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Summary of Hospital Quality Measures

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Memorial Hospital of Salem County
http://www.mhschealth.com

Hospital is not licensed to perform CABG surgery.

Recommended Care/Process of Care Measures
Higher Score is Better
  Hospital
Overall Score
State Median State Top 10%
Heart Attack (detail) 95 100
Pneumonia (detail) 94 99 100
Surgical Care Improvement (detail) 96 99 100
Heart Failure (detail) 99 100 100


Outcome of Care Measures: Mortality Inpatient Quality Indicator (IQI)
Lower Rate is Better
Hospital Rate National Average Rate (2013) Statewide Average Rate (2015)
Heart Attack 3.4 5.4 5.8
Pneumonia 2.8 3 3
Heart Failure 2.9 3.4 2.5
Stroke 4.7 7.9 7


Patient Safety Indicators
Lower Rate is Better
Hospital Rate National average rate (2013) Statewide number of adverse events (2015) Statewide average rate (2015)
Retained Surgical Item or Unretrieved Device Fragment 0 852 23 -
Iatrogenic pneumo thorax 0.5 0.3 160 0.2
Post-operative hip fracture 0 0.1 3 0
Post-operative hemorrhage or hematoma 2.7 4.5 791 4.4
Post-operative pulmonary embolism (PE) or deep vein thrombosis (DVT) 0 3.7 1090 5.5
Post-operative sepsis 58.9^ 4.3 117 8.1
Post-operative wound dehiscence 0 1.7 37 1.2
Accidental puncture or laceration 0 0.7 611 1
Transfusion reaction 0 38 0 -
Birth Trauma+ . 2 192 2
Obstetric trauma - vaginal delivery with instrument+ . 127.9 328 96
Obstetric trauma - vaginal delivery without instrument+ 0 @ 20 747 13.3

+ Observed rate (not risk-adjusted)

Not applicable - Rate is not applicable for "Retained Surgical Item or Unretrieved Device Fragment Count" and "Transfusion Reaction". Both indicators are measured using volume instead of rate.

. (Missing) Hospital did not perform the procedure during the year; or it performed less than 3 procedures (rate is not calculated when the denominator is less than 3).

^ Rate is based on less than 30 cases/patients and should be taken with caution.

@ Could be data Error




Healthcare Associated Infections (HAIs)
  Hospital to
National Comparison‡
Standardized Infection Ratio (SIR) NJ Statewide to
National Comparison
Abdominal Hysterectomy Surgical Site Infections, 2014 --- --- Similar
Catheter-Associated Urinary Tract Infections (CAUTI), 2014 Similar 0.65 Higher
Central Line-Associated Bloodstream Infections (CLABSI), 2014 --- --- Lower
Colon Surgical Site Infections, 2014 --- --- Lower
Knee Arthroplasty Surgical Site Infections, 2014 --- --- Lower
Overall Surgical Site Infections, 2014 --- --- Lower

‡ Each hospital is compared to the National Ratio=1. The National Ratio is derived using the CDCs NHSN data from 2009 for CAUTI due to a definition change (AJIC, 2010).


Outpatient measures for all hospitals [pdf 20k]
Healthcare Associated Infections (HAI) for all hospitals