Delaware Hospital Guide - A public service of the Delaware Healthcare Association

Quality Measures

Quality Measurements as reported on Hospital Compare / Definitions
Note that measures for systems have been consolidated for member hospitals.
Data are for the collection period beginning 07/01/2009 to 06/30/2010 and posted on 04/20/2011
This report is based on information from Hospital Compare, a website 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.
Beebe Medical Center
424 Savannah Road
Lewes, DE 19958
(302) 645-3300

Click here for information about the Measures and Conditions reported.
 
Condition: Heart Attack
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
AMI-1. Aspirin at Arrival  264    100%  99%  100%  99%
AMI-2. Aspirin at Discharge  261    100%  98%  100%  99%
AMI-3. ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD)  39    97%  96%  100%  95%
AMI-4. Smoking Cessation Advice/Counseling  85    100%  99%  100%  100%
AMI-5. Beta Blocker at Discharge  258    97%  98%  100%  98%
AMI-7a. Fibrinolytic Medication Within 30 Minutes Of Arrival  0    N/A  55%  100%  67%
AMI-8a. PCI Within 90 Minutes Of Arrival  40    92%  90%  100%  90%

Condition: Heart Failure
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
HF-1. Discharge Instructions  276    97%  88%  100%  92%
HF-2. Evaluation of Left Ventricular Systolic (LVS) Function  353    98%  98%  100%  99%
HF-3. ACE Inhibitor or ARB for Left Ventricular Systolic Dysfunction (LVSD)  104    95%  94%  100%  94%
HF-4. Smoking Cessation Advice/Counseling  59    98%  98%  100%  100%

Condition: Emergency Department: AMI Cardiac Care
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
OP-2. Fibrinolytic Therapy received within 30 minutes  N/A  5  N/A  54%  100%  0%
OP-3b. Median Time to transfer patients for Acute Coronary Intervention  N/A  5  N/A  61 minutes  40 minutes  72 minutes
OP-4. Aspirin at Arrival  4  1  100%  95%  100%  100%
OP-5. Median Time to ECG  5  1  2 minutes  8 minutes  3 minutes  6 minutes

Condition: Emergency Department: Surgical Care
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
OP-6. Timing of Antibiotic Prophylaxis  294     95%  92%  99%  90%
OP-7. Prophylactic Antiobiotic Selection  288     97%  94%  100%  87%

Condition: Pneumonia
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
PN-2. Pneumococcal Vaccination Status  260    97%  93%  100%  91%
PN-3b. Blood Cultures Performed in the Emergency Department Prior to Initial Antibiotic Received in Hospita  290    99%  96%  100%  94%
PN-4. Smoking Cessation Advice/Counseling  99    99%  97%  100%  100%
PN-5c. Initial Antibiotic(s) within 6 Hours After Arrival  273    97%  95%  100%  94%
PN-6. Appropriate Initial Antibiotic Selection  190    95%  92%  99%  90%
PN-7. Influenza Vaccination Status  165    98%  91%  100%  87%

Condition: Surgical Care Improvement
Measure Number Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
SCIP-CARD-2. Patients on beta blocker at admission who received beta blocker during perioperative period  462  2  99%  93%  100%  95%
SCIP-INF-1. Prophylactic Antibiotic Received Within 1 Hour Prior to Surgical Incision  982  2  98%  97%  100%  97%
SCIP-INF-2. Prophylactic Antibiotic Selection  988  2  99%  97%  100%  99%
SCIP-INF-3. Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time  981  2  100%  94%  100%  97%
SCIP-INF-4. Blood glucose controlled in days following heart surgery  138  2  96%  93%  99%  94%
SCIP-INF-6. Safe method of hair removal from surgical site used when needed  1279  2  100%  99%  100%  100%
SCIP-INF-9. Urinary catheter removed within two days following surgery  471  2  98%  90%  100%  95%
SCIP-VTE-1. Recommended Venous Thromboembolism Prophylaxis Ordered  264  2  96%  94%  100%  96%
SCIP-VTE-2. Appropriate Venous Thromboembolism Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery  264  2  96%  92%  100%  93%

Condition: Children’s Asthma Care
Measure Number of Patients Hospital Footnotes Hospital Score National Average Nat 90th Percentile State Average
No Data are available for this hospital.

Hospital Compare - Survey of Patient Hospital Experiences

Data are for the collection period beginning 07/01/2009 to 06/30/2010 posted on 04/20/2011 / Definitions
Report is based on information from Hospital Compare, a website 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.

Click individual questions for detailed definitions and comparisons.
Survey question Measure Percent Measure Percent Measure Percent
Nurses communicated well Always 79% Usually 16% Sometimes 5%
Doctors communicated well Always 79% Usually 15% Sometimes 6%
Help received quickly Always 68% Usually 24% Sometimes 8%
Pain controlled well Always 72% Usually 19% Sometimes 9%
Staff explained medicines Always 63% Usually 15% Sometimes 22%
Room and bath kept clean Always 68% Usually 22% Sometimes 10%
Area quiet at night Always 47% Usually 36% Sometimes 17%
Given discharge instructions Yes 83% No 17%    
Overall hospital rating High 70% Medium 21% Low 9%
Would recommend hospital Definitely 70% Probably 25% No 5%

Hospital Compare - Outcome Measures

Data are for the collection period beginning 07/01/2006 to 06/30/2009 and posted on 04/20/2011

Report is based on information from Hospital Compare, a website 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.

Click here for information about the Outcome Measures reported.

30-Day Risk Adjusted Mortality Rates
Measure Hospital Predicted Range National Average
Number Patients Mortality Rate from to
Heart Attack 370 16.3% 13.5% 19.5% 16.2%
Heart Failure 639 12.0% 9.9% 14.5% 11.2%
Pneumonia 444 9.8% 7.9% 12.4% 11.6%

30-Day Risk Adjusted Readmission Rates
Measure Hospital Predicted Range National Average
Number Patients Readmission Rate from to
Heart Attack 296 20.1% 17.1% 23.5% 19.9%
Heart Failure 760 23.9% 21.4% 26.7% 24.7%
Pneumonia 475 16.2% 13.7% 19.0% 18.3%

Hospital Compare - Efficiency Measures

Data are for the collection period beginning 01/01/2008 to 12/31/2008 and posted on 04/20/2011

Report is based on information from Hospital Compare, a website 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.

Click here for information about the Outcome Measures reported.

Imaging Efficiency
Measure Number Patients Hospital Footnotes Hospital Score National Average State Average
OP-8. MRI Lumbar Spine for Low Back Pain  293    23.5%  32.7%  25.8%
OP-9. Mammography Follow-up Rates  3147    5.7%  8.4%  7.3%
OP-10. Abdomen CT - Use of Contrast Material  2079    0.076%  0.191%  0.258%
OP-11. Thorax CT - Use of Contrast Material  1296    0.040%  0.054%  0.037%

 

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