Summary Star Rating (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

The “Summary Star Rating” combines information about different aspects of patient experience to make it easier for consumers to compare hospitals. The Summary Star Rating is the average of 11 HCAHPS measures: Nurse communication, doctor communication, responsiveness of hospital staff, pain management, communication about medicines, discharge information, care transition, cleanliness, quietness, overall hospital rating, and whether or not the patient would recommend the hospital.

Patient Experience (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This section shows how the hospital was scored by patients for nine of the eleven HCAHPS measures used for the Summary Star Rating.

• Would recommend hospital: Patients were asked whether they would recommend this hospital to friends and family. The higher the percentage shown, the more likely that they would recommend it.

• Received information and education: Patients need information about their care to make informed decisions. This measure shows how well providers answered questions about a patient’s condition, the drugs given, or what to expect after leaving the hospital.

• Nurses communicated well: This measure shows the percentage of patients who responded that their nurses “always” communicated well.

• Doctors communicated well: This measure shows the percentage of patients who responded that their doctors “always” communicated well.

• Help received: This measure shows the percentage of patients who responded that they “always” received help as soon as they wanted.

• Staff explained medicine: This measure shows the percentage of patients who responded that staff “always” explained about their medicines before giving it to them.

• Patient room and bathroom was clean: This measure shows the percentage of patients who responded that their room and bathroom were “always” clean.

• Quiet at night: This measure shows the percentage of patients who responded that the area around their room was “always” quiet at night.

This measure reflects patients who reported they understood their care when they left the hospital.

The percentage of Cesarean section deliveries among mothers whose pregnancies were nulliparous, term, singleton and vertex (NTSV) — which means the delivery of a single baby [versus twins or triplets] in a head-down position after 37 weeks gestational age to mothers having their first baby. In such “low-risk” pregnancies, C-sections should be avoided to reduce post-surgical infections, blood clots and other complications and improve overall health outcomes for both mother and baby. Women with prior cesarean births also have significantly higher rates of complications in their subsequent pregnancies.  A lower percentage is usually better and hospitals with an NTSV C-section rate above 23.9% are performing Cesareans outside the target goal set by Healthy People 2020. A woman who prefers a vaginal birth should look for a hospital with a low C-section rate. She should discuss this concern with her maternity care provider.

This measure shows the percentage of newborns that were fed only breastmilk before discharge from the hospital. Though there are many reasons breastfeeding rates vary, it is considered good practice for the hospital staff to support women who wish to breastfeed prior to discharge.

An episiotomy is a surgical cut in the vaginal opening to make more space for the birth of a baby. It was once a routine procedure; however, many recent studies show that this cut does not make the birth easier and actually may lead to more frequent and worse tears and may result in short- and long-term harm in women. Providers and hospitals aim to do fewer episiotomies. In general, a lower rate is better.

Some hospitals will not provide “vaginal birth after C-section” (VBAC), usually because they do not have the necessary medical personnel needed to respond immediately for an emergent C-section, according to ACOG guidelines. This measure, collected from a survey by the Hospital Quality Institute, can help consumers understand whether a facility routinely offers a trial of labor for vaginal birth after prior C-section. A hospital showing “yes” offers VBAC services for appropriate women who previously had C-sections. Contact the hospital to learn their current policy on VBACs. Also note that a hospital may have a published VBAC rate but not routinely offer the VBAC procedure. This may occur in an emergency situation or if a hospital changes its VBAC policy after reporting cases in a previous period.

A vaginal birth after Cesarean section (“VBAC”) is when a woman who has had a prior C-section gives birth to a new baby vaginally (that is, without needing a C-section). Many women who have had a prior C-section do not need to deliver all future babies by C-section. This measure shows how often vaginal births among women with a prior C-section occur at this facility. VBAC rates are calculated for eligible patients with previous C-sections when a hospital performs three or more VBACs during a calendar year. California hospitals had an average VBAC rate of 9.4% and the range among hospitals was from 0.7% to 42.8% in 2014 (the year of the data displayed).

A hip fracture is a break in the upper part of the thighbone, which fits into the socket of the hip joint. Hip fracture is a common cause for hospitalization among the elderly. This measure shows the percentage of patients admitted for hip fracture who died in the hospital. Lower rates suggest better quality of care. Note that this death rate is based on data reported by the California OSHPD Patient Discharge Database (non-public) and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions.

This readmission rate is the percentage of patients who returned to the hospital within 30 days after hip or knee surgery. Lower rates suggest better quality of care. A readmission may result from incomplete treatment or poor care by the hospital team of the underlying problem, or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Readmission rates can vary for many reasons and may not always indicate a hospital’s level of quality. Note that this readmission rate is based on data reported by CMS Hospital Compare and, while measured the same way for all hospitals, may be measured differently than readmission rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher readmission rates than the general population.

This complication rate is the percent of patients who electively had a primary total hip/knee replacement and developed at least one of eight complications: heart attack, pneumonia, sepsis/septicemia/shock, surgical site bleeding, pulmonary embolism, death, mechanical complication with the joint, or joint/wound infection. A complication may result from incomplete treatment or poor care by the hospital team or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Complication rates can vary for many reasons and may not always indicate a hospital’s level of quality. The data are based on the Medicare fee-for-service population.

This measure shows the number of primary and revision hip surgeries performed at this hospital. Hip replacement surgery involves a procedure that replaces the hip joint with a prosthetic implant. Low volume is associated with poor patient outcomes.

This measure shows the number of primary and revision knee surgeries performed at this hospital. Knee replacement surgery involves a procedure that replaces the damaged part of the knee joint with a metal or plastic artificial joint. Low volume is associated with poor patient outcomes.

Complication Prevention

Unplanned Surgical Wound Reopening (Data Source: CMS Hospital Compare 10/01/2015 -- 06/30/2017)

The medical term for this is “postoperative wound dehiscence.” An unplanned reopening of a surgical wound is a complication of surgery. This reopening usually occurs between seven and ten days after surgery and often leads to infection and sometimes even death if left untreated. The causes of wound reopening depend on the type of surgery but include infection of the wound, pressure on the stitches, stitches that are too tight, poor wound closing, and injury to the wound after closure. Signs of potential problems with a wound can include pain, bruising, inflammation, discharge, and breakdown of the skin around the wound area, as well as diarrhea, fever, and vomiting. Patients should check their wound site regularly and alert the surgeon or physician if it is not healing. Lower rates suggest better quality of care.

Death after Serious Treatable Complication (Data Source: CMS Hospital Compare 10/01/2015 -- 06/30/2017)

This measure shows the percentage of patients who died after developing a medical complication following inpatient surgery. Some hospitals are better than others at quickly identifying these complications and treating them aggressively. Lower death rates suggest better quality of care.

Accidental Lung Puncture (Data Source: CMS Hospital Compare 10/01/2015 -- 06/30/2017)

The medical term for this is “iatrogenic pneumothorax.” The problem occurs when a patient’s lung is accidentally punctured during a required medical procedure (for example, by a needle being used to give the patient medicine). The puncture causes air to leak out of the lung into the body and may lead to lung collapse. Lower rates suggest better quality of care.

Healthcare Workers Given Influenza Vaccination (Data Source: CMS Hospital Compare 10/01/2017 -- 03/31/2018)

The percentage of healthcare workers who were given the influenza vaccination.

Gastrointestinal Hemorrhage Death Rate (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

The rate of patients who die with their main diagnosis being gastrointestinal hemorrhage.  A GI hemorrhage is loss of blood from anywhere in the GI track from the pharynx to the rectum.

Sepsis Management (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

Sepsis Infection: This measure shows the percentage of patients who received appropriate care for severe sepsis and septic shock. This sepsis bundle measure examines six different types of care for patients with sepsis.  A hospital must complete all six to be counted as delivering appropriate care to patients.

Antibiotic-Resistant Infections (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

Bloodstream infections (BSIs) are among the most serious health care-associated infections and can lead to death, longer hospital stays, and additional costs.

MRSA Infection: Methicillin-resistant Staphylococcus aureus (MRSA) is a bloodstream infection Staph resistant to certain antibiotics. This measure shows the number of events identified by the lab.

VRE Infection: Vancomycin-Resistant Enterococci (VRE) is a bloodstream infection caused by Enterococci resistant to certain antibiotics. This measure shows the number of events identified by the lab.

C.diff Infection: This measure shows the number of C.diff events identified by the lab.

Infections Related to Catheters and Tubes (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

CLABSI and CAUTI are infections associated with hospital procedures that involve insertion of catheters and tubes during the patient’s hospital stay. The calculation of these measures adjusts for differences in the characteristics of hospitals and patients using a standardized infection ratio (SIR). The SIR is a summary measure that takes into account differences in the types of patients a hospital treats. For CLABSI and CAUTI, risk adjustment considers the following: type of hospital, whether the hospital is affiliated with a medical school, facility bed size, and the type of location within the hospital. A SIR is provided for CLABSI and CAUTI in ICUs and select wards.

Surgical Site Infections - Cardiovascular & Thoracic (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

This measure shows the percentage of patients who were identified with C.diff – lab identified.

Surgical Site Infections - Gastrointestinal (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

Surgical Site Infections - Orthopedic (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

Surgical Site Infections - OB/GYN (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

Surgical Site Infections - Gallbladder/Liver Related (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

Surgical Site Infections - Organ Transplant (Data Source: CDPH 01/01/2017 -- 12/31/2017)

Surgical Site Infections (SSIs) occur after surgery in the part of the body where the surgery took place. Some are superficial infections, while others are more serious and can involve muscle and other tissues under the skin, organs, or the space around organs, which often result in longer hospital stays or readmissions later. Surgical site infections may be prevented with proper preparation of the skin and administration of an antibiotic just prior to surgery. SSIs are shown in six categories: Cardiovascular & Thoracic, Gastrointestinal, Orthopedic, OB/GYN, Gallbladder/Liver Related, and Organ Transplant.

Cancer Surgery - Number of Cases (Data Source: OSHPD 01/01/2017 -- 12/31/2017)

Research shows that for many types of cancer, patients who have surgery at hospitals that perform a low number of surgeries (sometimes called “surgery volume”) are less likely to survive the surgery and more likely to suffer complications. While surgery is not always the best treatment for cancer, once you decide with your doctor that surgery is a good option, you can use the surgery numbers here to choose a hospital. You should also consider other quality or safety information on this website, such as hospital rates for: deaths; complications; infection prevention; readmissions; and patient experience/satisfaction.

Time in ED before being admitted (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

The page shows the average amount of time patients spend in the emergency department before being admitted to the hospital.

Time in ED before being sent home (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

The page shows the average amount of time patients spend in the emergency department before being sent home.

Time in ED before being seen (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This measure shows the average amount of time patients spend in the emergency department before being seen by a medical professional.

Left the ED before being seen (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This measure shows the percentage of patients who left the emergency department without being seen by a provider.

Time before receiving pain medication (patients with broken bones) (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This measure shows the duration of time patients with broken bones spent in the ED before receiving pain medication.

Brain scan results w/in 30 minutes (patients with stroke symptoms) (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This measure shows the percentage of ED patients with stroke symptoms who received brain scan results within 30 minutes.

Time before ECG conducted (patients with possible heart attack) (Data Source: CMS Hospital Compare 01/01/2017 -- 12/31/2017)

This measure shows the average number of minutes before outpatients with chest pain or possible heart attack received an ECG.

Death Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This measure estimates the patients who died from any cause within 30 days of being hospitalized for heart attack, regardless of whether the death was in the hospital or after discharge. Note that this death rate is based on data reported by CMS/Medicare and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher death rates than the general population.

Readmission Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This readmission rate is the percentage of patients who returned to the hospital within 30 days for any reason. Lower rates suggest better quality of care. A readmission may result from incomplete treatment or poor care by the hospital team of the underlying problem, or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Readmission rates can vary for many reasons and may not always indicate a hospital’s level of quality. Note that this readmission rate is based on data reported by CMS Hospital Compare and, while measured the same way for all hospitals, may be measured differently than readmission rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher readmission rates than the general population.

Angioplasty (PTCA) - Number of Cases (Data Source: OSHPD 01/01/2016 -- 12/31/2016)

The page shows the number of percutaneous transluminal coronary angioplasties (PTCA or “angioplasty”) performed at this hospital. Angioplasty is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle.

Angioplasty (PTCA) - Death Rate (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

The rate of patients who die after having percutaneous transluminal coronary angioplasties (PTCA or “angioplasty”), which is a non-surgical procedure used to treat the narrowed coronary arteries of the heart found in heart disease from the buildup of the cholesterol-laden plaques.

CABG Death Rate - No Valve (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

This measure shows the percentage of patients who died within 30 days of discharge after heart bypass surgery performed without other major procedures, such as valve repair or carotid endarterectomy, during the same surgery. The rate is adjusted because patients have different chances of dying due to individual risk factors. Lower rates suggest better quality of care. Note that this death rate is based on data reported by California CABG Outcomes Reporting Program (CCORP) / California OSHPD and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions.

CABG Death Rate - With Valve (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

This measure shows the percentage of patients who died within 30 days of discharge after heart bypass surgery that includes aortic valve replacement, mitral valve replacement or repair, or a combination thereof. The rate is adjusted because patients have different chances of dying due to individual risk factors. Lower rates suggest better quality of care. Note that this death rate is based on data reported by California CABG Outcomes Reporting Program (CCORP) / California OSHPD and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions.

Postoperative Stroke (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

This measure shows the percentage of patients who suffered a stroke after they had heart bypass surgery.

Death Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This measure estimates the patients who died from any cause within 30 days of being hospitalized for heart failure, regardless of whether the death was in the hospital or after discharge. Note that this death rate is based on data reported by CMS/Medicare and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher death rates than the general population.

Readmission Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This readmission rate is the percentage of patients who returned to the hospital within 30 days for any reason. Lower rates suggest better quality of care. A readmission may result from incomplete treatment or poor care by the hospital team of the underlying problem, or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Readmission rates can vary for many reasons and may not always indicate a hospital’s level of quality. Note that this readmission rate is based on data reported by CMS Hospital Compare and, while measured the same way for all hospitals, may be measured differently than readmission rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher readmission rates than the general population.

Death Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This measure estimates the patients who died from any cause within 30 days of being hospitalized for pneumonia, regardless of whether the death was in the hospital or after discharge. Note that this death rate is based on data reported by CMS/Medicare and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher death rates than the general population.

Readmission Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This readmission rate is the percentage of patients who returned to the hospital within 30 days for any reason. Lower rates suggest better quality of care. A readmission may result from incomplete treatment or poor care by the hospital team of the underlying problem, or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Readmission rates can vary for many reasons and may not always indicate a hospital’s level of quality. Note that this readmission rate is based on data reported by CMS Hospital Compare and, while measured the same way for all hospitals, may be measured differently than readmission rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher readmission rates than the general population.

Death Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This measure estimates the patients who died from any cause within 30 days of being hospitalized for COPD, regardless of whether the death was in the hospital or after discharge. Note that this death rate is based on data reported by CMS/Medicare and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher death rates than the general population.

Readmission Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This readmission rate is the percentage of patients who returned to the hospital within 30 days for any reason. Lower rates suggest better quality of care. A readmission may result from incomplete treatment or poor care by the hospital team of the underlying problem, or may reflect poor coordination of care by the hospital team at the time of discharge and afterward. Readmission rates can vary for many reasons and may not always indicate a hospital’s level of quality. Note that this readmission rate is based on data reported by CMS Hospital Compare and, while measured the same way for all hospitals, may be measured differently than readmission rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher readmission rates than the general population.

Death Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

This measure estimates the patients who died from any cause within 30 days of being hospitalized for a stroke, regardless of whether the death was in the hospital or after discharge. Note that this death rate is based on data reported by CMS/Medicare and, while measured the same way for all hospitals, may be measured differently than death rates for other conditions. Importantly, the data are based on the Medicare fee-for-service population, which has higher death rates than the general population.

Stroke Potentially Preventable Readmission Rate (Data Source: CMS Hospital Compare 07/01/2014 -- 06/30/2017)

Abdominal Aortic Aneurysm Repair - Number of Cases (Data Source: OSHPD 01/01/2016 -- 12/31/2016)

The abdominal aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs. If the blood vessel enlarges abnormally, surgery is usually performed to prevent a rupture of the ballooning vessel (“aneurysm”). More cases means the surgical team has more practice, which may lead to better results for the patient. A hospital must perform ten or more abdominal aortic aneurysm repairs per year to be rated as having “enough cases.” This may indicate that this hospital has a basic level of proficiency. If the “service was not provided,” then no cases were attempted and the hospital is not rated for this procedure.

Abdominal Aortic Aneurysm Repair - Death Rate (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

If a hospital meets the criteria for “enough cases” (ten or more abdominal aortic aneurysm repairs per year), then the page displays the death rate for this procedure at this hospital. Patients requiring this procedure usually have disease of other major vessels as well, which make them a high risk for stroke, heart attack, or other complications during or after surgery. The type of aneurysm and other patient-related factors greatly affect the death rate for this procedure.

Esophageal Resection - Death Rate (Data Source: OSHPD 01/01/2015 -- 01/01/2015)

If a hospital meets the criteria for “enough cases” (six or more esophageal resections per year), then the page displays the death rate for this procedure at this hospital.

Esophageal Resection - Number of Cases (Data Source: OSHPD 01/01/2016 -- 12/31/2016)

This measure indicates the number of cases of esophageal resection.

Pancreatic Resection - Death Rate (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

If a hospital meets the criteria for “enough cases” (ten or more pancreatic resections per year), then the page displays the death rate for this procedure at this hospital.

Pancreatic Resection - Number of Cases (Data Source: OSHPD 01/01/2016 -- 12/31/2016)

This measure indicates the number of cases of pancreatic resection.

Craniotomy Death Rate (Data Source: OSHPD 01/01/2015 -- 12/31/2015)

The rate of patients who die after having a craniotomy, a surgical operation in which a bone flap is temporarily removed from the skull to access the brain.