Website details the performance of US hospitals in handling four key areas of hospital care-heart attack, heart failure, pneumonia and prevention of surgical infections.
Important: In some cases, there may be valid reasons for an exception to the recommended treatment (for example, an allergy to a particular drug).
*Click the "Find and Compare Hospitals" button on the home page. By following the prompts, you can look up specific hospitals in your area or across the nation and review up to three hospitals' ratings side-by-side.
Heart Attack
Until recently, there was a considerable gap in the care that hospitals across the US provided for heart patients. Now there is much more consistency in the treatment standards and the hospitals' performance. Among the recommended measures…
- Aspirin on arrival. Most heart attacks occur when a blood clot blocks a coronary artery, Patients who are given an aspirin to chew (not swallow) upon arrival at a hospital at the onset of heart attack symptoms are more likely to survive.
National average performance: 93%.
- Clot-removing treatment within 90 minutes. A percutaneous coronary intervention (PCI), in which a catheter is inserted in a coronary artery and used to remove blockages, is the fastest way to restore circulation to the heart. If the procedure is performed within 90 minutes of a patient's arrival, it can significantly improve patient outcomes.
National average performance: 60%.
Other heart attack measures: Aspirin given at discharge, 90%...the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers for heart attack prevention, 85%.
Heart Failure
Also known as congestive heart failure, this condition occurs when the heart's pumping action is inadequate. It's often caused by high blood pressure, coronary artery disease or cardiomyopathy (a condition in which the heart muscle is severely damaged by infection, drug and/or alcohol use or other causes). Among the recommended measures..
- Evaluation of left ventricular systolic (LVS) function. This is an important test that tells whether the left side of the heart is pumping properly.
National average performance: 85%.
- Discharge instructions. Heart failure is a chronic condition that requires lifelong management. Patients should be given instructions on diet, exercise, medication use and monitoring their weight (even a small gain can signal potentially dangerous fluid retention along with instructions to make follow-up appointments.
National average performance: 66%.
Other heart-failure measures: Use of ACE inhibitors or angiotensin receptor blockers for treatment of heart failure symptoms, 84%.
Pneumonia
Pneumonia is one of the most common and potentially serious lung diseases, killing about 60,000 Americans annually. Among the recommended measures…
- Identify bacteria prior to giving antibiotics. Patients who come to the emergency room with symptoms of pneumonia (such as shortness of breath, chills, fever and chest pain) always should be given a blood-culture test to identify the type of bacterium causing the infection. This will help doctors to ascertain the most effective antibiotic.
National average performance: 90%.
- Antibiotics within six hours. Research has shown that pneumonia patients who are given antibiotics within six hours of arrival at the hospital have better outcomes than those who are given antibiotics later.
National average performance: 93%.
- Pneumococcal vaccine. Even when a patient already has bacterial pneumonia, giving a pneumococcal vaccine can help prevent future bacterial pneumonia infections. Every hospital patient with pneumonia should be given the vaccine.
National average performance: 75%.
Other pneumonia measures: The use of oxygenation assessment (to gauge the amount of oxygen in the patient's bloodstream and to determine if he/she needs oxygen therapy), 99%...smoking-cessation advice, 84%...the use of the most appropriate antibiotic, 86%.
Surgical Care
Surgery is a routine hospital procedure but is associated with some of the highest risks, Among the recommended measures…
- Stopping antibiotics within 24 hours. Taking antibiotics prior to surgery can greatly reduce the risk for infection-but continuing the drugs longer than 24 hours after the operation increases the risk for stomach pain, serious diarrhea and other side effects.
National average performance: 78%.
- Steps to prevent blood clots. Certain types of surgery, particularly orthopedic procedures such as hip replacement surgery, can result in venous thrombosis (a condition in which a blood clot forms, usually in a leg, and can travel to the lungs, causing pulmonary embolism-an often-fatal condition). Venous thrombosis is most likely to occur after procedures that make it difficult for patients to move for extended periods.
Clots can be prevented with the use of blood-thinning medications, elastic stockings or mechanical air stockings that promote blood circulation in the legs.
National average performance: 79%.
Other surgical measures: Administering preventive antibiotics one hour before incision, 82%.. the use of the appropriate preventive antibiotic, 90%.