Medications that decrease the constriction of blood vessels allowing better blood flow to the kidneys and decreased blood pressure.

A non-profit private council that evaluates and accredits medical residency and internship programs. The ACGME currently oversees the post-graduate education and training for all MD and the majority of DO physicians in the United States.

An injury resulting in the use of a drug. ADE's may result from medication errors, but most do not.

Harm directly caused by the drug at normal doses, during normal use. Non-preventable ADEs.

Any negative patient events that are expressed as symptoms, signs or laboratory abnormalities.

A part of the United States Department of Health and Human Services, which supports research and is designed to improve the outcomes and quality of healthcare. Additionally, the organization seeks to reduce costs, address patient safety and medical errors and broaden access to effective services. The AHRQ conducts and sponsors research, which helps people make more informed decisions and improve the quality of healthcare services.

Used in transplantation denoting tissue, particularly stem cells, from either bone marrow or peripheral blood, that are from the same species, but antigenically distinct.

A common statistic associated with the time patients are in a hospital bed. The total number of patient days, divided by the number of admissions and discharges during a specific period of time, which results in an average number of days in the hospital for each person admitted.

Commonly referred to as a "heart attack." Caused by a blockage in a blood vessel to the heart muscle. When blood flow is blocked, the heart muscle can die or be damaged, causing the heart to pump less well. There are evidence-based care interventions and best practices for managing AMI symptoms and for treating AMI, that are measured and reported to CMS.

Information resulting from the systematic analysis of data or statistics.

A substance that, when introduced into the body, stimulates the production of an antibody. Antigens include toxins, bacteria, foreign blood cells, and the cells of transplanted organs.

The physician assigned to oversee and coordinate the team caring for a patient during hospitalization. In teaching facilities, the attending also supervises and educates physicians-in-training, such as interns, residents, and fellows.

Used in transplantation; cells or tissues obtained from the same individual.

Any part of a patient day in the hospital during which either care is not delivered in a timely fashion or when acute hospital services are not needed or could have been safely/appropriately performed in an alternate setting, such as outpatient.

Computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images as “virtual slices” of specific areas of a scanned object, allowing the user to see inside the object without cutting.

Evidence-based clinical treatments that are considered to be best practices. CMS requires health care organizations to measure and report the number of patients that meet and do not meet each of the care measures for specific medical conditions, such as pneumonia.

A progressive disease that makes it hard to breathe. “Progressive” means the disease gets worse over time. COPD can cause coughing that produces large amounts of mucus (a slimy substance).

An emergency call for help to enact the rapid response team who can immediately come to a patient’s bedside to provide urgent medical care.

The simultaneous presence of two chronic diseases or conditions in a patient. Example: Diabetes and Hypertension.

A federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid.

A bloodstream infection that has developed in a patient who has had a central line (a large IV in a centralized vessel feeding into the heart) within 48 hours of the onset of symptoms.

A standardized patient satisfaction survey tool that is designed and regulated by CMS to measure patient’s perception of care provided in an office setting.

Advanced practice registered nurses (APRNs) with additional education and certification to manage acute and chronic medical conditions and are qualified to diagnose medical problems, order treatments, prescribe medications and make referrals for a wide range of acute and chronic medical conditions.

The deliberate organization of patient care activities between a multidisciplinary team of care providers involved in a patient's care to expedite efficient, patient-centered, high-quality healthcare services.

Advanced practice registered nurses (APRNs) with additional education and certification to deliver and manage anesthesia and anesthesia-related care to patients.

A process followed by our patient relations department to handle patient and family complaints and grievances.

A patient or family statement that a situation is unsatisfactory or unacceptable.

Advanced practice registered nurses (APRNs) with additional education and certification to provide care to women throughout the lifespan. CNMs perform physical exams, prescribe medications including contraceptive methods, order laboratory tests as needed, provide prenatal care, gynecological care, labor and birth care, as well as health education and counseling to women of all ages.

Hospital staff face a variety of stressors daily and, in general, cope very well. Occasionally, they deal with situations that can produce strong emotional reactions and are therefore labeled critical incidents; for example, the death of a patient they have been caring for long-term. The CISM team is a group of trained individuals who respond after an event to help staff cope and manage their stress.

A computerized electronic system and an element of our enterprise electronic health record (eRecord) used at UPMC's inpatient areas for documentation of patient conditions.

Bacterial infection of the intestines that causes severe diarrhea and cramping.

An infection of the bladder, kidneys or associated areas that occurs when organisms, usually bacteria, enter through an indwelling catheter, also known as a Foley Catheter.

An antiseptic solution containing sodium hypochlorite and developed to treat infected wounds.

A statistical measure of drug consumption, defined by the World Health Organization. It is used to standardize the comparison of drug usage between different drugs or between different health care environments.

The Pennsylvania DOH licenses and verifies compliance with state and federal health and safety standards.

A condition caused by a blood clot in a deep vein and can be life-threatening. Symptoms may include swelling, pain, and tenderness, often in the legs.

An employee benefits program offered by many employers. EAPs are intended to help employees deal with personal problems that might adversely impact their job performance, health, and well-being. EAPs generally include short-term counseling and referral services for employees and their household members. Supervisors may also refer employees (supervisor referral) based upon unacceptable performance or conduct issues.

Clinical treatments that are based on specific kinds of research studies that are supported by a distinct set of criteria.

A procedure performed on individuals with angina, heart failure, or cardiomyopathy in order to diminish symptoms of ischemia and improve functional capacity and quality of life.

A federal law requiring hospitals to provide a medical screening examination to any individual who comes to the hospital and requests such an examination. EMTALA prohibits hospitals from refusing to examine or treat individuals with an emergency medical condition.

A computerized electronic system and an element of our enterprise electronic health record (eRecord) used at UPMC’s Physician offices for documentation of patient conditions.

A program focused on improving surgical outcomes and enhancing the patient experience before, during and after surgery.

A catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patient airway and to ensure the adequate exchange of oxygen and carbon dioxide.

The department responsible for providing a healthy and clean environment for patients to heal and provides a safe place to work.

The name of a project where documents are given to the patient and family member in surgical services outlining the planned navigation through the surgical process.

A practice of the University of Pittsburgh Physicians (UPP)

Required education for medical students, residents, educators, academic physicians, and residency/fellowship program directors.

A condition that might occur after an allogeneic transplant. The donated bone marrow or peripheral blood stem cells view the recipient’s body as foreign and the donated cells/bone marrow attack the body.

A real or perceived wrong that triggers out Patient Relations department to perform a formal investigation and follow-up. Also, see “patient grievance.”

Descriptions of the terminology in the "Healthcare Terms for Non-Healthcare Related Individuals" are specifically defined for use in the context of the UPMC Presbyterian Shadyside Campus and may differ from other usage.

A rare or avoidable event that occurs during a hospital stay or at a medical facility, such as a foreign object retained after surgery, pressure ulcers, falls, etc.

An infection not known to be present at the time of admission to a healthcare setting. The infection may include central line, urinary catheter, or surgical site infections.

Used in transplantation, a HAPLO transplant is when the donor is only half matched to the patient.

A pressure ulcer that is acquired during a hospital stay or at a medical facility.

A metric developed by the Agency for Healthcare Research and Quality (AHRQ) to standardize information that is to be collected for all patient safety concerns, including incidents, near misses and unsafe conditions.

An ambulatory care clinic (i.e.: ‘doctor’s office’) where patients are able to receive outpatient care in a setting that is owned and/or operated by a hospital. Patients are able to receive medical care (both primary and subspecialty care) in an integrated setting within the hospital or in an off-site location.

Care measures that require monitoring and reporting to the Joint Commission and CMS. The care measures include indicators such as restraint use and continuing care plans at discharge.

The national standard/methodology for collecting and publicly reporting information about the patient’s experience of care (from the patients’ perspectives). It allows for objective/meaningful comparisons of hospitals using patient-focused measures. It also enhances accountability in health care through transparent reporting of results and associated financial incentives.

Also known as Congestive Heart Failure, a condition where the heart is inefficient in pumping blood through the body. The heart’s inefficiency causes fluid to build up in the body in areas where it does not belong such as the lungs, legs or abdomen. This is a condition for which the CMS requires monitoring and reporting.

A website that provides publicly reported data about the quality and experience of care at over 4000 Medicare-certified hospitals across the country.

A hospital-based physician usually trained in internal medicine, who assumes the care of hospitalized patients in the place of primary care physicians.

A group of inflammatory conditions of the colon and small intestine. Crohn’s disease and ulcerative colitis are the principal types of inflammatory bowel disease.

An event, occurrence, or situation involving the clinical care of a patient that could have injured the patient, but did not either cause an unanticipated injury or require the delivery of additional health care services to the patient.

Measurement of the amount of fluid a patient takes into their body (by drinking/eating, intravenous therapy, etc.) and the amount of fluid eliminated (through urination, sweating, etc.). The measurement is used to confirm fluid balance for the patient.

A term used for on-the-job training and can be associated with any profession including finance and radiology. However, the term is most frequently associated with a physician who has completed medical school, does not have their full license to practice without supervision and is in the first post-medical school training year.

A culture of safety for patients and associates to speak up and identify opportunities to improve patient safety without fear of retaliation. This will ensure confidence that leaders will listen and take action in a fair and consistent manner by using guidelines.

A numerical value used by the United Network for Organ Sharing (UNOS) to assign relative priority for distributing donated lungs for transplantation within the United States. The lung allocation score takes into account various measures of a patient’s health in order to direct donated organs towards the patients who would best benefit from a lung transplant.

A comprehensive regional resource that is a tertiary care facility central to the trauma system. A Level 1 Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.

A surgical procedure performed to remove diseased, emphysematous lung tissue. This procedure: reduces the size of an over-inflated lung; and allows the expansion of the remaining, often more functional lung; and allows the expansion of the remaining, often more functional lung. Lung volume reduction surgery has been shown to help improve breathing ability, lung capacity and overall quality of life in selected patients.

The Magnet Recognition Program recognizes healthcare organizations for quality patient care.

A student enrolled in an accredited medical school or osteopathic school.

Metastasis is the spread of cancer or other diseases from one organ or part of the body to another without being directly connected with it. The new occurrence of disease is referred to as metastases.

The two are often used together to calculate the prevalence of a disease and how likely that disease is to be deadly, particularly for certain demographics.

Traditional, recurring conferences held by medical services at academic medical centers. They are an intense, detailed review of the care delivered to a patient(s) where patient safety issues have occurred. Many times the M&M is used as a learning opportunity for all who attend.

Measures the total cost per Medicare patient for their hospital stay plus three days prior to admission to the hospital and 30-days after discharge.

Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the health care professional.

A Patient Safety/Quality Peer-Review of Reportable Patient Events as either an Incident or Serious Event involving the ordering, prescription, dispensing, administration, or use of medications that results in unanticipated injury or harm or that could, if repeated, result in unanticipated injury or harm.

A process of reviewing medications to validate with the patient the correct medication (including dose and frequency) a patient is taking at specific intervals in their care experience. Medication reconciliation may be completed in a physician office, when being admitted for surgery or medical care, when transferred between units and at discharge from the hospital.

A non-profit corporation dedicated to raising awareness for multiple myeloma research. MMORE’s goal is to find new life-prolonging treatments, improve the quality of life for myeloma patients, and ultimately to find a cure, by raising awareness and funds through fun and inspiring community events.

Estimates of deaths from any cause within 30 days of a hospital admission, for patients originally hospitalized.

A committee that reviews transplant program post-transplant outcomes to identify underperforming programs and work with those programs to implement performance improvement measures.

A test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases, MRI gives different information about structures in the body than can be seen with an X-ray, ultrasound or computed tomography (CT) scan. MRI also may show problems that cannot be seen with other imaging methods.

A bacterium responsible for infections in humans which has developed resistance to several commonly used antibiotics.

A system-wide survey that gives all staff the opportunity to share their thoughts, feelings, and ideas.

The term used by medical professionals to describe adverse events that are serious and usually preventable.

An advanced practice registered nurse (APRN) who has completed advanced didactic and clinical education beyond that required of the generalist registered nurse (RN) role. This additional education allows the NP to manage acute and chronic medical conditions and is qualified to diagnose medical problems, order treatments, prescribe medications and make referrals for a wide range of acute and chronic medical conditions.

A category of hospital stay in which a patient is in a hospital setting, but accessing an outpatient benefit. The intent of the stay is to decide whether inpatient hospitalization is required to resolve an issue within a defined period of observation, usually 24 hours.

A common sleep disorder characterized by brief interruptions of breathing during sleep.

The condition of a patient at the end of therapy or a disease process, including the degree of wellness and the need for continuing care, medication, support, counseling, or education.

The results of patient treatments such as mortality, improved function, complication or infection rates that are measured using standard definitions and used to determine the quality of organizational performance in pay-for-performance programs such as Value-Based Purchasing.

An independent state agency which provides a resource of comparative information about the efficiency and effectiveness of health care provided to individual consumers and group purchasers of health services in the State of Pennsylvania.

A drug pricing program that requires drug manufacturers to provide outpatient drugs to eligible health care organizations/covered entities at significantly reduced prices.

A medical test that characterizes blood coagulation, also known as clotting.

A committee at a hospital or an insurance plan that meets to decide which drugs will appear on that entity’s drug formulary. The committee usually consists of both physicians and pharmacists.

A set of indicators providing information on potential “in-hospital” complications and adverse events following surgeries, procedures, and childbirth.

Facilitates the collaborative efforts of more than 2,800 physicians, 1,700 resident and fellow physicians, and 52,00 staff in distinctive programs and specialties located in 400+ clinical and outpatient locations in western Pennsylvania. They have six distinct, yet complementary companies including Community Medicine Inc. (CMI), Emergency Resource Management Inc. (ERMI), Erie Physicians Network (EPN), Graduate Medical Education (GME), Renaissance Family Practice (RFP) and University of Pittsburgh Physicians (UPP).

A document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare.

A Latin phrase meaning “as needed.” The administration times are determined by the patient’s needs.

Localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. The most common sites are the skin overlying the sacrum, coccyx, heels or hips, but other sites such as the elbows, knees, ankles or the back of the cranium can be affected. Pressure Ulcers occur due to pressure applied to soft tissue resulting in completely or partially obstructed blood flow to the soft tissues resulting in completely or partially obstructed blood flow to the soft tissue. Pressure ulcers most commonly develop in persons who are not moving about or are confined to wheelchairs. Also known as decubitus ulcers or bedsores.

A vendor that coordinates all of the patient satisfaction surveys used by the organization including HCAHPS and Patient Satisfaction surveys for Inpatient, Emergency Department, Outpatient, Ambulatory Surgery, and Medical Practices. Press Gamey submits to CMS on our behalf.

Specialized clothing or equipment worn by employees for protection against health and safety hazards. Personal protective equipment is designed to protect many parts of the body, i.e., eyes, head, face, hands, feet, and ears.

An acronym originally developed to notify Emergency Medical Personnel and other clinical providers about end-of-life directives such as CPR, tube feeding, and antibiotics. It is widely used in Skilled Nursing Facilities.

An inflammatory condition of the lungs that may be caused by viruses, bacteria, microorganisms, or autoimmune diseases. It is usually accompanied by fever, an elevated white blood cell count and abnormalities on chest imaging. Distinctions are made between hospital acquired, ventilator-associated (VAP) and community-acquired (CAP) pneumonia. Pneumonia is a care measure that is monitored and reported to CMS.

Medical professionals who are educated and certified to work as part of a team with a physician to deliver medical practice and perform physical examinations, diagnose and treat illnesses, order and interpret lab tests, perform procedures, assist in surgery, provide patient education and counseling and make rounds in hospitals and nursing homes.

The methodology used to transform the patient experience by viewing care through the eyes of patients and families. PFCC promotes the use of a six-step improvement process (including in-depth shadowing) in order to evaluate, co-design and transform care in partnership with patients and families.

A care provider who performs specified tasks under the supervision of an RN. Examples of the responsibilities may include baths, vital signs, feeding patients, blood draws, etc.

A blockage of the lung’s main artery or one of its branches by a substance that has traveled from elsewhere in the body through the bloodstream (embolism). PE results from a deep vein thrombosis (commonly a blood clot in a leg) that breaks off and migrates to the lung, a process termed venous thromboembolism (VTE).

The number of survey respondents who have rated you with the most favorable response, such as “always” or “yes, definitely.” The patient satisfaction surveys (HCAHPS & CGAHPS) use Top Box for public reporting.

A tool used for improving processes and may be used with other tools and methods. It provides a process to follow for small improvement projects.

The physician responsible for coordinating patient care.

Payment is provided based on how well a provider or organization performs on established standardized measures. These types of programs are used in health care by insurance providers including the government’s Medicare and Medicaid programs who adjust hospital payment strategies based on an organization’s ability to meet or exceed specific targets (see Value Based Purchasing as an Example).

A formal or written complaint made to any hospital representative or employee by a “grieving party” regarding the patient’s care when the issue is not resolved at the time of the complaint by staff present. It also includes any formal or informal written complaints of patient abuse or neglect and/or issues related to the hospital’s compliance with the CMS Hospital Conditions of Participation or a Medicare beneficiary billing complaint related to rights and limitations.

A verbal concern or issue made to the hospital by a patient or patient representative (“grieving party”) that can be resolved at the time of the staff present, including, but not limited to nursing, administration, nursing supervisors or patient relations representatives.

Also known as care pathways, critical pathways or integrated care pathways, these are one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes. Clinical pathways promote organized and efficient patient care based on evidence-based practices.

Specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stresses of a serious illness – whatever the diagnosis. The goal is to improve the quality of life for both the patient and the family.

A program of the American Society of Clinical Oncology (ASCO). The QOPI program includes measurement, feedback and improvement tools for hematology-oncology practices and requires chart-abstracted data to be submitted twice a year.

The Highmark Quality Blue program is a “Pay for Performance” program in which the organization participates as part of our contracted reimbursement. The performance indicators and requirements vary from year to year and include items such as readmissions, infections, etc.

An extremely fast-paced change methodology that provides a methodical approach wherein a number of individuals involved in a defined process take part and work together to collaboratively and objectively evaluate a process, develop targets and make changes to achieve the desired state.

A patient who experiences unplanned readmissions to a hospital after a previous hospital stay.

This term is most often used for a physician who is completing post-graduate medical training. Other post-graduate programs, such as pharmacy and nursing use this term, but typically, with the specialty noted in the title, for example, “pharmacy resident.”

(a) Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head freely or (b) A drug or medication when it is used as a restriction to manage the patient’s behavior or restrict the patient’s freedom of movement and is not a standard treatment or dosage for the patient’s condition.

Items that are left in the patient after a surgery or procedure, often a sponge or instrument.

A software database used to organize and monitor risk and reportable events. The software provides analysis and reporting capabilities.

The nursing or nursing assistant practice of regularly checking on patients’ needs.

A UPMC initiative to improve patient experience in partnership with Studer Group.

Care measures that are specifically associated with patients who have had certain surgical interventions as outlined by the CMS regulations. The reportable indicators for these measures are considered best practices for improving patient outcomes.

The involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving. Seclusion may only be used for the management of violent or self-destructive behavior.

A summary measure used to track HAIs at a national, state or local level over time. The SIR adjusts for the fact that each healthcare facility treats different types of patients. For example, the experience with HAIs at a hospital with a large burn unit (a location where patients are more at risk of acquiring infections) cannot be directly compared to a facility without a burn unit.

CMS created the Five-Star Quality Rating system to help consumers, their families and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.

An unexpected occurrence involving death or serious physical/psychological injury, or risk thereof. Serious injury specifically includes loss of limb or function.

A life-threatening whole-body inflammation caused by an infection in the bloodstream. The infection can be caused by a variety of bacteria, fungi, viruses and parasites in the blood, urinary tract, lungs, skin or other tissues.

A serious event is an event, occurrence, or situation involving the clinical care of a patient in a medical facility that results in death or compromises patient safety and results in an unanticipated injury requiring the delivery of additional health care services to the patient. The term does not include an Incident.

See HAI for more information about surgical site infections.

A care location that provides a skilled level of care to its patients. Residents live in nursing homes which may offer SNF and intermediate levels of care, as well as hospice, etc.

When blood flow to a part of the brain stops because of a blood clot, plaque, or bleeding. Stroke is also known as a “brain attack.”

The methodology used to create, test, and implement changes to improve care delivered. Improvements are categorized into four main groups: Safe and Reliable Care; Vitality and Teamwork; Patient-Centered Care; Value-Added Care Processes.

Identifies, analyzes, and develops new solutions to address health care’s greatest challenges and creates the next generation of healthcare Information Technology products for use inside and outside of UPMC. Additionally, they assess new and existing technology investment opportunities to pursue a fresh vision for health care innovation with our commercial and academic partners.

The use of telecommunication and information technology to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. It is also used to save lives in critical care and emergency situations.

A cycle in the Plan-Do-Study-Act (PDSA) process by planning it, trying it, observing the results and acting on what is learned. This is the scientific method used for action-oriented learning.

An intervention in which the patient consents to be alone in a designated area for an agreed-upon timeframe from which the patient is not physically prevented from leaving. Time out is not to exceed 30 minutes at a time.

A US-based non-profit organization that accredits more than 19,000 health care organizations and programs in the US. In most states, accreditation is a condition of licensure and the receipt of Medicaid reimbursement. Many research grants and educational certifications also require TJC certification, as well as specialty certifications such as Stroke and Rehabilitation.

A mobile robot. It uses Wi-Fi and built-in maps and sensors to navigate throughout the hospital, delivering linen and supplies to designated areas.

A computerized electronic system and an element of our enterprise electronic health record (eRecord) used at UPMC’s Cancer Center offices for documentation of patient conditions.

A program established by the Affordable Care Act to promote better clinical outcomes for hospital patients as well as improve their experience of care during hospital stays. Incentive payments to hospitals for services provided will be impacted beginning in Federal Fiscal Year 2013 (Oct. 2012), based on either how well they perform on identified measures or how much they improve their performance on those measures compared to their baseline performance. The measures include patient experience (HCAHPS), Outcomes (HAC and Mortality), Care Measures, and Efficiency measures (MSPB), which are defined in this glossary.

A bacterial strain of the type Enterococcus that is resistant to the antibiotic vancomycin.

A blood clot that forms within a vein either in an arm or leg which is called deep vein thrombosis (DVT) or in the lung which is called pulmonary embolism (PE). It is a common, lethal disorder that affects hospitalized and non-hospitalized patients and results in long-term complications.

A nursing tri-specialty involved with the treatment of patients with acute and chronic wounds, patients with an ostomy (those who have had some kind of bowel or bladder diversion), and patients with continence conditions (those with bladder and bowel control and associated skin care issues).

A woven fabric having warp yarns and filling yarns woven together in a plain weave to provide a pill resistant fabric having identical surfaces on both sides thereof. A surface of the fabric, when exposed to a pathogenic environment for twenty hours, allows no more than a total average of about twenty-two CFUs of pathogens per square centimeter to be formed thereon.