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Glossary of Terms and Reports

A | B-C | E-H | I-L | M-N | P | T-V | Reports Defined | Quality Initiatives Involvement Descriptions

If the word or terms you seek are not listed in this glossary, see also: "Deciphering Medspeak" which provides both English and Spanish definitions.

"Acute care hospital" A general, medical or surgical hospital providing medical care to patients in medical and surgical units on the basis of physicians' orders and approved nursing care plans.

"Actual rate" The exact number of times something occurs, such as a death, birth, medical procedure or illness.

"Admissions" is the actual number of patients that went to the hospital and were admitted for further inpatient care See also: Total Admissions.

"Antibiotic, antibiotics" Any substance that can destroy or inhibit the growth of bacteria and similar microscopic organisms.

"Average charge" is the published price that hospitals set as a starting point for negotiating with insurance companies, rarely the amount that patients actually pay. Roughly 10 percent or less of hospital claims statewide are paid at the charges rate.

"Average length of stay" is the amount of time, measured in days that a patient stays in the hospital. A hospital's goal is to reduce the average length of stay to promote patient safety and efficiency.

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"Bacteria" A single-celled organism. Bacteria in a wound can cause infection. Bacteria are the plural form of bacterium, and refer to more than one organism.

Diabetes:
Diabetes is a disease characterized by high blood sugar (glucose) and other signs. It occurs when your body fails to make or use insulin correctly. Insulin is needed to move glucose (blood sugar) into cells, where the body uses it for energy to keep the body functioning. There are several types of diabetes, and family history, lifestyle and genetics play a role in whether you will get this disease. Diabetes can occur in childhood and be life-long (called type 1 diabetes), or can develop as an adult (called type 2 diabetes). Type 1 diabetes means the cells of the pancreas produce little or no insulin which is responsible for allowing (blood sugar) glucose to enter the cells of the body. Lack of exercise, poor nutrition and being overweight significantly increase your risk of type 2 diabetes.

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"Expected rate" See predicted rate.

"Fall" A patient fall is an unplanned descent to the floor (or extension of the floor), e.g. trash can or other equipment) with or without injury to the patient and occurs on an eligible reporting nursing unit. All types of falls are included whether they result from physiological reasons (such as fainting) or environmental reasons (such as a slippery floor). It includes assisted falls, such as when a staff member attempts to minimize the impact of the fall. It excludes falls by visitors, students, staff members, patients on units not eligible for reporting or patients from eligible reporting unit when that patient was not on the unit at the time (such as in the radiology department).

"Healthcare provider" A general term referring to a health professional or a healthcare organization. Examples include physician, surgeon, nurse, nurse practitioner, or organizations such as a hospital.

"Heart" An organ of the body that pumps blood.

"Heart attack" The sudden occurrence of a blockage in the heart that obstructs the blood supply to the heart and results in death of cells or tissues of heart muscle. It is characterized by sudden severe chest pain often moving to the shoulder, arm, or jaw, shortness of breath, nausea, loss of consciousness, and sometimes resulting in death.

"Heart failure" The chronic inability of the heart to pump a sufficient amount of blood throughout the body, leading to a pooling of blood in the body and shortness of breath.

High blood pressure:
Blood pressure refers to the pressure exerted by blood against the walls of large blood vessels that deliver the blood to parts of the body. When the pressure of the blood is greater that what is considered normal for an individual, it is called high blood pressure, or hypertension. A person with high blood pressure has a higher risk of heart attack or stroke. High blood pressure that is left untreated by medication or diet places an individual at risk for strokes, heart attacks, heart failure and kidney failure.

Hip Replacement
A hip replacement is a surgical procedure in which all or part of the hip joint is replaced by a synthetic implant (prothesis). The hip consists of a ball and socket joint, linking the thigh and the pelvis. The ball at the head of the thigh rests within the cup-shaped socket joint of the pelvic bone. Hip replacement is usually for a patient over 60 years old and can be due to severe arthritis pain, fractures or tumors in these bones, all of which can severely limit activities of daily living. It can also be done for younger patients with arthritis or trauma to that area of the body. A total hip replacement involves three parts as follows. The hip socket is replaced by a plastic, ceramic or metal cup. Second, the head of the femur is replaced by a ball and lastly a metal stem is attached to the bone shaft to make the device more stable. For more information please see the National Library of Medicine's Medline Plus "Hip Replacement" information.

"Hospital(s); acute care hospital(s)" Is a general, medical or surgical hospital providing medical care to patients in medical and surgical units on the basis of physicians' orders and approved nursing care plans.

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"Infection, infectious" An uncontrolled growth of bacteria or harmful microscopic organisms in a person resulting in illness.

"Inpatient" A person admitted into a hospital

"Inpatient care" Medical services delivered to a patient who needs physician care for at least 24 hours, usually in an acute care hospital.

Knee Replacement
This is a surgical procedure that is performed on a patient with a damaged or diseased knee. It replaces the joint surfaces of the knee with metal or plastic implants (prosthesis) to allow the knee to have continuous motion and freedom from pain. Typically, severe arthritis of the knee affecting everyday activity is the main reasons for total knee replacement. The surgery is performed by an orthopedic surgeon and the knee cap is moved aside so that that ends of the thigh bone and the shin bone can be cut, as well as the undersurface of the knee cap, to fit the prosthesis. The parts of the prothesis can consist of metal, plastic, ceramic or combinations of these materials. For more information please see the National Library of Medicine's Medline Plus "Knee Replacement" information.

"Lung, lungs" An organ of the body for breathing, that takes oxygen from the air for use in the body.

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"Microscopic" An organism or substance so small that it can only be seen using a microscope.

"Mortality" Death.

"Myocardial infarction" The cessation of the heartbeat; a heart attack, sometimes resulting in death.

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"Participation" is a list of the quality improvement programs a hospital participates in as part of its ongoing effort to improve patient care.

"Physician" A person qualified by education and authorized by law to practice medicine and provide medical care. Sometimes called a doctor, though doctor can have a broader meaning.

"Pneumonia" An inflammation of the lungs caused by a virus, bacteria or other microscopic organisms or substances.

"Pressure" in a pressure ulcer compresses underlying tissue and small blood vessels against the surface beneath. Pressure is exerted vertically. Tissue then dies.

"Pressure Ulcer" A pressure ulcer develops after admission to the hospital and is a localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. Pressure ulcers can develop on any skin surface subject to excess pressure such as under oxygen tubing, drainage tubing, casts, cervical collars or other medical devices. If there is no documentation that the pressure ulcer was present on admission then the ulcer is counted as a hospital-acquired pressure-ulcer.

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"Predicted rate" Also termed the expected rate. It is an estimate of the number of times something should occur when additional factors a patient may have are taken into account. These factors may include age and health issues that could make a patient more likely to die or to have medical complications.

"Primary care provider" A health professional who provides medical care services and manages routine healthcare needs. Examples include physician, nurse or nurse practitioner.

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"Shear or Friction" Friction is the resistance created when one surface moves horizontally across another (such as dragging a patient across bed linen). Shear occurs when one layer of tissue slides horizontally over another, deforming and disrupting blood flow (such as when the head of the bed is raised greater than 30 degrees). Both require pressure exerted by the body against the bed or chair surface to create the tissue injury.

"Total admissions" is the number of patients that went to this hospital in the specified time period and were admitted to stay for further inpatient care. The total admissions included in this data reflect all the admissions hospitals report to the New Jersey Department of Health and Senior Services. Total hospital admissions include inpatients, same day surgery and newborn patients.

"Virus" A microscopic infectious agent that reproduces itself within the cells of an individual and can result in illness.

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Reports Defined

The following are definitions of the four reports available in this Web site.

"Heart Failure Mortality Report" - Is a report of the percentage of patients who die from heart failure in each hospital. (This is the actual rate.) Also provided is the predicted rate that adjusts factors such as the patient's age and other health issues that could make the patient more at risk for heart failure complications. (This is the predicted rate.) The hospital's quality goal is to have a rate that is equal to or lower than the predicted rate.

"Myocardial Infarction Mortality Report" - Is a report of the percentage of patients who die from myocardial infarction - or heart attack in each hospital. (This is the actual rate.) Also provided is the predicted rate that adjusts factors such as the patient's age and other health issues that could make the patient more at risk for having a fatal heart attack. (This is the predicted rate.) The hospital's quality goal is to have a rate that is equal to or lower than the predicted rate.

"Pneumonia Mortality Report" - Is a report of the percentage of patients who die from pneumonia in each hospital - that is, pneumonia that already existed when the patient entered the hospital, (i.e. community-acquired). The report excludes pneumonia acquired by the patient after entering the hospital. (This is the actual rate.) Also provided is the predicted rate that adjusts factors such as the patient's age and other health issues that could make the patient more at risk for pneumonia complications. (This is the predicted rate.) The hospital's quality goal is to have a rate that is equal to or lower than the predicted rate.

"Postoperative Surgical Infections Report" - Is a report of the percentage of patients who developed an infection following surgery in each hospital. (This is the actual rate.) Also provided is the predicted rate that adjusts factors such as the patient's age and other health issues that could increase the chances for developing an infection following surgery. (This is the predicted rate.) The hospital's quality goal is to have a rate that is equal to or lower than the predicted rate.

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Quality Initiatives Involvement Descriptions

Adopted the NJHA Position Statement Dangerous Abbreviations and Dose Designations
This position statement adopts a standard list of banned abbreviations and dose designations to minimize confusion when physicians and nurses work in different facilities, including hospitals, post-acute facilities and ambulatory surgical centers. For example, it urges clinicians to avoid using a zero after a decimal point (such as 1.0 mg) because the 1.0 could easily be mistaken for 10 if the decimal point is not seen. Hospitals are encouraged to incorporate this statement into their own policies and procedures and it was endorsed by the NJHA Board of Trustees and developed in collaboration with clinicians and physicians from across the state.

Adopted the NJHA Position Statement Surgical Site Marking and Verification
This position statement helps reduce wrong-site surgeries through a standard policy for the marking and verification of surgical sites. It outlines a multi−step process for marking surgical sites by indelible marker with the word "yes' or the physician's initials. It encourages patient involvement when possible when marking the surgical site and calls for a 'time-out' before any procedure is performed, for the entire surgical team to verify the patient identification, the correct side and site, the procedure to be performed and the availability of any necessary equipment or implants. Hospitals are encouraged to incorporate this statement into their own policies and procedures and it was endorsed by the NJHA Board of Trustees and developed in collaboration with clinicians and physicians from across the state.

Participates in the NJHA Antimicrobial Resistance Initiative (AMRI)
AMRI helps to exchange the latest information on the rise of antimicrobial resistant infections in the use of indwelling urinary catheters (a tube that drains urine from the bladder into a bag). Participating hospitals and healthcare facilities work with industry experts and NJHA Quality Institute staff and share best practice protocols, to stop the spread of these antibiotic-resistant infections. This initiative is currently active.

Participates in NJHA's Expecting Success: Excellence in Cardiac Care Learning Network
NJHA's Expecting Success: Excellence in Cardiac Care Learning Network is funded by the New Jersey Health Initiatives (NJHI) and is under the aegis of the NJHA Quality Institute. Ten New Jersey hospitals have been selected as grant recipients who will participate in this 24-month quality improvement program. The Project in New Jersey is modeled after the National Project: Expecting Success. Using a collaborative Learning Network of 10 hospitals around the state, this initiative will develop and disseminate quality improvement strategies, models and resources to improve cardiac care for African-American and Hispanic/Latino patients diagnosed with heart failure.

Participated in the NJHA Intensive Care Unit (ICU) Collaborative
The NJHA ICU Collaborative was designed to improve patient safety and quality of care in intensive care units. Participating hospitals worked with national experts in critical care and patient safety, and shared their experiences and lessons learned with each other. Hospitals focused on several dimensions of care, including the culture of patient safety, ventilator−associated pneumonia and catheter-related blood stream infections. This initiative was concluded in 2006 and yielded impressive results in reducing the occurrences of pneumonia and bloodstream infections in ICU patients.

Participated in the NJHA Pressure Ulcer Collaborative
The NJHA Pressure Ulcer Collaborative is designed to improve patient safety and the quality of care provided in all healthcare settings where the elderly might develop pressure ulcers, commonly called bed sores. Participating healthcare facilities work with national experts in pressure ulcers and patient safety, and with each other, focusing on several dimensions to treat and prevent pressure ulcers. This initiative is currently closed. Participating organizations achieved a 70% reduction in pressure ulcer incidents.

Participated in the NJHA Rapid Response Teams Collaborative
A rapid response team consists of clinicians who are specially trained to quickly bring critical care expertise to the patient bedside (or wherever it is needed). This team identifies unstable patients and those patients likely to suffer cardiac or respiratory arrest. The purpose is to respond proactively to patient complaints, signs and symptoms. The NJHA Rapid Response Teams Collaborative has developed a Learning Network to communicate relevant issues, share best practice protocols, ask questions and seek additional resources for use in RRT performance improvement.

Participates in the New Jersey Hospital Quality Initiative (NJHQI)
The New Jersey Hospital Quality Initiative is a project funded by the Healthcare Foundation of New Jersey and implemented through a partnership with the New Jersey Department of Health and Senior Services, the Rutgers Center for State Health Policy and the NJHA Quality Institute. It was designed to assist hospitals in improving the reliability of care delivered to patients within the broad diagnostic area of heart failure. Participating hospitals will learn principles of high reliability organizations and improvement strategies that can be applied to practices and systems to ensure that recommended care and information is consistently delivered to all patients.

Participates in VHA, Inc. Patient Quality and Safety Initiatives
VHA, Inc. is a national healthcare provider alliance of more than 2,400 not-for-profit healthcare organizations. VHA, Inc. is sponsoring several clinical improvement initiatives to help its members address hospital−acquired infections in different arenas. VHA, Inc. programs include the prevention of methicillin-resistant Staphyloccus aureus (MRSA) infections, surgical site infection, catheter-related blood stream infection, central line infections; ventilator-associated pneumonia prevention and initiatives for improving hand hygiene, isolation and barrier precautions and implementing active surveillance methods.

Participates in Eliminating MRSA (VHA)
This VHA initiative focuses on the reduction of MRSA infections and will redesign processes in their hospitals to actively detect MRSA carriers, isolate and use of dedicated equipment, improve hand hygiene, decontaminate the environment and equipment and manage central venous catheter and ventilator bundles. Efforts will include changing the culture of care and use proven techniques from previous projects on patient safety from the Institute for Healthcare Improvement.

Participates in Medication Reconciliation Collaborative (VHA)
This VHA initiative provides support to hospitals to ensure that the information about the patient's medications (i.e. prescription and over-the-counter drugs) is reconciled at transition points for the patient, such as admission to the hospital, transfer to another healthcare facility and discharge from the hospital. It involves processes including creating the most accurate list possible of all medications a patient is taking - including drug name, dosage, frequency, and route - and comparing that list against the physician's admission, transfer, and/or discharge orders, with the goal of providing correct medications to the patient at all transition points within the hospital.

Participates in Rapid Response Team Collaborative (VHA)
VHA, Inc. is a national healthcare provider alliance of more than 2,400 not−for−profit healthcare organizations. VHA, Inc. is sponsoring several clinical improvement initiatives. A rapid response team consists of clinicians who are specially trained to quickly bring critical care expertise to the patient bedside (or wherever it is needed). This team identifies unstable patients and those patients likely to suffer cardiac or respiratory arrest. The purpose is to respond proactively to patient complaints, signs and symptoms.

Participates in VHA, Inc. Transformation of the ICU (TICU) Project
VHA, Inc. is a national healthcare provider alliance of more than 2,400 not−for−profit healthcare organizations. VHA, Inc. is sponsoring several clinical improvement initiatives. The Transformation of the ICU (TICU) project seeks to improve the intensive care units of participating hospitals starting with improvements to the ICU culture, teamwork and ventilator associated pneumonia and catheter related blood stream infections.

Participates in Transformation of the OR (VHA)
Transformation of the OR is a multi-year program designed to help member hospitals improve clinical quality, OR efficiency and financial performance. Through participation, organizations will transform their operating rooms into high-quality, safe and efficient centers of excellence.

Member of the Institute for Healthcare Improvement 100,000 Lives Campaign
Developed by the Institute for Healthcare Improvement, the 100,000 Lives Campaign had 3,100 participating hospitals. It reduced inpatient deaths by an estimated 122,000 in 18 months through overall improvement in care, including improvement associated with six interventions recommended by the initiative. This initiative concluded in 2006 and the new 5 Million Lives Campaign builds upon this success. It promotes the adoption by hospitals of up to 12 improvements in care that can save lives and reduce patient injuries in order to protect patients from five million incidents of medical harm over a 24-month period, ending Dec. 9, 2008. It represents a continuation of the largest improvement effort undertaken in recent history by the healthcare industry. Formally unveiled in December 2006, this new campaign includes all hospitals participating in the 100,000 Lives Campaign and will include additional hospitals. It has been endorsed by the American Hospital Association, the American Nurses Association, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services and the Joint Commission.

Participates in the Leapfrog Hospital Rewards Program™
The Leapfrog Group is a voluntary program of employers that work to encourage easy access to health care information and to reward hospitals that meet specific criteria like the use of computerized physician order entry (CPOE) systems for ordering patients' medications. The Leapfrog Hospital Rewards Program™ provides incentives to hospitals that achieve and sustain quality and efficiency improvements in several clinical areas. The program works with established clinical measures from The Joint Commission and the federal Centers for Medicare and Medicaid Services (CMS).

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