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Definitions

Acute Myocardial Infarction (AMI)
A condition (also called a heart attack) that occurs when the 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.

Angioplasty
In angioplasty, a catheter is used to insert a balloon that is inflated to open a blocked blood vessel. Percutaneous transluminal coronary angioplasty (PTCA) is one of several procedures used to open a blocked blood vessel, known collectively as a percutaneous coronary intervention or PCI

Angiotensin Converting Enzyme (ACE) Inhibitor
A medicine used to treat heart attacks, heart failure, or a decreased function of the left heart. They stop production of a hormone that can narrow blood vessels. This helps reduce the pressure in the heart and lower blood pressure.

Angiotensin Receptor Blocker (ARB)
A medicine used to treat patients with heart failure and a decreased function of the left heart. ARBs block the action of a hormone that can narrow blood vessels. This helps reduce the pressure in the heart and lower blood pressure.

Antibiotic
Medicine used to fight bacteria in the body.

Beta Blocker
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 the heart by slowing the heart rate and reducing the force with which the heart muscles contract to pump blood. They also help keep blood vessels from constricting in the heart, brain and body.

Blood Culture
A blood test that shows if there are bacteria in the blood, and what type of bacteria it is. It helps your doctor decide which antibiotic to use to treat a bacterial infection.

Centers for Medicare & Medicaid Services (CMS)
The federal agency that runs the Medicare program for the elderly, aged and disabled. In addition, CMS works with the states to run the Medicaid program for low-income individuals. CMS works to make sure that people in these programs are able to get high quality health care.

Do hospitals that treat sicker patients have worse death rates? (Risk adjustment)
Hospitals that treat sicker patients do not necessarily have worse death rates. The hospital specific 30-day death (mortality) rates used in this report have been adjusted to account for differences in patients' health before their hospital admission. Sicker patients or patients with more health-related risks may be more likely to die than healthier patients. Moreover, patients who are sicker may be more likely to be treated at particular hospitals while patients who are healthier may be more likely to be treated at other hospitals. To compare hospitals fairly (and to avoid penalizing those that treat sicker patients) it is therefore important to consider differences in patients' health before they were admitted to the hospital. The statistical process of accounting for differences in patients' sickness before they were admitted to the hospital is called risk-adjustment. This statistical process aims to "level the playing field" by accounting for health risks that patients have before they enter the hospital.

Hospital Outcome of Care Measures
Measures designed to reflect the results of care, rather than how frequently a specific treatment or intervention was performed.

Hospital Process of Care Measures
Measures that show, in percentage form or as a rate, how often a health care provider gives recommended care; that is, the treatment known to give the best results for the most patients with a particular condition.

Hospital Quality Alliance (HQA) Improving Care Through Information
In December 2002, the American Hospital Association (AHA) Federation of American Hospitals (FAH), and the Association of American Medical Colleges (AAMC) launched the Hospital Quality Alliance (HQA), a national public-private collaboration to encourage hospitals to voluntarily collect and report hospital quality performance information. This effort is intended to make important information about hospital performance accessible to the public and to inform and invigorate efforts to improve quality. CMS and the Joint Commission participate in the HQA, along with the AHA, the FAH, the AAMC, the American Medical Association, the American Nurses Association, the National Association of Children's Hospitals and Related Organizations, American Association of Retired People, American Federation of Labor and Council of Industrial Organizations, the Consumer-Purchaser Disclosure Project, the Agency for Healthcare Research and Quality, the National Quality Forum, the Blue Cross and Blue Shield Association, the National Business Coalition on Health, General Electric and the U.S. Chamber of Commerce.

Influenza
Influenza is a serious and sometimes deadly lung infection that can spread quickly in a community. Symptoms included fever - often a high temperature of more than 102° Fahrenheit (38.9° Celsius), headache, muscle aches and pains, chills, cough and chest pain when you take a breathe ("pleuritic chest pain"). Although most people recover from the illness, the Centers for Disease Control and Prevention (CDC) estimates that in the United States more than 200,000 people are hospitalized and about 36,000 people die from the flu and its complications every year.

Influenza Vaccination ("Flu Shot")
The main way to keep from getting the flu is to get a yearly flu vaccination. Scientists make a different vaccine every year because the strains of flu viruses change from year to year. Nine to 10 months before the season beings, they prepare a new vaccine made from inactivated (killed) flu viruses. Because the viruses have been killed, they cannot cause infection. The vaccine preparation is based on the strains of the flu viruses that are in circulation at the time.

Left Ventricular Function Assessment
A test to check how well the heart is pumping.

Measurement
The process of collecting data to assess performance conducted at a single point in time or repeated over time.

Oxygenation Assessment
Test that measures the amount of oxygen in your blood to see if you need oxygen therapy.

Percutaneous Coronary Interventions (PCI)
The procedures called Percutaneous Coronary Interventions (PCI), such as angioplasty and atherectomy are among those that are the most effective for opening blocked blood vessels that cause heart attacks. Doctors may perform a PCI, or give medicine to open the blockage, and in some cases, may do both.

Pneumonia (pnemococcal) Vaccination
Vaccine given to prevent pneumonia, estimated to protect against 80% of bacteria causing pneumonia.

Quality
Quality health care is how well a doctor, hospital, health plan, or other provider of health care, keeps its members healthy or treats then when they are sick. Good quality health care means doing the right thing at the time, in the right way, for the right person and getting the best possible results.

Risk-Adjusted 30-Day Death (Mortality) Rates
The 30-day Risk-Adjusted Death (Mortality) Rates are produced using a complex statistical model, that relies on Medicare claims and enrollment information. The model predicts patient deaths for any cause within 30 days of hospital admission for heart attack o heart failure or pneumonia, whether the patients die while still in the hospital or after discharge. 30-day mortality is used because this is the time period when deaths are most likely to be related to the care patients received in the hospital. Deaths that occur outside the hospital within 30 days are included along with deaths that occur in the hospital, because some hospitals discharge patients sooner than others.

Stent
A small wire tube inserted in a blood vessel by a catheter to hold open a blocked blood vessel. One of several procedures to open a blocked blood vessel called a percutaneous coronary intervention (PCI).

Survey of Patients' Hospital Experiences
A national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay. This is also referred to as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).

The Joint Commission
An organization that evaluates and accredits health care organizations and programs in the United States. The Joint Commission looks at how well a hospital treats patients and how good a hospital's staff and equipment are. A hospital is accredited by The Joint Commission if it meets certain quality standards. These checks are done at least every 3 years. Most hospitals take part in these accreditations.