Below are some helpful definitions of key terms used throughout the PatientCareLink website:

Agencies and Organizations
Types of Hospitals
Types of Hospital "Units"
Other Terms

Agencies and Organizations:

This website was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS) along with the Hospital Quality Alliance (HQA). The HQA is a public/private collaboration established to promote reporting on hospital quality of care. The HQA consists of organizations that represent consumers, hospitals, doctors, employers, accrediting organizations, and Federal agencies. The information on this website can be used by anyone needing hospital care.

The Hospital Quality Alliance: Improving Care Through Information (HQA) is a public-private collaboration to improve the quality of care provided by the nation's hospitals by measuring and publicly reporting on that care.

This collaboration includes the Centers for Medicare & Medicaid Services (CMS), the American Hospital Association, the Federation of American Hospitals, and the Association of American Medical Colleges, and is supported by other organizations such as the Agency for Healthcare Research and Quality, the National Quality Forum, the Joint Commission on
Accreditation of Healthcare Organizations, American Medical Association, American Nurses Association, National Association of Children's Hospitals and Related Institutions, Consumer-Purchaser Disclosure Project, AFL-CIO, AARP, U.S. Chamber of Commerce, America's Health Insurance Plans, Blue Cross and Blue Shield Association, and the National Business Coalition on Health.

The goal of the program is to identify a robust set of standardized and easy-to understand hospital quality measures that would be used by all stakeholders in the healthcare system in order to improve quality of care and the ability of consumers to make informed healthcare choices. An important element of the collaboration is Hospital Compare (see above).

Types of Hospitals:

There are four major categories of hospitals at which you may receive care.

• Acute care community hospitals provide medical and nursing care for medical and surgical conditions.
• Specialty hospitals include long-term acute care hospitals, and rehabilitation or behavioral health hospitals that provide diagnostic and treatment services to patients with specified medical conditions or, in the case of behavioral health hospitals, diagnostic and treatment services for patients who have mental health-related illnesses.
• Teaching hospitals provide training for interns and residents who are studying to advance their skills as doctors. In general, all tertiary hospitals are teaching hospitals. Some acute care community hospitals may also have training programs for interns and residents.
• Tertiary hospitals provide medical and nursing care for medical and surgical conditions and also provide specialized consultative care by specialists, usually on referral from a medical provider, such as your primary care doctor.
  

Note: The staffing plans and reports you will see are divided into three groups: Acute Community Hospitals (58), Tertiary (10) and Specialty (13).

Types of Hospital "Units":

Hospitals have different types of units that are usually categorized based on the care that a patient will need.

• A medical surgical unit may have a mix of patients with different kinds of problems, such as respiratory, cardiac, or cancer problems.
• An Intensive Care Unit (ICU) cares for patients needing more focused, high-level care for part of their hospital stay. Specialized intensive care can also be provided in areas such as a cardiac care unit (CCU) or surgical intensive care unit (SICU).
• Some hospitals also have "step-down" units or telemetry units, for those patients who require more monitoring but do not need to be in an ICU.

Other Terms:

Falls

All documented falls with or without injury, experienced by patients on an eligible patient care unit. In this report, the rate of patient falls is reported, which is the number of falls for every 1,000 days of inpatient hospital care in the unit types reported. A fall is defined as an unplanned descent to the floor or an extension of the floor.

Falls with injuries (see also Falls)

All documented falls with an injury level of "minor" or greater experienced by patients on an eligible patient care unit. In this report, the rate of patient falls is reported, which is the number of falls for every 1,000 days of inpatient hospital care in the unit types reported. An injury level of minor is one that resulted in the application of a dressing, ice, cleaning of a wound, limb elevation, or topical medication.

Healthcare-Associated Infection (HAI)

Healthcare-associated infections are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting.

Nurse Sensitive Measures

Nationally standardized performance measures that provide a framework for how to measure the quality of nursing care and assess the extent to which nurses in hospitals contribute to patient safety, healthcare quality, and a professional work environment. Consumers can use them to assess the quality of nursing care in hospitals; providers use them to identify opportunities for improvement of critical outcomes and processes of care.

Smoking cessation counseling for heart failure, heart attack, pneumonia

A measure of the extent to which patients who smoke are hospitalized for heart attack, heart failure, or pneumonia and who receive counseling from medical professionals about the need to quit smoking. Smoking is linked to heart attacks, heart failure, and pneumonia, and quitting may prevent future occurrences of help improve a patient's current condition.

Pressure ulcer

A pressure ulcer is a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure in combination with shear and/or friction. A less-specific, general term for pressure ulcers is bed sores.

A pressure ulcer is an area of skin that breaks down when a person stays in one position for too long without shifting weight. This often happens with wheelchair use or if a person is bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies.

A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.

Readmission

Readmission, also known as re-hospitalization, occurs when patients who have had a recent stay in the hospital go back into a hospital again. Patients may have been readmitted back to the same hospital or to a different hospital or acute care facility. They may have been readmitted for the same condition as their recent hospital stay, or for a different reason.

Staffing Plan

Every hospital develops a staffing plan for each unit in its facility, estimating the number of nurses and/or other caregivers needed per shift for that particular unit to ensure patients receive appropriate care. Many different factors go into development of a staffing plan. Some of these include the experience and education of the registered nurse, the availability of other caregivers, the needs of the patients on the unit, and the severity of the patients' illnesses.

Worked Hours Per Patient Day (WHPPD)

Worked hours per patient day (WHPPD) are the number of hours of direct care a patient can expect to receive from an RN, along with LPNs and nursing assistants, in a 24-hour period. The actual number of direct care (worked) hours per patient day for RNs only - and for RNs, LPNs, and nursing assistants combined - are nationally recognized measures endorsed by the National Quality Forum and are included among a larger set of nursing-sensitive care measures. The NQF assembled experts in the fields of nursing and quality measurement to develop this set of measures.

This number will tell patients how many hours of nursing care they are receiving. It is not meant to be compared across units or across hospitals because it doesn't measure how sick the patients are or the skills and experience of the nurses are providing the care. It's important to look at the unit staffing plans to see what other types of caregivers are providing care and services on each unit.  It is also important to look at the annual reports to learn why care provided may be different from what was planned. t is one more piece of information for consumers to have in understanding how care is provided to them when they are in the hospital.