Clinical Specialties

Groiup of nurses in a patient room

What We Measure

Inpatient Mortality Index: The mortality ratio of actual mortalities (observed) to expected mortalities

Expected mortalities takes into account each patient’s condition prior to admission and is higher for sicker patients.
A ratio that is less than one indicates fewer mortalities than expected.
This metric captures deaths that occur in the hospital and is influenced by patient’s end of life wishes.
Our goal is to have a mortality index of less than 0.8

30 Day Readmission Rate: Patients who return to Santa Barbara Cottage Hospital for additional hospitalization for any reason within 30 days of their discharge are counted as a readmission.

This is viewed as a measure not only of quality care during the hospitalization, but also good discharge planning and follow up post discharge.
Our goal is to be well below the national average.

How Are We Performing

Overall Mortality and Readmission graphs encompass all inpatients who die in the facility for all clinical conditions.

Santa Barbara Cottage Hospital - Clinical Specialties - Inpatient Mortality Index data Click to Enlarge

Santa Barbara Cottage Hospital - Clinical Specialties - 30 Day Readmission Rate data Click to Enlarge

Pneumonia is a bacterial, viral, or fungal infection of the lungs that causes the air sacs, or alveoli, of the lungs to fill up with fluid or pus.

Santa Barbara Cottage Hospital - Clinical Specialties - Pneumonia Mortality O:E data Click to Enlarge

Santa Barbara Cottage Hospital - Clinical Specialties - Pneumonia 30 Day Readmission data Click to Enlarge

Sepsis is caused by an overwhelming immune response to infection. The body releases immune chemicals into the blood to combat the infection. Those chemicals trigger widespread inflammation, which leads to blood clots and leaky blood vessels. As a result, blood flow is impaired, and that deprives organs of nutrients and oxygen and leads to organ damage.

Santa Barbara Cottage Hospital - Clinical Specialties - Sepsis Mortality O:E data Click to Enlarge

Santa Barbara Cottage Hospital - Clinical Specialties - Sepsis 30 Day Readmission data Click to Enlarge

Stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts.

Carotid artery stenting is a procedure in which a catheter is inserted through an artery in the groin up to the blocked carotid artery in the neck. A slender, metal-mesh tube, called a stent is expanded inside the carotid artery to increase blood flow.

Santa Barbara Cottage Hospital - Clinical Specialties - Carotid artery stent mortality index data Click to Enlarge

Santa Barbara Cottage Hospital - Clinical Specialties - Carotid artery stent 30 day readmission data Click to Enlarge

Endovascular mechanical thrombectomy is a procedure that uses a slim catheter to remove a clot blocking a large blood vessel in the brain. A wire-cage device called a stent retriever is threaded through an artery in the groin to the blocked artery in the brain. The stent opens and grabs the clot.

Santa Barbara Cottage Hospital - Clinical Specialties - Endovascular mechanical thrombectomy mortality index data Click to Enlarge

Santa Barbara Cottage Hospital - Clinical Specialties - Endovascular mechanical thrombectomy 30 day readmission data Click to Enlarge

What We Are Doing to Improve

We review all hospital mortalities and readmissions to look for any concerning quality issues or opportunities to improve internal systems and discharge planning that extends beyond the hospital stay.
Our Community Case Management program contacts patients after they go home to ensure their wellbeing and that they understand their discharge instructions, know how to take their medications, follow up with their primary care physicians and address their questions.
Our Advance Care Planning program provides an opportunity for patients to document their healthcare agent and preferences so their wishes will be honored if they can no longer speak for themselves.
We benchmark our performance to similar facilities as we strive to provide the best possible care.

We also review and encourage you to review additional mortality and readmission data published by Medicare on www.medicare.gov/care-compare. These metrics differ slightly from the measures we use for improvement:

Medicare data is 1-3 years old, whereas our data is current through the most recent quarter.
Medicare reports mortalities within 30 days of discharge and readmissions to all hospitals based on claims data and official death records.
We can only track readmissions to a Cottage hospital and deaths that occur in the hospital.
Both sources of data provide insight into performance.

What We Measure

Nulliparous, Term, Singleton, Vertex (NTSV) Cesarean Birth Rate, identifies the proportion of live babies born at or beyond 37.0 weeks gestation to women in their first pregnancy, that are singleton (no twins or beyond) and in the vertex presentation (no breech or transverse positions), via cesarean birth. Our goal is to be lower than the 23.9 target set by California Health and Human Services Agency, Hospital Quality Institute, and Cal Hospital Compare.

How We Are Performing

Santa Barbara Cottage Hospital - Clinical Specialties - Nulliparous, Term, Singleton, Vertex (NTSV) Cesarean Birth Rate data Click to Enlarge

What We Measure

Early elective delivery is defined as a delivery by induction of labor without medical necessity followed by vaginal or caesarean section delivery or a delivery by caesarean section before 39 weeks gestation without medical necessity. Our goal is to be less than the national benchmark.

Santa Barbara Cottage Hospital - Clinical Specialties - Early elective delivery data Click to Enlarge

What We Do to Improve

A team of nurses and OB/GYN physicians review the data every month, investigate best practices and work to implement and sustain high levels of performance.