Quality Transparency Dashboard

The Quality Transparency Dashboard, which displays the outcome measures and program status, is designed to provide transparency into how Cedars-Sinai is performing, in comparison to hospitals across California and the entire nation, among 5 key quality-of-care metrics:

The data below will be updated regularly, and at a more frequent rate than most other quality-measures data, ensuring that patients and the public have access to the most recent information. Note, lower numbers are indicative of better performance.

Patients can be confident in our commitment to improving safety and quality of care on a continual basis. Our goal is to make Cedars-Sinai one of the safest hospitals in the nation. 

Central line-associated bloodstream Infection (CLABSI): This is a serious infection that occurs when germs enter the bloodstream through a central line (a special intravenous catheter that allows access to a major vein close to the heart, and which can stay in place for weeks or months). The value shown above is a standardized infection ratio (SIR), which is the ratio of observed-to-expected infections during a certain period of time. SIRs below 1.00 indicate that the observed number of infections during the measured period was lower than would be expected under normal conditions, while values above 1.00 indicate that the observed number of infections was higher than expected.

Limitation: When calculating the SIR, the Centers for Disease Control and Prevention (CDC) adjust for differences between hospitals, but patient risk factors aren’t taken into account. These patient-specific variables (such as poor skin integrity or a suppressed immune system) can increase the risk of developing a central line infection. As a result, the SIR for hospitals that care for more medically complex or immunosuppressed patients may not be adequately adjusted to account for those patient-specific risk factors. 

Colorectal surgical-site infection (SSI): An infection (usually bacterial) that occurs after a person has had colorectal surgery, which occurs at the site on the body where the surgery took place. While some involve only the skin, others are more serious and can involve tissues under the skin, the organs, or implanted material. The value shown above is a standardized infection ratio (SIR), which is the ratio of observed-to-expected infections during a certain period of time. SIRs below 1.00 indicate that the observed number of infections during the measured period was lower than would be expected under normal conditions, while values above 1.00 indicate that the observed number of infections was higher than expected.

Limitation: Some patient-specific risk factors are included in the adjustment of the SIR for these types of infections, but not all (such as trauma or emergency procedures). As a result, the SIR for hospitals that perform more complex procedures, or with larger volumes of trauma or emergency procedures, may not be adequately adjusted to account for those patient-specific risk factors.

Nulliparous, Term Singleton, Vertex (NTSV) cesarean birth rate: This is the percentage of cesarean (surgical) births that occur among primarily low-risk, first-time mothers, who are at least 37 weeks pregnant with one baby in a head-down position (not breech or transverse). Lower values indicate that fewer cesareans were performed among this group of mothers.

Limitation: NTSV rates don’t take into account certain obstetric conditions, such as placenta previa, that may make a cesarean delivery the safer route for both mother and infant.

Sepsis mortality: This is the percentage of patients with a severe infection who die in the hospital. Most cases of sepsis (over 90%) start outside the hospital. A lower percentage indicates better survival rates.

Limitation: The use of discharge/administrative data is less specific than clinical data in providing a diagnosis. In addition, without adjusting for differences in patient-specific risk factors, comparing rates among hospitals is difficult.

This hospital has a maternity safety program in place. The program provides a coordinated approach and emergency response to risks associated with pregnancy and childbirth, such as severe hypertension, excessive bleeding, and blood clots.

This hospital has a sepsis protocol in place. The protocol provides guidance for a coordinated approach to identification and treatment of a serious infection that can result in damage to multiple organ systems, causing them to fail.

This hospital has a respiratory monitoring program in place. The program provides guidance for assessment of risk of respiratory depression, and includes continuous monitoring of breathing, and functioning of the lungs and circulatory system, when indicated.