Acute conditions

Acute conditions are severe and sudden in onset. Some examples of acute conditions are a heart attack, influenza or broken bone.

Acute Stroke Ready Hospital

Acute Stroke Ready Hospitals (ASRH) – ASRH are hospitals that can provide emergency stroke care. These hospitals can diagnose, treat, and transport acute stroke patients to a higher level of care as warranted. ASRH hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting an application and supporting documentation. ASRHs must annually attest their continued compliance to the Illinois Department of Public Health to maintain designation. ASRH hospitals may pursue a national certificate in addition to the Illinois Department of Public Health designation. These hospitals were previously called “Emergent Stroke Ready Hospitals.”

Admission from another hospital

Admission from another hospital indicates the patient was admitted to the hospital from another short term, acute-care hospital. This usually signifies that the patient required the transfer in order to obtain more specialized services that the originating hospital could not provide.

Admission from long term care facility

Admission from long term care facility indicates the patient was admitted to a hospital from a long term care facility, such as a nursing home.

Aggregate

An aggregate represents the sum total or the whole. For example, infection rate data displayed in aggregate for the state of Illinois cannot be used to determine the infection rate of a specific health care facility.

Ambulatory Surgical Treatment Centers (ASTCs)

These are outpatient facilities that perform specific non-complicated procedures.

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 Inhibitor (ACEI)

This is a group of medications used to treat heart attacks, heart failure, or 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)

This is a group of medications 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

An antibiotic is a medicine used to fight bacteria in the body.

Appendectomy

An appendectomy is the surgical removal of an inflamed or infected appendix.

Asthma

Asthma is a disease that affects the lungs. It can cause repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. People with asthma need to identify and remove any triggers in the environment that can make their asthma worse.

Baby Friendly

Scientific evidence currently demonstrates that breast feeding has important health benefits to both mothers and babies. Breast milk contains antibodies that can protect infants from bacterial and viral infections, and breastfed infants are at lower risk of certain chronic diseases, including diabetes, obesity and asthma. Research indicates that women who breastfeed may also have lower risk of some health problems, including certain breast and ovarian cancers, obesity and diabetes.

Despite the numerous benefits of breastfeeding, the number of women who breastfeed continues to lag behind national health objectives. A complex variety of factors have contributed to the barriers women face in breastfeeding. Nearly all births in the U.S. occur in hospitals, and hospitals can play an important role in supporting a mother's decision to breastfeed. The Baby Friendly Hospital Initiative, established by the United Nations Children's Fund (UNICEF) and the World Health Organization, is designed to encourage and recognize hospitals that offer an optimal level of care for breast feeding. Over 20,000 hospitals across the world have been recognized as "Baby Friendly". The essential components of the Baby Friendly Hospital Initiative involve implementation of the 'Ten Steps to Successful Breastfeeding". The ten steps include:

1. Hospitals have a written breastfeeding policy that is routinely communicated to all health care staff.
2. Train all health care staff in the skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within one hour of birth.
5. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants.
6. Give infants no food or drink other than breast milk unless medically indicated.
7. Practice rooming-in - allow mothers and infants to remain together twenty four hours a day.
8. Encourage breastfeeding on demand.
9. Give no pacifiers or artificial nipples to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

Beta Blocker

A beta blocker is a type of medicine that is used to lower blood pressure, treat chest pain 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 culture is a blood test that shows if there are bacteria in the blood, and if so, what type of bacteria. It helps health care providers determine which antibiotic to use to treat a bacterial infection.

CCS

The Clinical Classifications Software (CCS) is used to categorize diagnoses and procedures so that the data can be analyzed.

Central line

A central line is a flexible tube that is inserted near a patient's heart or into one of the large blood vessels near the heart. A central line can be used to administer fluids, antibiotics or medical treatment such as chemotherapy. If a central line is inserted incorrectly or not cared for properly, a bloodstream infection can result.

Central line-associated blood stream infection (CLABSI)

The National Healthcare Safety Network defines a CLABSI as a primary blood stream infection in a patient that had a central line in place, at the time of or within, 48-hours before the development of the bloodstream infection.

Charge

Charge is the amount the hospital charged for the entire hospital stay. It does not include professional (MD) fees. If you asked for information about procedures, charges will reflect the total hospital charge, not just the charge for that procedure. Charges are not necessarily how much was reimbursed.

Children's Acute Care Hospital

A Children’s Acute Care Hospital is a hospital that provides a wide array of specialized medical, surgical and psychological services for children with serious health care needs.

Children's Speciality Hospital

A children’s specialty hospital is a hospital that provides services for one or more focused health problems, such as spinal cord injuries, orthopedic conditions, certain chronic diseases like sickle cell disease, etc. Usually an array of medical, surgical and/or rehabilitative services for these conditions is provided.

Chronic condition

Chronic condition is defined as one condition that lasts over a long period of time.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma.

Composite measure

A composite measure is a single measure that is created by combining different measures together.

Comprehensive Stroke Center

Comprehensive Stroke Center (CSC) – are hospitals that meet standards to treat the most complex stroke cases which include all components of a PSC plus the following: advanced imaging techniques, availability of personnel trained in vascular neurology, neurosurgery, and endovascular procedures, 24/7 availability of personnel, imaging, operating room, and endovascular facilities, and other eligibility standards. Certified CSC hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting verification of the CSC national certification and a completed Application for Stroke Center Designation to the Department of Public Health.

Confidence Intervals

The confidence interval for a hospital's standardized infection ratio(SIR) is the range of possible SIRs within which there is a 95 percent confidence that the real SIR for that hospital lies, given the number of infections and procedures that were observed in that hospital in a specific time period.

Congestive Heart Failure

Congestive heart failure (CHF) is a condition in which the heart cannot pump enough blood to the body's other organs and is a progressive, chronic disease. CHF has substantial short-term mortality, which can vary from provider to provider.

COPD (Chronic Obstructive Pulmonary Disease)

Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma.

Coronary artery bypass surgery

Coronary artery bypass surgery re-establishes effective blood flow in the heart, when one or more heart blood vessels (arteries) are blocked by deposits and build up of a substance called plaque. New blood vessels are grafted inside the heart that help circulate blood more effectively.

Costs

Costs tend to reflect the actual costs of production (while charges represent what the hospital billed for the case). Total charges were converted to costs using cost-to-charge ratios based on hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS). In general, costs are less than charges.

Death rate

Death rate is how often patients who were treated for a particular illness or who had a particular procedure died before leaving the hospital. Usually the death rate is displayed as the number of deaths out of 100 or 1,000 patients discharged from the hospital. This information is noted at the bottom of each chart.

Deep Vein Thrombosis

A deep vein thrombosis, (also called DVT or blood clot) occurs when a blood clot forms in a large vein. These clots usually develop in the lower leg, thigh or pelvis and can cause serious illness, disability or in some cases death. A DVT is preventable and treatable if diagnosed correctly and early.

Denominator

This is the number of people (population) who are potentially capable of experiencing the event or outcome of interest. The denominator, along with the numerator, is used to calculate rates. The denominator is the bottom half of a fraction.

Diabetes

Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugar to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the sixth leading cause of death in the United States.

Diagnosis Related Groups

Diagnosis Related Groups (DRGs) are the diagnosis codes doctors and hospitals put on patient's medical bills that Medicare uses to decide how much to pay the hospital.

Died

This generally indicates in-hospital mortality. Please note, some unknown number of cases may have died outside the hospital but may still be included.

Discharge status

Discharge status indicates the disposition of the patient at discharge from the hospital, e.g., routine (home); to another short term hospital; to a nursing home; to home health care; or against medical advice (AMA).

Emergency Department Approved for Pediatrics

A hospital participating in an approved emergency medical system and designated by the Department pursuant to Section 515.4000 of the Illinois Emergency Medical Services and Trauma Code, to provide optimal emergency department care to pediatric patients 24 hours per day.

Emergency Medical System for Children

Since 1998, more than 100 hospitals in Illinois have received recognition by the Illinois Department of Public Health and the Emergency Medical Services for Children (EMSC) program for having the essential resources and capabilities in place to meet the emergency and critical care needs of seriously ill and injured children.

Hospitals can apply for one of three levels of voluntary recognition. Facilities that have a pediatric intensive care unit and can provide specialty inpatient services for the pediatric patient can seek recognition as a Pediatric Critical Care Center (PCCC). Hospitals that provide comprehensive emergency services and meet defined pediatric emergency care requirements can seek recognition as an Emergency Department Approved for Pediatrics (EDAP). The Standby Emergency Department for Pediatrics (SEDP) recognition is for hospitals that provide stabilization measures and have transfer guidelines in place when more definitive pediatric care is needed. Hospitals seeking this designation receive a site visit by the EMSC program staff to verify that the emergency department and pediatric department are capable of meeting the following key pediatric care standards:

• Professionals specially trained in pediatric emergency and critical care;
• Adequate staffing and provisions for pediatric consultation and backup support;
• Availability of essential pediatric equipment, supplies and medication;
• Protocols for the treatment of the abused child, of critically ill and injured children and of those children requiring transfer to a specialized care center; and
• Conduction of pediatric quality improvement activities.

The specific definitions of each level of recognition are outlined below:

• PCCC - Pediatric Critical Care Center. A hospital participating in an approved emergency medical system and designated by the Department to provide optimal critical and specialty care services to pediatric patients, and to provide all essential services either in-house or readily available 24 hours per day. Hospitals that are designated at the PCCC level must also meet all EDAP requirements.
• EDAP – Emergency Department Approved for Pediatrics. A hospital participating in an approved emergency medical system and designated by the Department pursuant to Section 515.4000 of the Illinois Emergency Medical Services and Trauma Code, to provide optimal emergency department care to pediatric patients 24 hours per day.
• SEDP – Standby Emergency Department for Pediatrics. A hospital participating in an approved emergency medical system and designated by the Department pursuant to Section 515.4010 of the Illinois Emergency Medical Services and Trauma Code, to provide optimal emergency department care to pediatric patients; and have transfer agreement(s) and transfer mechanisms in place when more definitive pediatric care is needed.

For more information on the Emergency Medical System for Children, visit http://www.luhs.org/emsc

Expected rate

The expected rate is the rate the facility would have if it performed the same as the reference population given the facility's actual case-mix (e.g., age, gender, DRG, and comorbidity categories).

Fibrinolytic Drugs

These are "clot-busting" medicines that can help dissolve blood clots in blood vessels and improve blood flow to your heart. They are important for treating heart attacks. If you have a heart attack, your doctor may give you a fibrinolytic drug, perform a percutaneous coronary intervention, or both.

Gender

Gender is coded as male or female, and appears as provided in the medical record.

Health care-associated infections (HAI)

Health care-associated infections are infections that patients acquire during the course of receiving treatment for other conditions within a health care setting.

Healthcare Facility Onset Incidence Rate of Clostridium difficile infections (CDI)

The number of lab results (from non-duplicate specimens) positive for Clostridium difficile identified 4 or more days after a patient was admitted to the facility, divided by number of patient days, multiplied by 10,000. For calculation of CDI rates, patient days for newborn populations (neonatal intensive care units, special care nurseries, well-baby nurseries, and newborns in labor and delivery units) are not included in the denominator. The standardized infection ratio for Healthcare Facility Onset Incidence Rate of CDI adjusts for the type of testing used at the facility, medical school affiliation, facility bed size, and the prevalence rate of Community Onset CDI.

Healthcare Facility Onset Incidence Rate of Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections

The number of positive lab culture results for MRSA (from non-duplicate unique blood source specimens) occurring hospital-wide identified 4 or more days after a patient was admitted to the facility, divided by total number of patient days, multiplied by 1,000. The standardized infection ratio for Healthcare Facility Onset Incidence Rate of MRSA bloodstream infections adjusts for medical school affiliation, facility bed size, and the prevalence rate of Community Onset MRSA.

Heart Attack

A heart attack or acute myocardial infarction (AMI) occurs when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle cannot get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die. Timely and effective treatments for a heart attack, which are essential for patient survival, include appropriate use of thrombolytic therapy to prevent blood clots and revascularization or opening of clogged blood vessels.

Hip Fracture

A hip fracture is a fracture (break) in a bone in the hip.

Hip Replacement

A hip arthroplasty (joint surgery) is an elective procedure performed to improve function and relieve pain among patients with chronic osteoarthritis, rheumatoid arthritis, or other degenerative processes involving the hip joint.

Hospital Central Line Associated Bloodstream Infections (CLABSI) rate per 1000

The total number of CLABSIs/Central-line days divided by 1,000.

Hospital charge

Hospital charge is the amount the hospital charged for the entire hospital stay. It does not include professional fees. If you asked for information about procedures, charges will reflect the total hospital charge, not just the charge for that procedure. Charges are not necessarily how much was reimbursed.

Hospital CLABSI rate per 1000

The total number of CLABSIs/Central-line days divided by 1,000.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

HCAHPS is a standardized survey instrument and data collection methodology for measuring patients' perspectives of hospital care.

Hospital costs

Hospital costs tend to reflect the actual costs of production (while charges represent what the hospital billed for the case). Total charges were converted to costs using cost-to-charge ratios based on hospital accounting reports from the Centers for Medicare and Medicaid Services (CMS). In general, costs are less than charges.

Hospital Service Areas

Hospital Service Areas (HSAs) are based on the Dartmouth Atlas Hospital Service Areas, which are defined as local health care markets for hospital care. HSAs are based on the collection of ZIP codes whose residents receive most of their hospitalizations from the hospitals in that area. HSAs were defined by assigning ZIP codes to the hospital area where the greatest proportion of their Medicare residents were hospitalized.

Hypertension

Hypertension is high blood pressure. Having high blood pressure raises your risk for heart disease and stroke, the first and third leading causes of death in the United States.

ICD-9-CM

ICD-9-CM stands for the "International Classification of Diseases - 9th revision - Clinical Modification." All diagnoses (or conditions) and all procedures that patients receive in the hospital are assigned an ICD-9-CM code. Codes for diagnoses can be up to 5 digits long and codes for procedures can be up to 4 digits long. There are about 12

Infection

An infection is a harmful colonization of the body by a foreign species (e.g. viruses, bacteria, parasites, etc.).

Infection Rate

An infection rate is the number of infections reported in a specified period of time divided by the number of exposures to an infection during the same specified period of time.

Influenza

Influenza or "flu" is a serious and sometimes deadly lung infection that can spread quickly in a community. Symptoms include fever - often a high temperature of more than 102 degrees Fahrenheit (38.9 degrees Celsius), headache, muscle aches and pains, chills, cough and chest pain when you take a breath (pleuritic chest pain). Although most people recover from the illness, the Centers for Disease Control and Prevention 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.

Inpatient Quality Indicators

Inpatient Quality Indicators (IQIs) The IQIs are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on quality. The IQIs include a variety of indicators, which are measured at the provider, hospital, or area level. Additional information can be found at https://qualityindicators.ahrq.gov/.

Intensive Care Unit (ICU) (a/k/a Critical Care Unit)

ICUs are hospital units that provide intensive observation and treatment of patients either dealing with or at risk of developing life-threatening problems. Smaller hospitals typically care for both medical and surgical patients in a combined medical/surgical ICU. Larger hospitals typically have separate ICUs.

Laparoscopic Cholecystectomy

A laparoscopic cholecystectomy is the removal of the gall bladder (cholecystectomy) performed with a laparoscope (a surgical instrument used to make small incisions). Laparoscopic cholecystectomy, which has been identified as an underused procedure, is associated with less morbidity in less severe cases.

Length of stay

Length of stay (LOS) is the number of nights the patient remained in the hospital for this stay. A patient admitted and discharged on the same day has a length of stay = 0.

Level II/III Neonatal ICU

Combined nursery housing both Level II and III newborns and infants. These nurseries are located in hospitals categorized as “Level 2 with Extended Capabilities (II/III)”: Hospitals with extended neonatal capabilities that provide an intermediate level of care to pregnant women and more complex care to newborns, when required. These hospitals do not have a neonatal intensive care nursery, but they do maintain a special care nursery that is covered by a neonatologist who is specifically trained to treat newborns requiring special care.

Level III Neonatal ICU

A hospital neonatal care unit (NICU) organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness. Level III is subdivided into four levels differentiated by the capability to provide advanced medical and surgical care as defined by the American Academy of Pediatrics. These units, located in hospitals designated as Level 3 hospitals, provide an intensive care approach for high-risk women who are vulnerable to complicated pregnancies and for at-risk newborns. They provide sub-specialty care for both high-risk pregnancies and for newborns at-risk, and are equipped with neonatal intensive care units.

Magnet Recognition

The magnet recognition program was developed by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association. It recognizes health care organizations that demonstrate excellence in nursing practice and quality patient care as a driving force. Organizations that are formally recognized must possess a number of specific qualities;

• Strong nursing leadership, shared organizational decision-making and effective communication;
• A model of patient care that emphasizes nursing accountability, coordination of patient care and vision of patient advocacy;
• Commitment to professional nursing “best practices” and professional growth;
• Continuous quality improvement in practice;
• Interdisciplinary relationships.

Major Diagnostic Categories

Major Diagnostic Categories (MDCs) are broad groups of Diagnosis Related Groups (DRGs) that relate to an organ or a system (such as the digestive system) and not to an etiology. Examples include MDC 01 - Diseases and Disorders of the Nervous System, MDC 02 - Diseases and Disorders of the Eye, MDC 03 - Diseases and Disorders of the Ear, Nose, Mouth and Throat. Each hospital stay has one DRG and one MDC assigned to it.

Median

The median refers to the midpoint of all charges or lengths of stay for a particular measure. Half of the charges or lengths of stay were lower than the median and the other half were higher than the median.

Median charges

Charges are the undiscounted "list price" that a facility would charge someone with no insurance. The median refers to the midpoint of all charges. Charges are for facility services and accommodation and may not include physician or surgeon fees.

Median Length of Stay

The median length of stay for patients who had each condition or procedure.

Medicaid

A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Mood Disorders

The National Institute of Health defines Mood Disorder as "a category of mental illnesses in which the underlying problem primarily affects a person’s persistent emotional state (their mood)."

MS DRG

Medicare Severity Diagnosis Related Groups are the diagnosis codes doctors and hospitals put on patient's medical bills that Medicare uses to decide how much to pay the hospital.

National Healthcare Safety Network (NHSN)

The National Healthcare Safety Network (NHSN) is a voluntary, secure, internet-based surveillance system that integrates and expands legacy patient and health care personnel safety surveillance systems managed by the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention.

The reporting criteria and methods required by NHSN are detailed on the NHSN Web site at https://www.cdc.gov/nhsn/.

National Healthcare Safety Network (NHSN) Central Line-Associated Bloodstream Infections (CLABSI) rate per 1000

An aggregate central line-associated bloodstream infection (CLABSI) rate for all hospitals participating in the National Healthcare Safety Network (NHSN) with the location type adult ICU. This can be viewed as a "standard" population to which hospital specific rates are compared.

NHSN CLABSI rate per 1000

CLABSI rate for all participating NHSN hospitals of that location type (the patient care area to which a patient is assigned while receiving care while in the facility, e.g. ICU). This can be viewed as a "standard population" to which hospital specific rates are compared.

Number of Central Line Days

The total number of days of exposure to the device (central line) by all of the patients in the selected population (ICU) during the selected time period.

Numerator

Numerator the number of individuals who actually experience the event or outcome of interest. The numerator, along with the denominator, is used to calculate rates. The numerator is the top half of a fraction.

P Value

The probability value from a significance test comparing the local hospital to the NHSN aggregate rate.

Patient Age In Years

Patient age in years is calculated on the basis of the admission date to the hospital and date of birth. Information is listed as provided in the medical record.

Patient Safety Indicators

PSIs are a set of measures that screen for adverse events that patients experience as a result of exposure to the health care system. These events are likely amenable to prevention by changes at the system or provider level. Additional information can be found at https://qualityindicators.ahrq.gov/.

Patients

These measures count the number of patients classified into each Diagnosis Related Group.

Pediatric Cardiothoracic ICU

Critical care area specializing in the care of patients < 18 years old following cardiac and thoracic surgery.

Pediatric Critical Care Center

A hospital participating in an approved emergency medical system and designated by the Department to provide optimal critical and specialty care services to pediatric patients, and to provide all essential services either in-house or readily available 24 hours per day. Hospitals that are designated at the PCCC level must also meet all EDAP requirements.

Pediatric Medical ICU

Critical care area for patients < 18 years old who are being treated for nonsurgical conditions.

Pediatric Medical-Surgical ICU

An area where critically ill patients <18 years old with medical and/or surgical conditions are managed.

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.

Perinatal

The Illinois Regionalized Perinatal System was developed to improve perinatal outcomes by ensuring an appropriate level of care is provided for all pregnant women, and by effectively meeting the needs of the patient. The system aims to reduce the incidence of perinatal complications through early identification and treatment of the high-risk woman of childbearing age, fetus and newborn.

The system is a specifically coordinated program that combines medical, nursing and other ancillary services to focus on risk factors of pregnancy, potential complications of labor and delivery, and high-risk neonatal procedures. It consists of 10 administrative perinatal centers; each connected to its group of network hospitals.

Illinois's perinatal system distinguishes between three major levels of care. The levels vary by the type and complexity of patients served, the availability of sub-specialists, and access to specialized equipment and facilities. The specifically designated administrative perinatal centers oversee 133 hospitals, providing each with high-risk medical services, meeting the educational needs of hospital staff, reviewing the quality of services provided, and preparing them for designation or re-designation of specific Perinatal care level status.

The levels of perinatal care in Illinois hospitals are

• Level 1: Hospitals provide care to women with uncomplicated pregnancies and no history of medical complications. These do not contain special care or neonatal intensive care nurseries.
• Level 2: Hospitals provide care to pregnant women and newborns with a selected level of risk for medical complications. They have additional facilities and services, but they do not contain special care or neonatal intensive care nurseries.
• Level 2 with Extended Capabilities: Hospitals with extended neonatal capabilities that provide an intermediate level of care to pregnant women and more complex care to newborns, when required. These hospitals do not have a neonatal intensive care nursery, but they do maintain a special care nursery that is covered by a neonatologist who is specifically trained to treat newborns requiring special care.
• Level 3: Hospitals provide an intensive care approach for high-risk women who are vulnerable to complicated pregnancies and for at-risk newborns. They provide sub-specialty care for both high-risk pregnancies and for newborns at-risk, and are equipped with neonatal intensive care units.

Perinatal 0

Hospitals with no obstetric services available.

Perinatal I

Hospitals that provide care to low-risk pregnant women and newborns, operate general care nurseries and do not operate an NICU or Special Care Nursery.

Perinatal II

Hospitals that provide care to women and newborns at moderate risk, operate intermediate care nurseries and do not operate NICU or Special Care Nursery.

Perinatal II+

Hospitals with Extended Neonatal Capabilities which can provide care to women and newborns at moderate risk and do operate a Special Care Nursery but do not operate a NICU.

Perinatal III

Hospitals that provide care for patients requiring increasingly complex care and do operate a NICU.

Pneumonia

Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Signs of pneumonia can include coughing, fever, fatigue, nausea, vomiting, rapid breathing or shortness of breath, chills, or chest pain. Certain people are more likely to become ill with pneumonia. This includes adults 65 years of age or older and children younger than 5 years of age. People younger than 64 years of age who have underlying medical conditions (like diabetes or HIV/AIDS) and people 19 through 64 who smoke cigarettes or have asthma are also at increased risk for getting pneumonia.

Pneumonia (pneumococcal) Vaccination

This is a vaccine given to prevent pneumonia, estimated to protect against 80 percent of bacteria causing pneumonia.

Primary Stroke Center

As certified and defined by a nationally recognized certifying body, PSCs are hospitals that meet standards to support better outcomes for stroke care, including the following: a dedicated stroke-focused program, staffing by qualified medical professionals trained in stroke care, coordination of post-discharge patient self-care, and other eligibility standards. Certified PSC hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting verification of the PSC national certification and a completed Application for Stroke Center Designation to the Department of Public Health.

Principal diagnosis

Principal diagnosis The condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care. The principal diagnosis is always the reason for admission.

Principal procedure

Principal procedure The procedure that was performed for definitive treatment rather than one performed for diagnostic or exploratory purposes, or the procedure that was necessary to take care of a complication. If two procedures appear to meet this definition, then the one most related to the principal diagnosis should be selected as the principal procedure.

PTCA (Percutaneous Transluminal Coronary Angioplasty)

PTCA, Percutaneous Transluminal Coronary Angioplasty, often called angioplasty is a procedure that can be performed to open up or enlarge narrowed arteries in the heart. When the arteries in the heart become narrowed, blood will not flow through as effectively.

Pulmonary Edema

Pulmonary edema (PE), or fluid in the lungs, can occur for a variety of reasons. One cause is when part of a clot in a vein or from a deep vein thrombosis breaks off and travels through the bloodstream to the lungs. Pulmonary edema can cause serious illness, disability or death. Symptoms can include difficulty breathing, breathing faster than normal, chest pain and coughing up blood. Immediate medical attention is indicated.

Rate

A rate is an expression of probability of occurrence of an event. It is usually expressed as (x/y)k, where x, the numerator, is the number of times an event has occurred during a specified time period; y, the denominator, equals the population from which those experiencing the event were derived during the same time period; and k is the base or a round number (e.g., 100, 1000, or 10,000) that can help express the rate as a whole integer. The time period must be specified and be identical for the numerator and denominator for the rate to be meaningful.

Risk Adjustment

Some hospitals tend to treat higher-risk patients who have a greater chance of dying following a surgical procedure or treatment for a serious medical condition. To assure all Illinois hospitals are assessed fairly, IDPH uses statistical risk adjustment to account for patient differences. Inpatient mortality indicators and patient safety indicators presented here have been risk-adjusted using the All Patient Refined Diagnosis Related Groups (APR-DRGs), a proprietary tool of the 3M Health Information Systems Corporation. Risk-adjusted rates are the estimated performance of hospitals if they had an ‘average’ mix of patients, known as "case mix". Estimates of the average case mix reflect the distribution in age, sex, and risk of mortality and severity of illness.

For specific information about the adjustments used, please consult https://qualityindicators.ahrq.gov/measures/pqi_resources

Standardized Infection Ratio

The Standardized Infection Ratio (SIR) is a summary measure used to compare the central line associated bloodstream infection (CLABSI) experience among one or more groups of patients to that of a standard population. It is the observed number of infections divided by the expected number of infections.

For health care associated infection reports, the standard population comes from National Health Safety Network (NHSN) data reported from all hospitals using the system. "Expected" is based on historical data for those procedures at the national level.

A general interpretation of the SIR is as follows:

• If the SIR equals 1.0 (observed number of CLABSI infections equals the expected number of CLABSI infections based on the NHSN data) there is no difference between the observed number and the expected number.
• If the SIR is greater than 1.0, the number of CLABSI infections observed in a specific hospital is greater than the number of CLABSI infections expected based on the NHSN pooled data.
• If the SIR is less than 1.0, the number CLABSI infections observed in a specific hospital is less than the number of CLABSI infections expected based on the NHSN pooled data.
• To assess whether the difference between the observed number of CLABSI infections is significantly different from the expected number of CLABSI infections, a 95% confidence interval for the SIR is calculated. The confidence interval for a hospital’s SIR is the range of possible SIRS within which there is a 95% confidence that the real SIR for that hospital lies, given the number of infections and procedures that were observed in that hospital in a specific time period.
• If the 95% confidence interval includes 1.0, the hospital’s infection rate is similar (not statistically significantly different) from the “expected” (predicted).
• If the SIR is greater than 1.0 and the 95% confidence interval does not include 1.0, the hospital’s infection rate is statistically significantly higher than “expected” (predicted).
• If the SIR is less than 1.0 and the 95% confidence interval does not include 1.0, the hospital’s infection rate is statistically significantly lower than “expected” (predicted).
• All conclusions are based on the assumption that the hospital’s patient population is similar to the NHSN pooled patient population.

Standby Emergency Department for Pediatrics

A hospital participating in an approved emergency medical system and designated by the Department pursuant to Section 515.4010 of the Illinois Emergency Medical Services and Trauma Code, to provide optimal emergency department care to pediatric patients; and have transfer agreement(s) and transfer mechanisms in place when more definitive pediatric care is needed.

Stroke

A stroke occurs either when the blood supply to part of the brain is blocked or when a blood vessel in or around the brain bursts, causing damage to a part of the brain. A stroke is also sometimes called a brain attack.

Stroke Hospital

The Illinois stroke designated hospital system was developed to improve stroke outcomes in Illinois by ensuring that evidence-based guidelines are followed that can reduce the occurrence, disabilities and death associated with stroke. The system also helps to coordinate stroke care across the state. The Illinois Department of Public Health (IDPH), Office of Preparedness and Response, Division of Emergency Medical Services and Highway Safety is in charge of designations for stroke centers in Illinois. IDPH identifies hospitals capable of providing emergent stroke care and directs Emergency Medical Services providers to transport possible acute stroke patients to these hospitals. The stroke designated system distinguishes and provides oversight for three levels of stroke care hospitals. The levels vary by the availability of sub-specialists and access to specialized equipment. The three levels of care are:

• Acute Stroke Ready Hospitals (ASRH) – ASRH are hospitals that can provide emergency stroke care. These hospitals can diagnose, treat, and transport acute stroke patients to a higher level of care as warranted. ASRH hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting an application and supporting documentation. ASRHs must annually attest their continued compliance to the Illinois Department of Public Health to maintain designation. ASRH hospitals may pursue a national certificate in addition to the Illinois Department of Public Health designation. These hospitals were previously called “Emergent Stroke Ready Hospitals.”
• Primary Stroke Center (PSC) – As certified and defined by a nationally recognized certifying body, PSCs are hospitals that meet standards to support better outcomes for stroke care, including the following: a dedicated stroke-focused program, staffing by qualified medical professionals trained in stroke care, coordination of post-discharge patient self-care, and other eligibility standards. Certified PSC hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting verification of the PSC national certification and a completed Application for Stroke Center Designation to the Department of Public Health.
• Comprehensive Stroke Center (CSC) – are hospitals that meet standards to treat the most complex stroke cases which include all components of a PSC plus the following: advanced imaging techniques, availability of personnel trained in vascular neurology, neurosurgery, and endovascular procedures, 24/7 availability of personnel, imaging, operating room, and endovascular facilities, and other eligibility standards. Certified CSC hospitals may pursue voluntary designation from the Illinois Department of Public Health by submitting verification of the CSC national certification and a completed Application for Stroke Center Designation to the Department of Public Health.

Substance Related Disorders

The Substance Abuse and Mental Health Services Administration defines Substance Related Disorders as https://www.samhsa.gov/find-help/disorders

Surgical Care Improvement Project (SCIP)

The Surgical Care Improvement Project is a national quality partnership of organizations that are dedicated to improving surgical care. SCIP develops evidence-based measures to determine how well hospitals care for their surgical patients.

Trauma Center

The Illinois trauma system coordinates activities within the state involving pre-hospital and inter-hospital emergency medical services, and is an integral part of the overall emergency medical system. The trauma system is divided into 11 regions and its purpose is to ensure that each region has the necessary resources to deliver high quality trauma care.

A trauma surgeon serves as the medical director for each center, which provides special trauma services. An array of additional specialized services are provided including sub-specialty surgical care, emergency medicine, anesthesiology services, radiology and intensive care.

Trauma centers can focus on either adults or children, and are categorized by levels:

• Level I trauma centers must provide all essential services in-house 24 hours a day and must have helicopter landing capacity.
• Level II trauma centers must have some these essential services available in-house 24 hours a day and others readily available (within 60 minutes) 24 hours a day.

There are more than 60 trauma centers in Illinois, all of which are classified as either Level I or Level II adult trauma centers or Level I pediatric trauma centers. The Illinois Department of Public Health performs verification of the resource and process requirements for Level I and Level II trauma center designations.

Specific criteria for attaining Level I or II trauma center designation is outlined in Section 515.2030 – 2045 of the EMS and Trauma Center Administrative Code.