Glossary
Accreditation—An
evaluation process in which an official group examines a
health care organization to ensure that it is meeting certain
standards established by experts in the field.
ACEI—An Angiotension
Converting Enzyme Inhibitor is a category of medication used
in the treatment of heart failure and hypertension. An ACEI
drug enables blood vessels to dilate and improve blood flow.
Abdomen—A part
of the body from below the ribs to the pelvis. Some call
it the stomach.
Anesthesiologist—A
doctor who delivers drugs that remove sensation before and
during surgery. For mothers giving birth, the anesthesiologist
maintains safe pain relief during labor and delivery, and
delivers pain control during labor and appropriate sedation
for cesarean deliveries.
Antibiotics—A medication
that kills the germs that cause pneumonia. These germs may
be bacteria or fungus. Viruses also can cause pneumonia,
but they are rarely susceptible to antibiotics.
Arrhythmia—An abnormal
heartbeat rhythm.
Average length of stay—The
average number of days spent in the hospital. For a new mother,
this includes the time before and after childbirth.
Blood cultures—A
blood test to check for bacteria or fungus in the blood.
Cardiomyopathy—A
disease of the heart muscle. This can be caused by inherited
factors, viral infection, or coronary artery disease.
Cesarean section—A
surgical procedure to deliver a baby. The doctor makes an
incision through the mother's abdomen and uterus. Also referred
to as a C-section, Cesarean, and Cesarean birth.
Complications—Any
disease or other unwanted effect that occurs during the course
of because of another medical problem. For pregnancy and
childbirth, this can mean problems that develop during the
pregnancy, labor, delivery, or post-partum period.
Congenital heart disease—A
heart problem you were born with.
Congestive heart failure—A
condition in which the heart can't pump enough blood and
oxygen to the body's other organs. It is usually caused by
a heart disorder.
Cord blood—The
blood that is in the umbilical cord.
Data Collection—The
process of getting raw information, either from a single
source or from multiple sources.
Data Editing—The
process of correcting errors or supplying missing information.
Data Sources—The
primary source document(s) used for collecting information.
Database—An organized,
comprehensive collection of information.
Diagnosis—The identification
of a disease or condition from its signs and symptoms.
Doula—A non-medical
person experienced and trained in childbirth whose role is
to comfort and support the mother and family before, during,
and after birth. A doula provides the mother with information,
support, reassurance, and assistance throughout the birth
process, including assistance with breast feeding.
DRG—Diagnosis-Related
Group, or DRG, is a term used for classifying medical conditions
into standard categories. The federal Medicare system identifies
more than 500 DRGs. For each DRG, there is a guideline for
the patient’s standard treatment and length of stay
in a hospital. Hospitals use DRGs to define a patient’s
illness for billing purposes. Click here for more information.
Click here for
a list of the medical conditions used in the Hospital Guide.
Drug—Any substance
taken by mouth, injection, or applied locally to prevent
or treat a medical disorder.
Episiotomy—During
childbirth, an incision the doctor makes into the mother’s
perineum to prevent tearing.
Fallopian tubes—The
tubes in a woman’s reproductive system that move the
egg to the uterus (also called the womb).
Fetus— An unborn
baby, from the beginning of the third month of pregnancy
until birth.
HealthChoice—Maryland’s
managed care program for Medicaid recipients. Medicaid patients
who qualify for HealthChoice will choose a Primary Care Provider
and be enrolled in a Managed Care Organization (MCO) of their
choice. These MCOs offer more free health care services than
standard Medicaid providers. For more information, see Paying
for Care.
High risk—Compared
to the rest of the population, the patient has a greater
chance of having or developing a medical problem because
of a current medical condition.
Highest rate—When
comparing Maryland hospitals, this is the highest number
or rating on an individual quality indicator for the time
period that is being analyzed.
Joint Commission on Accreditation
of Healthcare Organizations (JCAHO)—An independent,
not-for-profit organization that evaluates and accredits
health care organizations and programs in the United States
including hospitals, nursing homes, and home health agencies.
Labor, delivery, recovery (LDR)
room—Labor, Delivery, Recovery rooms (LDR's)
are rooms in which the mother labors, delivers the baby,
and recovers. Mothers are then transported to a separate
postpartum room.
Labor, delivery, recovery, postpartum
(LDRP) room—Labor, Delivery, Recovery, Postpartum
rooms (LDRP's) are those rooms in which the mother labors,
delivers the baby, and recovers, and she spends her postpartum
period in the same room. She does not move to a separate
postpartum area.
Lacerations—A wound
with a jagged edge. For a new mother, a laceration means
a tear in the vagina. Third- and fourth-degree lacerations
are the most severe types of tears and can result in rectal,
vaginal, and urinary problems.
Lactation consultant—A
specialists who helps mothers with breast-feeding skills.
Lactation consultants give information and guidance and help
prepare pregnant mothers for breastfeeding. They also give
support to mothers having problems after delivery and after
leaving the hospital.
Length of Stay (LOS)—The
number of days a patient spends in the hospital. LOS can
indicate the efficiency of hospital care, and it can help
indicate when a patient should leave the hospital.
Level of care—The
range of treatment or procedure a patient receives. This
includes the medical level of expertise available.
Level I Nursery Services—Level
I hospitals have all the capabilities for normal births and
births with minor complications. This type of hospital is
designed for newborns who have been carried to nearly full
term and the delivery is expected to be uncomplicated.
Level II Nursery Services—Level
II hospitals have additional equipment and staff to handle
more complicated births. This level is for newborns with
a slight potential for risk during the delivery. In general,
Level II hospitals can provide care to newborns delivered
at 32 weeks or at 3 pounds, 5 ounces or more. Level II hospitals
also provide care for uncomplicated births.
Level III Nursery Services—Level
III hospitals have equipment and staff to handle very complicated
births. This type of hospital can care for babies who are
premature (babies delivered before 32 weeks and at very low
birth weights of less than 3 pounds 5 ounces) or who have
serious illnesses or abnormalities requiring intensive care
before, during, or after delivery. Level III hospitals also
provide care for uncomplicated births.
Level III Plus Nursery Services—Level
III Plus hospitals can provide care for very complicated
births; they are located near a Level IV hospital to ensure
rapid transfer of the newborn if additional care is needed.
Level III Plus hospitals provide selected specialty services.
Level III Plus hospitals also provide care for uncomplicated
births.
Level IV Nursery Services—Level
IV hospitals can care for the most complicated births. Level
IV hospitals provide comprehensive critical care for the
newborn and have a full range of specialty services. Level
IV hospitals also provide care for uncomplicated births.
Level I Obstetrics Services—Level
I hospitals have all the capabilities for normal births and
births with minor complications. This type of hospital is
for mothers who have carried their babies to nearly full
term and expect an uncomplicated pregnancy and delivery.
Level II Obstetrics Services—Level
II hospitals have additional equipment and staff to handle
more complicated births. This type of hospital is for mothers
with a slight potential for risk during delivery.
Level III Obstetrics Services—Level
III hospitals have equipment and staff to handle very complicated
births. Mothers and or newborns with serious illnesses or
abnormalities requiring intensive care before, during, and/or
after delivery may receive care at a Level III hospital.
Level III hospitals also provide care for uncomplicated births.
Level III Plus Obstetrics Services—Level
III Plus hospitals can provide care for very complicated
births; they are located near a Level IV hospital to ensure
rapid transfer of the newborn if additional care is needed.
Level III Plus hospitals provide selected specialty services.
Level III Plus hospitals also provide care for uncomplicated
births.
Level IV Obstetrics Services—Level
IV hospitals can care for the most complicated births. Level
IV hospitals provide comprehensive critical care for the
newborn and have a full range of specialty services. Level
IV hospitals also provide care for uncomplicated births.
LVF—Left ventricular
function is a measurement of how well the heart’s left
ventricle can pump blood to the organs of the body.
LVSD—Left ventricular
systolic dysfunction. The heart’s left ventricle does
not effectively pump blood to the organs.
Medicaid—A joint
federal and state program that pays for health care for certain
persons with low income or some special health needs. Medicaid
will usually pay for medications, lab tests, and nursing
home services. In Maryland, most Medicaid patients are required
to receive health care through the HealthChoice program.
For more information, see Paying
for Care.
Medicare—The federal
government's health insurance program for persons who are
65 and older, who are permanently disabled, or who require
kidney dialysis or transplantation. Most persons become eligible
for Medicare when they turn 65. All Maryland hospitals provide
care for persons enrolled in Medicare. For more information,
see Paying
for Care.
Midwife—Certified
nurse midwives are licensed care providers educated in both
nursing and delivering babies. Midwives provide care to mothers
during pregnancy, labor and delivery, and after birth, and
to newborns.
Neonatologist—A
neonatologist treats disorders in newborns from birth and
throughout the baby’s stay in the neonatal intensive
care unit (NICU). Neonatology is a pediatric specialty.
Neonatal Intensive Care Unit (NICU)—A
neonatal intensive care unit (NICU) is a hospital unit where
highly-trained medical professionals specialize in the care
of babies born prematurely and/or with other special problems.
Doctors who care for newborns are specially-trained pediatricians
called neonatologists. Nurses are specially trained to provide
the intensive level of care for premature babies. Special
beds are used to provide warmth and isolation, and to handle
any devices that monitor the baby's heart rate, blood pressure,
breathing, special blood, and feeding equipment. In Maryland,
this term applies to hospitals designated as Level III or
above (see the definition for Level III Nursery Services).
Obstetrician—A
doctor who specializes in caring for pregnant women and delivering
babies.
Obstetrics—Care
provided in the delivery of babies. Doctors and nurses provide
the care.
Outcome—The impact
of care provided to a patient. Outcomes can be positive,
such as a patient’s ability to walk freely as a result
of rehabilitation, or negative, such as bedsores that might
develop because of a patient’s lack of movement while
staying in the hospital.
Outpatient birth—Childbirth
that occurs outside the hospital, at the mother's home, or
in a birthing center.
Perinatologist—An
obstetric specialist who cares for mothers their and unborn
babies who are at high risk for complications. The perinatologist
provides care before, during, and after delivery.
Perineum—The area
between the vagina and anus.
Pneumococcal vaccination—A
shot to prevent pneumonia.
Pneumonia—A lung
infection caused by bacteria, viruses, or fungus.
Postpartum—The
time after childbirth.
Prenatal—The time
before childbirth.
Primary Cesarean section—A
woman's first Cesarean section birth.
Readmission—A patient
has to go back into the hospital for the same disease or
condition (or for an infection) within 15 days of being discharged
from the hospital. This can indicate a problem with the patient’s
medical treatment. A readmission is not counted in this guide’s
reports if it occurs because a patient leaves the hospital
before the doctor advises, or if the patient transfers to
another hospital.
Repeat Cesarean section—A
Cesarean section birth for a mother’s second or later
pregnancy.
Risk Adjustment—This
guide takes into account the fact that some hospitals take
care of patients who are sicker or at greater risk of developing
complications, than the "average" patient. Therefore,
a “risk adjustment” method is used to make fair
comparisons between hospitals. The actual numbers for length
of stay and readmission are adjusted according to the severity
of illness of each hospital’s patients. Each patient's
other medical conditions, age, and other factors are considered
in this calculation. For more information on risk adjustment,
, select Technical Information on the sidebar and look in
the “Risk Adjustment Methodology” section, or
click here to select Technical
Information.
Risk Factors—Factors
related to age, other medical problems, and lifestyle choices
that increase the likelihood of a person developing an illness.
Tubal ligation—A
surgical procedure performed to prevent pregnancy. The woman’s
fallopian tubes are closed to prevent a fertilized egg from
reaching the uterus. Also referred to as tying tubes.
Umbilical cord—A
structure for passing blood and nutrients between the mother
and unborn baby. The umbilical cord is attached to the placenta,
which is the organ that houses the unborn baby inside the
mother’s uterus.
Umbilical cord blood—The
blood that is in the umbilical cord.
Uterus—An organ
in the female body where a baby grows. Also called the womb.
Vagina—The birth
canal.
VBAC—Vaginal birth
after cesarean section. A regular delivery after a woman
has had a previous cesarean section birth.
Vaginal Birth after Cesarean Section—A
regular delivery after a woman has had a previous cesarean
section birth. Also called VBAC.
Ventricle—Ventricles
are the lower chambers in the heart. The right ventricle
pumps blood into the left side of the heart, and the left
ventricle pumps blood to the body.
Volume—The number
of patients a hospital treats with one medical condition. Measuring
volume is useful because it gives an idea of the experience
a hospital has in treating patients with a particular disease.
Some studies have shown that treating more cases of a certain
type can lead to better outcomes.
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