Process of Care Measures

When it comes to choosing where to receive medical treatment, patient safety should be one of the most important factors considered. At Yale New Haven Hospital, we are committed to delivering the highest quality, safest care possible.

From the emergency room to your physician's office, successful medical care depends on three key factors:

  • A prompt and accurate diagnosis
  • The most effective known treatment, delivered in a timely manner
  • An individualized, comprehensive follow-up plan to monitor and maintain health

Specific patients and conditions require different tests, treatments and interventions. The experience and expertise of healthcare providers, as well as access to the latest, most technology-advanced tools and techniques, all contribute to how effective and safe the care you receive will be.

Patient safety includes everything from working to minimize the spread of infectious diseases (like pneumonia) to administering the right dose of antibiotics at the right time to minimize the risk of infection after surgery.

Process of Care Measures

Studies show that proper preventative care can reduce the occurrence of surgical site infections and other common post-surgical complications. Learn more at Hospital Compare.

Results/Info Table

Scorecard What was asked/why it's important
Outpatients having surgery who got an antibiotic at the right time - within one hour before surgery Hospitals can prevent surgical wound infections. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections. The timing is important: getting an antibiotic earlier, or after surgery begins, is not as effective. Hospital staff should make sure patients get antibiotics at the right time. Higher percentages are better.
Outpatients having surgery who got the right kind of antibiotic Hospitals can prevent surgical wound infections. Medical research has shown that certain antibiotics work better to prevent wound infections for certain types of surgery. Hospital staff should make sure patients get the antibiotic that works best for their type of surgery. Higher percentages are better.
Surgery patients who were taking heart drugs called beta blockers before coming to the hospital, who were kept on the beta blockers during the period just before and after their surgery It is often standard procedure to stop patients' usual medications for awhile before and after surgery. But if patients who have been taking beta blockers suddenly stop taking them, they can have heart problems such as a fast heartbeat. For these patients, staying on beta blockers before and after surgery makes it less likely that they will have heart problems. Higher percentages are better.
Surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection Surgical wound infections can be prevented. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective. Hospital staff should make sure surgery patients get antibiotics at the right time. Higher percentages are better.
Surgery patients who were given the right kind of antibiotic to help prevent infection Surgical wound infections can be prevented. Medical research has shown that certain antibiotics work better to prevent wound infections for certain types of surgery. Hospital staff should make sure patients get the antibiotic that works best for their type of surgery. Higher percentages are better.
Surgery patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery) Continuing the use of antibiotics any longer than necessary can increase the risk of side effects or cause drug resistance, which means the antibiotics won't work as well the next time they are needed. Percentages represent the number of patients whose antibiotics were stopped at the right time (within 24 hours after surgery). Higher percentages are better.
Heart surgery patients whose blood sugar (blood glucose) is kept under good control in the days right after surgery Even if heart surgery patients do not have diabetes, keeping their blood sugar under good control after surgery lowers the risk of infection and other problems. "Under good control" means their blood sugar should be 200 mg/dL or less when checked first thing in the morning. Higher percentages are better.
Surgery patients needing hair removed from the surgical area before surgery, who had hair removed using a safer method (electric clippers or hair removal cream - not a razor) Preparing a patient for surgery may include removing body hair from skin in the area where the surgery will be done. Medical research has shown that shaving with a razor can increase the risk of infection. It is safer to use electric clippers or hair removal cream. Higher percentages are better.
Surgery patients whose doctors ordered treatments to prevent blood clots after certain types of surgery Certain surgeries (those for which the patient are still for long periods of time after surgery) increase the risk of blood clots. A blood clot slows down the flow of blood, causing swelling, redness, and pain. It can also travel to other parts of the body and—if it gets into the lungs—is a serious, potentially fatal, complication. Percentages represent timeliness and appropriateness of blood clot preventative treatment (blood-thinning medication, elastic support stockings, mechanical air stockings, etc.) ordered by doctors for at-risk patients after surgery. Higher percentages are better.
Patients who got treatment at the right time (within 24 hours before or after their surgery) to help prevent blood clots after certain types of surgery For certain types of surgery, studies show that measures to prevent blood clots work best when they are administered in a timely manner. Percentages represent number of at-risk patients who received blood clot prevention treatment at the right time (within 24 hours before or after surgery). Higher percentages are better.

Pneumonia is an infectious, bacterial disease that causes abnormal inflammation and irritation in the lungs. It can interfere with treatment for other conditions and be fatal in high-risk patients. Learn more at Hospital Compare.

Results/Info Table

Scorecard What was asked/why it's important
Outpatients having surgery who got an antibiotic at the right time - within one hour before surgery The pneumococcal vaccine may help you prevent, or lower the risk of complications of pneumonia caused by bacteria. It may also help you prevent future infections. Patients with pneumonia should be asked if they have been vaccinated recently for pneumonia and, if not, should be given the vaccine. Higher percentages are better.
Pneumonia Patients Whose Initial Emergency Room Blood Culture Was Performed Prior To The Administration Of The First Hospital Dose Of Antibiotics Different types of bacteria can cause pneumonia. A blood culture is a test that can help your health care provider identify which bacteria may have caused your pneumonia, and which antibiotic should be prescribed. A blood culture is not always needed, but for patients who are first seen in the hospital emergency department, it is important for the accuracy of the test that blood culture be conducted before any antibiotics are started. It is also important to start antibiotics as soon as possible. Higher percentages are better.
Pneumonia Patients Given Smoking Cessation Advice/Counseling Smoking damages your lungs and can make it hard to breath. Smoking increases your chances of getting pneumonia or other chronic lung diseases like emphysema and bronchitis. Smoking is also linked to lung cancer, heart disease, and stroke, and can cause premature death. It is important for you to get information to help you quit smoking before you leave the hospital. Quitting may reduce your chance of getting pneumonia again. Higher percentages are better.
Pneumonia Patients Given Initial Antibiotic(s) within 6 Hours After Arrival Antibiotics are used to treat adults with pneumonia caused by bacteria. Early treatment with antibiotics can cure bacterial pneumonia and reduce the possibility of complications. This information shows the percent of patients who were given their first dose of antibiotics within 6 hours of arrival at the hospital. Patients who get pneumonia during their stay at the hospital are not counted in this measure. Higher percentages are better.
Pneumonia Patients Assessed and Given Influenza Vaccination Pneumonia is a lung infection that is usually caused by bacteria or a virus. If pneumonia is caused by bacteria, hospitals will treat the infection with antibiotics. Different bacteria are treated with different antibiotics. To learn about how hospitals use a blood test to choose the most effective treatment for pneumonia patients, refer to the Process of Care measure named Percent of Pneumonia Patients Whose Initial Emergency Room Blood Culture Was Performed Prior To The Administration Of The First Hospital Dose Of Antibiotics. Higher percentages are better.
Pneumonia Patients Assessed and Given Influenza Vaccination Flu shots reduce the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a community or facility. Hospitals should check to make sure that pneumonia patients, particularly those who are age 50 or older, get a flu shot during flu season to protect them from another lung infection and to help prevent the spread of influenza. Since a flu shot is effective for just one flu season, the period of time used to calculate this rate is the flu season (from approximately November through March), in contrast to other measures on Hospital Compare, which are generally collected throughout the year. Higher percentages are better.
Pneumonia Mortality (Death) Rates Percentages represent the death rate of pneumonia patients (based on 795 total patients) compared to the U.S. National 30-day death rate for all Medicare patients with pneumonia. Ratings have been risk-adjusted, meaning they take into account how sick people were before hospital admission. Lower percentages are better.

The heart is a muscle that gets oxygen through blood vessels. Blood clots sometimes form in these vessels and block the flow of oxygen to heart, which can cause a heart attack (also known as a myocardial infarction or AMI). Decisive, accurate and swift action for patients experiencing a heart attack, as well as the right follow-up plan, can improve outcomes. Learn more at Hospital Compare.

Results/Info Table

Scorecard What was asked/why it's important
Average number of minutes before outpatients with chest pain or possible heart attack got an ECG "ECG" (sometimes called EKG) stands for electrocardiogram. An ECG is a test that can help doctors know whether patients are having a heart attack. Process of care say that patients with chest pain or a possible heart attack should have an ECG upon arrival, preferably within 10 minutes. This measure tells the average (median) number of minutes it takes before patients got an ECG. A lower number is better.
Outpatients with chest pain or possible heart attack who got drugs to break up blood clots within 30 minutes of arrival

Blood clots can cause heart attacks. Certain patients having a heart attack should get a "clot busting" drug to help break up the blood clots and improve blood flow to the heart.

Standards for care say that a clot busting drug should be given within 30 minutes of arrival at the hospital. This measure tells the percent of patients who got a clot busting a within 30 minutes of arrival. Higher percentages are better.
Outpatients with chest pain or possible heart attack who got aspirin within 24 hours of arrival or prior to transfer Blood clots can cause heart attacks. For many patients having a heart attack, taking aspirin soon after symptoms of a heart attack begin may help break up a clot and make the heart attack less severe. If patients have not taken aspirin themselves before going to the hospital, they should get aspirin when they arrive. Standards for care say patients should get aspirin within 24 hours of arrival at the hospital. This measure tells what percent of patients got aspirin within this time period.
Heart Attack Patients Given Aspirin at Arrival The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart can't get enough oxygen. This can cause a heart attack. Chewing an aspirin as soon as symptoms of a heart attack begin may help reduce the severity of the attack. This chart shows the percent of heart attack patients who were given (or took) aspirin within 24 hours of arrival at the hospital. Higher percentages are better.
Heart Attack Patients Given Aspirin at Discharge Blood clots can block blood vessels. Aspirin can help prevent blood clots from forming or help dissolve blood clots that have formed. Following a heart attack, continued use of aspirin may help reduce the risk of another heart attack. Aspirin can have side effects like stomach inflammation, bleeding, or allergic reactions. Talk to your health care provider before using aspirin on a regular basis to make sure it's safe for you. Higher percentages are better.
Heart Attack Patients Given ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD) ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure and are particularly beneficial in those patients with heart failure and decreased function of the left side of the heart. Early treatment with ACE inhibitors and ARBs in patients who have heart failure symptoms or decreased heart function after a heart attack can also reduce their risk of death from future heart attacks.
Heart Attack Patients Given Smoking Cessation Advice/Counseling Smoking increases your risk for developing blood clots and heart disease that can result in a heart attack, heart failure or stroke. Smoking causes your arteries to thicken and your blood vessels to narrow. Fat and plaque stick to the walls of your arteries, which makes it harder for blood to flow. Reduced blood flow to your heart may result in chest pain, high blood pressure, and an increased heart rate. Smoking is also linked to lung disease and cancer, and can cause premature death. It is important that you get information to help you quit smoking before you leave the hospital. Quitting may help prevent another heart attack. Higher percentages are better.
Heart Attack Patients Given Beta Blocker at Discharge Beta blockers are a type of medicine that is used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on your heart by slowing the heart rate and reducing the force with which your heart muscles contract to pump blood. They also help keep blood vessels from constricting in your heart, brain, and body. If you have a heart attack, you should get a prescription for a beta blocker before you leave the hospital. Higher percentages are better.
Heart Attack Patients Given Fibrinolytic Medication Within 30 Minutes Of Arrival The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels and the heart can't get enough oxygen. This can cause a heart attack. Fibrinolytic drugs are medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. You should get them within 30 minutes of arrival at the hospital. Higher percentages are better.
Heart Attack Patients Given PCI Within 90 Minutes Of Arrival The heart is a muscle that gets oxygen through blood vessels. Sometimes blood clots can block these blood vessels, and the heart cannot get enough oxygen. This can cause a heart attack. Percutaneous Coronary Interventions (PCI) are procedures that are among the most effective ways to open blocked blood vessels and help prevent further heart muscle damage. A PCI is performed by a doctor to open the blockage and increase blood flow in blocked blood vessels. Improving blood flow to your heart as quickly as possible lessens the damage to your heart muscle. It also can increase your chances of surviving a heart attack.
Heart Attack Mortality (Death) Rates Percentages represent the death rate of heart attack patients (based on 674 total patients) compared to the U.S. National 30-day death rate for all Medicare patients suffering a heart attack. Ratings have been risk-adjusted, meaning they take into account how sick people were before hospital admission. Lower percentages are better.

Heart failure is a condition resulting in a weakened heart muscle. The condition is most commonly due to high blood pressure, coronary artery disease (CAD), heart attack or cardiomyopathy. In its weakened state, the heart cannot pump enough blood to meet the demands of the body. Proper and timely interventions for heart failure patients can improve outcomes. Learn more at Hospital Compare.

Results/Info Table

Scorecard What was asked/why it's important
Heart Failure Patients Given Discharge Instructions Heart failure is a chronic condition. It results in symptoms such as shortness of breath, dizziness, and fatigue. Before you leave the hospital, the staff at the hospital should provide you with information to help you manage the symptoms after you get home.
Heart Failure Patients Given an Evaluation of Left Ventricular Systolic (LVS) Function The proper treatment for heart failure depends on what area of your heart is affected. An important test is to check how your heart is pumping, called an "evaluation of the left ventricular systolic function." It can tell your health care provider whether the left side of your heart is pumping properly. Higher percentages are better.
Heart Failure Patients Given ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD) ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure and are particularly beneficial in those patients with heart failure and decreased function of the left side of the heart. Early treatment with ACE inhibitors and ARBs in patients who have heart failure symptoms or decreased heart function after a heart attack can also reduce their risk of death from future heart attacks. Higher percentages are better.
Heart Failure Patients Given Smoking Cessation Advice/Counseling Smoking increases your risk for developing blood clots and heart disease, which can result in a heart attack, heart failure or stroke. Smoking causes your blood vessels to thicken. Fat and plaque then stick to the wall of your blood vessels, which makes it harder for blood to flow. Reduced blood flow to your heart may result in chest pain, high blood pressure, and an increased heart rate. Smoking is linked to lung disease and cancer, and can cause premature death. It is important for your health that you get information to help you quit smoking before you leave the hospital. Higher percentages are better.
Heart Failure Mortality (Death) Rates Percentages represent the death rate of heart failure patients (based on 910 total patients) compared to the U.S. National 30-day death rate for all Medicare patients diagnosed with heart failure. Ratings have been risk-adjusted, meaning they take into account how sick people were before hospital admission. Lower percentages are better.
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