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Quality and Safety at Rush

Quality and safety at Rush

At Rush, our mission is to provide the best possible care for our patients. We measure many aspects of our care processes and our clinical outcomes to ensure that our patients get the very best care available. Learn more about our quality measures below.

Core measures

Core measures show how consistently hospitals give recommended treatments for certain common conditions. The most commonly used and compared nationally are the core measures established by the Joint Commission based on data from the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and Medicaid.

The measures are based on uniform standards for health care processesand the outcomes of those processes for common conditions such as heart attacks, heart failure and pneumonia. For each condition, there are multiple process measures that, when added up, help tell you about the quality of care at a hospital. These measures are based on research and are widely accepted.

Core measures help identify which aspects of a hospital's care need improving, and they can give you important insights into a hospital's ability to manage specific aspects of a disease. View Rush's core measures.

Example of a core measure set: treatment for a heart attack

A patient who is in a hospital because of a heart attack has treatments such as medication to address pain and actions to unclog, or open up, the artery feeding the heart muscle. The core measures look at whether that patient received appropriate related drugs, education and testing, and whether these actions occurred within certain timeframes.

The core measure score tells what percentage of the patients who came to the hospital for a heart attack within a certain timeframe (usually broken down by three months of the year) received all the right tests and treatments at the right times.

Hospital readmission rates

Readmission rates show whether patients who enter a hospital for a particular condition are readmitted to the hospital within 30 days after an initial discharge. Data on 30-day readmission rates are publicly available online from the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and Medicaid.

Because some hospitals, such as academic medical centers like Rush, tend to take care of significantly sicker patients and more complicated cases, the rate of readmissions is adjusted to take into account how sick patients were before being admitted to the hospital. This rate is then referred to as "risk adjusted." View Rush's readmission rates.

Mortality rates by condition

Mortality (or death) rates by condition show whether patients who enter a hospital for a particular condition are still alive 30 days after their initial admission to the hospital. Data on 30-day mortality rates are publicly available online from the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and Medicaid.

Because some hospitals, such as academic medical centers like Rush, tend to take care of significantly sicker patients and more complicated cases, the rate of mortality is adjusted to take into account how sick patients were before being admitted to the hospital. This rate is then referred to as "risk adjusted." View Rush's mortality rates by condition.

Mortality rates by service

Mortality observed to expected (o/e) is the risk-adjusted measure of a hospital's mortality (death) rate. Risk adjustment takes into account how sick patients are upon entering the hospital. (See more on risk adjustment below.) The mortality observed-to-expected measure tells us how we are performing on mortality relative to what is expected for our patients given a variety of complicating characteristics, including their age, chronic conditions like diabetes or heart failure, and whether the patient was transferred from another hospital or admitted as an emergency.

This measure is created from two different numbers:

  1. Observed mortality rate, which is measured as the percent of patients who die during their hospital stay. An example of this rate is 50 deaths among 5000 patients, or 1 percent observed mortality.
  2. Expected mortality, which adjusts for how sick or complex our patients are compared with patients seen at other hospitals in the country. The national average is used as a starting point and then adjusted higher or lower depending on the complicating characteristics of our patients.

Why do we need risk adjustment?

Healthier patients who come to the hospital for elective procedures have a much lower risk of death than patients who come to the hospital for life-threatening emergencies. Risk adjustment is a statistical process for estimating what percent of patients might die, given how sick they are. Without risk adjustment, we cannot accurately compare our performance with other hospitals. View Rush's mortality rates by service.

Patient safety indicators

The Agency for Healthcare Research and Quality (AHRQ), run by the U.S. Department of Health and Human Services, developed patient safety indicators to measure potential inpatient complications following certain procedures. Although not all the complications identified in these indicators are preventable, the process of monitoring patient safety indicators shows hospitals where to focus their attention for further review. View Rush's patient safety indicators.

Central line-associated blood stream infection rates

A central line-associated bloodstream infection is a type of infection that is associated with having a catheter inserted in a major vein, usually for the delivery of medications, nutrition or fluids. Bloodstream infections are often serious enough to cause a longer hospital stay or even death. These can be prevented through proper management of the central lines and the removal of these lines when they are no longer needed. View Rush's central line-associated blood stream infection rates.

Surgical patient outcomes

The American College of Surgeons’ National Surgical Quality Improvement Program is an outcomes-based program to measure and improve the quality of surgical care across surgical specialties. As a participant in the program, Rush University Medical Center is required to track the outcomes of inpatient and outpatient surgical procedures and collect data that is used to help improve patient safety and quality of surgical care.

This program provides risk-adjusted data. Because some hospitals, such as academic medical centers like Rush, tend to take care of significantly sicker patients and more complicated cases, the rate of mortality is adjusted to take into account how sick patients were before being admitted to the hospital. This rate is then referred to as "risk adjusted." View Rush's surgical patient outcomes.