Quality Statistics Surgical Care: How do we compare? At CHA, we take pride in the care we provide. To monitor the quality of that care, we track specific quality measures and compare them to benchmark measures. We publish this information so that you can see how effective Community Hospital Anderson is in the treatment of Surgical Patients. % Unscheduled returns to the OR CHA 2004 CHA 2005 National .63% .58% 1.5% Unscheduled returns to the operating room (OR) may result from problems involving surgical complications, anesthesia or infection control. Quality and Safe Care will keep return rates to a minimum. CHA should be near or below the national benchmark. % Surgical Site Infections (Class 1) CHA 2004 CHA 2005 NNIS .67 .31 1 to 5% % Surgical Site Infections (Class 2) CHA 2004 CHA 2005 NNIS .31% .5% 8 to 11% Infections after surgery have a significant impact on the cost and quality of health care. By monitoring infection rates, the infection surveillance program can identify potential problems in surgical practice for selected procedures. All surgical site infections are monitored at CHA and benchmarked with the Centers for Disease Control Rates(CDC). CHA rates should be near or below CDC benchmarks. % Patients said pain management excellent or very good after surgery CHA 2004 CHA 2005 CHA 95% 96% > 90% According to the AHCPR Pain Management Guideline Panel, approximately 23 million people undergo surgery each year in the United States. Despite the use of pain medications, at least 40 to 50 percent of postoperative patients report inadequate pain relief. CHA should be above goal. % of patients that rate their safety in Outpatient surgery as excellent or very good CHA 2004 CHA 2005 CHA 93% 95% > 90% Patient Safety is a high priority goal at CHA. We want our patients to feel safe when they are in the care of our hospital. CHA strives to make the Surgical Care environment as safe as possible for our patients. CHA should be above the goal. Number of surgeries CHA 2004 CHA 2005 CHA Goal 7010 6323 Number of wrong site surgeries CHA 2004 CHA 2005 CHA Goal 0 0 0 The health care team at CHA follows a multiple-step process to prevent wrong-site surgery (e.g. surgery performed on the left foot instead of the right). This process includes left or right designation at the time the surgery is scheduled, verification of the site on the day of surgery with the patient and the patient's current medical record, marking the site, and final verification in the operating room. CHA should be at the goal of zero. Antibiotic received within 1 hour CHA 2004 CHA 2005 State 90% 91.5% 66% Appropriate antibiotic used CHA 2004 CHA 2005 State 95% 95% 90% Receiving the appropriate antibiotic within an hour before surgery reduces the risk of a patient developing an infection. CHA should be at or above the benchmark

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