Cooley Dickinson Hospital is committed to providing patients with care that is safe and of the highest quality. We strive every day to provide the best possible care to every patient receiving services at any of our sites.

Measuring our performance against a set of measures where experts agree on the best treatment for a certain condition helps us evaluate and improve the way we deliver care. It is the goal at Cooley Dickinson Hospital to score 100% on all of these measures.

You may access a complete set of our performance data in four areas: heart attack care, pneumonia care, congestive heart failure care and preventing surgical infections.

Heart Attack Care

A heart attack (also called AMI or acute myocardial infarction) happens when arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can't get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die. These quality measures show some of the standards of care provided, if appropriate, to someone who has a heart attack (higher % is better).

The symptoms of a heart attack can include:

• chest pain (often described as a crushing, squeezing or burning pain in the center of the chest and may radiate to your arm or jaw)
• shortness of breath
• dizziness or faintness
• sweating
• nausea
• cold or clammy skin
• a gray or very ill appearance.

Sometimes there may be no symptoms, especially if you have diabetes. Women sometimes have different symptoms, such as a different kind of chest pain and/or abdominal pain.

More information about heart health is on the:

• American Heart Association's website
• National Library of Medicine and the National Institutes of Health website

Heart Failure Care

Heart failure is a weakening of the heart's pumping power. With heart failure your body doesn't get enough oxygen and nutrients to meet its needs. Your heart tries to pump more blood, but the muscle walls become weaker over time. These quality measures show some of the standards of care provided, if appropriate, to someone who has heart failure (higher % is better).

Symptoms of heart failure may include:

• shortness of breath from fluid in the lungs
• swelling (such as in legs, ankles or abdomen)
• dizziness
• fatigue
• weakness
• cold or clammy skin
• a rapid or irregular heartbeat.

Heart failure can be a result of heart condition due to

• hardening of the arteries, also known as coronary artery disease
• a heart attack
• cardiomyopathy (heart muscle damage from infection or alcohol or drug abuse), or
• an overworked heart (caused over time by conditions like high blood pressure, kidney disease, diabetes, or a defect from birth)

For more information about heart health, check the American Heart Association's website or Medline Plus for health information from the National Library of Medicine and the National Institutes of Health.

Patient Falls

Falls are the leading cause of injury-related visits to the emergency departments in the United States and the primary etiology of the accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. More than 90 percent of hip fractures occur as a result falls. Falls are usually the number one adverse event in any hospital. Approximately 2% of all admissions will fall.

The rate of inpatient falls on medical-surgical units. This rate is calculated based on 1000 patient days.

At Cooley Dickinson Hospital, the Falls Prevention Team uses a variety of risk assessment measures, including:

• Implementation of unit based safety boards
• Review of hourly rounding to include identification of safety strategies related to the falls protocol
• Communication/ validation of activation of all alarms/ safety measures for identified fall risk patients during patient transitions
• Implementation / utilization of the "falling star" sign on the white boards in patient rooms to communicate falls risk to staff
• Use of a "Hall Pass" that includes a "check box" for bed alarms as a communication tool for transportation staff
• Real time review of fall incident reports with staff face to face follow up
• Stryker Bed In-service

More information about patient falls can be found online at:
http://www.premierinc.com/safety/topics/falls/
http://www.ihi.org/ihi/search/searchresults.aspx?searchterm=falls&searchtype=basic

Pneumonia Care

Pneumonia is caused by a viral or bacterial infection that fills your lungs with mucous. This lowers the oxygen level in your blood. These quality measures show some of the recommended treatments for pneumonia (higher % is better).

Symptoms of pneumonia can include the following:

• Difficulty breathing
• “Wet” cough. Your mucus may look green or bloody.
• Chest pain
• Fever and chills
• Fatigue

For more information about lung health, check the American Lung Association's website or Medline Plus for health information from the National Library of Medicine and the National Institutes of Health.

You should also be aware that flu shots reduce the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a community. Hospitals should check to make sure that pneumonia patients get a flu shot during flu season to protect them from another lung infection and to help prevent the spread of influenza in the community.

Pressure Ulcer

Pressure ulcers are areas of damage to the skin and underlying tissue, usually occurring over bony areas.

The assessment of patients at risk for pressure ulcers is an important component of care management. Not only do hospital-acquired pressure ulcers prolong the hospital stay but they also may contribute to serious complications and increased patient discomfort. Certain patient populations are at greater risk for pressure ulcers, including post-operative patients, overweight patients, and the frail elderly. Efficient application of preventive measures against pressure ulcers requires the identification of patients at risk. Adequate risk assessment tools are still needed because the predictive value of existing tools is sometimes unsatisfactory.

Percent of inpatients with Stage II (& above) pressure ulcers acquired while in the hospital on medical-surgical units.

At Cooley Dickinson Hospital, the Pressure Ulcer Prevention Team uses a variety of risk assessment measures, including:

• In-service for nursing staff
• Increased use of evidence-based measures
• Improvements in Hospitalist activity order process
• Daily Braden scores
• Supplemental risk measures
• Reallocation of air pumps
• Changes in the microclimate of beds
• Replacement of particular model of bed

More information about pressure ulcers can be found online at:
http://www.ihi.org/ihi/search/searchresults.aspx?searchterm=pressure+ulcer&searchtype=basic

Sepsis Care

Septicemia, or septic shock, is a syndrome that results from an acute invasion of the bloodstream by certain microorganisms or their toxic products.

Early identification and comprehensive resuscitation of high-risk patients are key links in the chain of survival for the management of severe sepsis and septic shock. Research has shown that the first 6 hours of early sepsis management are especially critical from a diagnostic, pathogenic, and therapeutic perspective. Steps taken during this period can have a significant impact on outcome. Sepsis joins trauma, stroke, and acute myocardial infarction in having "golden hours," or a window of time early on in the course of disease for actions that offer the most benefit.

Rate of inpatient admissions with any discharge diagnosis of septicemia, simple sepsis, severe sepsis or septic shock. This rate is calculated based on 1000 patient days.

The symptoms of sepsis can include:

• Fever, chills and shaking
• Rapid heart rate
• Rash on skin
• Pain in joints

More information about sepsis can be found online at:
http://www.ihi.org/ihi/search/searchresults.aspx?searchterm=sepsis&searchtype=basic

Stroke Care

A stroke is a sudden interruption in the blood supply of the brain. Most strokes (about 80 %) are caused by a sudden blockage of the arteries leading to the brain (ischemic stroke), other strokes are caused by bleeding into the brain tissue when a blood vessel burst (hemorrhagic stroke). Because stroke occurs rapidly and requires immediate treatment, being aware of the signs and symptoms of stroke and its effects can make a significant difference in the outcome.

Stroke warning signs:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

More information about stroke can be found online at:
http://www.ihi.org/ihi/search/searchresults.aspx?searchterm=stroke&searchtype=basic
http://www.americanheart.org/presenter.jhtml?identifier=3053#Stroke

 

Surgical Infection Prevention

Hospitals can reduce the risk of wound infection after surgery by making sure patients get the right medicines at the right time on the day of their surgery. These quality measures show some of the standards of care provided, if appropriate, for someone having surgery (higher % is better).

Hospitals can reduce the risk of wound infection after surgery by providing the right medicines at the right time on the day of surgery. There are also steps that you, as a patient, can take to make sure the surgery is as safe as possible. You should give your doctor or nurse a list of all your medications, including vitamins, herbal medicines, and over-the-counter medications. You should also tell your doctor or nurse about any allergies and bad reactions to anesthesia.

Sometimes patients get an infection after surgery, even if the hospital took steps to prevent it. Here are signs to watch for:

• The surgical wound is red, hot, and swollen.
• You have a fever of over 100 degrees after you go home.
• A smelly or yellow/green fluid is coming out of the wound.
• Your pain is increasing even though you are taking pain medication.
• Call your doctor or local hospital immediately if you have any of these signs.

Disclaimer:

Information on the Cooley Dickinson Hospital’s website:

• Is not intended as a substitute for medical advice
• Does not establish a doctor-patient relationship
• Is not intended or assumed to be a guarantee of a specific result

Our goal is to provide meaningful information so that you may make informed decisions about your healthcare. Please remember that medical information provided by Cooley Dickinson Hospital, in the absence of a visit with a health care professional, must be considered as an educational and informational service only.