150 hospital benchmarks

Hospitals across the nation are competing in a number of areas, including quality and price, and many use benchmarking as a way to determine the areas most in need of improvement. The continuous process of benchmarking allows hospital executives to see how their organizations stack up against competitors as well as national leaders.

For the fifth year, Becker's Hospital Review has collected benchmarks related to some of the most important day-to-day areas executives oversee: quality, patient satisfaction, operations, utilization and finance.

Quality and process of care
Source: Hospital Compare, HHS, Complications-National Averages and Timely and Effective Care Measures-National Averages December 2015, the latest available data for these measures.

Hospital-acquired conditions
The following represent the average percentage of patients who experienced the conditions.

Collapsed lung due to medical treatment: 0.39 percent
A wound that splits open on the abdomen or pelvis after surgery: 1.7 percent
Accidental cuts and tears from medical treatment: 1.81 percent
Serious blood clots after surgery: 4.35 percent
Serious complications: 0.81 percent

Heart attack patients
Who were given fibrinolytic medication within 30 minutes of arrival: 60 percent
Who were given primary percutaneous coronary intervention within 90 minutes of arrival: 96 percent

Outpatients with chest pain or possible heart attack
Who received aspirin within 24 hours of arrival or before transferring from the emergency department: 97 percent
Who got drugs to break up blood clots within 30 minutes of arrival: 59 percent

Lower extremity join replacement patients
Who experienced complications: 3.1 percent

Pneumonia patients
Who were given the most appropriate initial antibiotics(s): 96 percent

Surgery patients
Who were given an antibiotic within one hour before surgery to help prevent infection: 99 percent
Whose preventive antibiotics were stopped within 24 hours after surgery: 98 percent
Who were taking beta blockers before coming to the hospital and who were kept on the beta blockers: 98 percent
Who were given the appropriate kind of antibiotic to help prevent infection: 99 percent
Whose urinary catheters were removed on the first or second day after surgery: 98 percent
Who got treatment within 24 hours before or after surgery to help prevent blood clots after certain types of surgery: 100 percent

Stroke patients
Who were evaluated for rehabilitation services: 98 percent
Who received a prescription for medicine known to prevent complications caused by blood clots before discharge: 99 percent
Who were given a prescription for a blood thinner at discharge: 97 percent
Who got treatment to keep blood clots from forming anywhere in the body within two days of arriving at the hospital: 98 percent
Who received written educational materials about stroke care and prevention during the hospital stay: 94 percent

Preventive care patients
Who were assessed and given flu vaccination: 94 percent

Healthcare workers
Who received flu vaccination: 84 percent

Pregnancy and delivery care
Mothers whose deliveries were scheduled 1-2 weeks early, when a scheduled delivery was not medically necessary: 3 percent

Emergency department care
Source: Hospital Compare, HHS, Timely and Effective Care Measures-National Averages December 2015, the latest available data for these measures.

Average time spent in the ED before patients were admitted to the hospital as an inpatient: 279 minutes
Average time patients spent in the ED after the physician decided to admit them as an inpatient but before leaving the ED for their inpatient room: 99 minutes
Average time patients spent in the ED before being sent home: 148 minutes
Average time patients spent in the ED before they were seen by a healthcare professional: 27 minutes
Average time patients who came to the ED with broken bones had to wait before receiving pain medication: 54 minutes
Percentage of patients who came to the ED with stroke symptoms who received brain scan results within 45 minutes of arrival: 66 percent

Patient satisfaction
Source: Hospital Compare, HHS, HCAHPS National Survey Results December 2015, the latest available data for these measures.

Overall hospital rating
Patients who gave the hospital a rating of nine or 10: 71 percent
Patients who gave the hospital a rating of seven or eight: 21 percent
Patients who gave the hospital a rating of six or lower: 8 percent

Patient recommendation
Patients who said, yes, they would definitely recommend the hospital to friends and family: 71 percent
Patients who said, yes, they would probably recommend the hospital to friends and family: 24 percent
Patients who said, no, they probably or definitely would not recommend the hospital to friends and family: 5 percent

Cleanliness
Patients who said their room and bathroom was "always" clean: 74 percent
Patients who said their room and bathroom was "usually" clean: 18 percent
Patients who said their room and bathroom was "sometimes" or "never" clean: 8 percent

Noise
Patients who said the area around their room was "always" quiet at night: 62 percent
Patients who said the area around their room was "usually" quiet at night: 29 percent
Patients who said the area around their room was "sometimes" or "never" quiet at night: 9 percent

Physician communication 
Patients who said their physicians "always" communicated well: 82 percent
Patients who said their physicians "usually" communicated well: 14 percent
Patients who said their physicians "sometimes" or "never" communicated well: 4 percent

Nurse communication
Patients who said their nurses "always" communicated well: 79 percent
Patients who said their nurses "usually" communicated well: 17 percent
Patients who said their nurses "sometimes" or "never" communicated well: 4 percent

Pain control
Patients who said their pain was "always" well controlled: 71 percent
Patients who said their pain was "usually" well controlled: 22 percent
Patients who said their pain was "sometimes" or "never" well controlled: 7 percent

Staff explanations
Patients who said staff "always" explained medicines before administering: 65 percent
Patients who said staff "usually" explained medicines before administering: 17 percent
Patients who said staff "sometimes" or "never" explained medicines before administering: 18 percent

Staff help
Patients who said they "always" received help as soon as they wanted: 68 percent
Patients who said they "usually" received help as soon as they wanted: 23 percent
Patients who said they "sometimes" or "never" received help as soon as they wanted: 9 percent

Recovery information
Patients who said staff provided information about what to do during their recovery at home: 86 percent
Patients who said staff did not provide information about what to do during their recovery at home: 14 percent

Staffing
Source: American Hospital Association "Hospital Statistics" report, 2016 Edition.

Full-time and part-time staff averages are for the hospital unit only and do not include separate nursing home units.

Average full-time staff
Hospitals with 6 to 24 beds: 98
Hospitals with 25 to 49 beds: 169
Hospitals with 50 to 99 beds: 278
Hospitals with 100 to 199 beds: 637
Hospitals with 200 to 299 beds: 1,132
Hospitals with 300 to 399 beds: 1,693
Hospitals with 400 to 499 beds: 2,479
Hospitals with 500 or more beds: 4,911

Average part-time staff
Hospitals with 6 to 24 beds: 49
Hospitals with 25 to 49 beds: 77
Hospitals with 50 to 99 beds: 128
Hospitals with 100 to 199 beds: 263
Hospitals with 200 to 299 beds: 425
Hospitals with 300 to 399 beds: 591
Hospitals with 400 to 499 beds: 809
Hospitals with 500 or more beds: 1,303

Utilization

Inpatient volume
Source: American Hospital Association "Hospital Statistics" report, 2016 Edition.

Inpatient and outpatient averages include both hospital and nursing home units.

Average admissions per year
Hospitals with 6 to 24 beds: 381
Hospitals with 25 to 49 beds: 896
Hospitals with 50 to 99 beds: 2,062
Hospitals with 100 to 199 beds: 5,774
Hospitals with 200 to 299 beds: 10,745
Hospitals with 300 to 399 beds: 15,823
Hospitals with 400 to 499 beds: 20,742
Hospitals with 500 or more beds: 33,744

Average length of stay:
Hospitals with 6 to 24 beds: 4.8 days
Hospitals with 25 to 49 beds: 5.5 days
Hospitals with 50 to 99 beds: 6.9 days
Hospitals with 100 to 199 beds: 5.3 days
Hospitals with 200 to 299 beds: 5.1 days
Hospitals with 300 to 399 beds: 5.1 days
Hospitals with 400 to 499 beds: 5.3 days
Hospitals with 500 or more beds: 5.7 days

Average inpatient surgeries per year
Hospitals with 6 to 24 beds: 85
Hospitals with 25 to 49 beds: 187
Hospitals with 50 to 99 beds: 467
Hospitals with 100 to 199 beds: 1,476
Hospitals with 200 to 299 beds: 2,843
Hospitals with 300 to 399 beds: 4,299
Hospitals with 400 to 499 beds: 5,769
Hospitals with 500 or more beds: 10,276

Outpatient volume
Source: American Hospital Association "Hospital Statistics" report, 2016 Edition.

Average total outpatient visits per year
Hospitals with 6 to 24 beds: 23,279
Hospitals with 25 to 49 beds: 40,985
Hospitals with 50 to 99 beds: 63,555
Hospitals with 100 to 199 beds: 132,026
Hospitals with 200 to 299 beds: 197,320
Hospitals with 300 to 399 beds: 260,931
Hospitals with 400 to 499 beds: 414,613
Hospitals with 500 or more beds: 628,288

Average outpatient surgeries per year
Hospitals with 6 to 24 beds: 638
Hospitals with 25 to 49 beds: 1,007
Hospitals with 50 to 99 beds: 1,647
Hospitals with 100 to 199 beds: 3,420
Hospitals with 200 to 299 beds: 5,296
Hospitals with 300 to 399 beds: 6,785
Hospitals with 400 to 499 beds: 9,302
Hospitals with 500 or more beds: 14,961

Average emergency outpatient visits per year
Hospitals with 6 to 24 beds: 4,083
Hospitals with 25 to 49 beds: 7,485
Hospitals with 50 to 99 beds: 12,485
Hospitals with 100 to 199 beds: 28,325
Hospitals with 200 to 299 beds: 45,675
Hospitals with 300 to 399 beds: 59,505
Hospitals with 400 to 499 beds: 71,619
Hospitals with 500 or more beds: 101,769

Finance

Hospital adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in 2016 and based on 2014 data.

Adjusted expenses per inpatient day include expenses incurred for both inpatient and outpatient care; inpatient days are adjusted higher to reflect an estimate of the volume of outpatient services.

Nonprofit hospitals: $2,346
State/local government hospitals: $1,974
For-profit hospitals: $1,798

Key ratios
Source: Moody's Investors Service, "U.S. Not-for-Profit Hospital 2014 Medians" report, September 2015.

The medians are based on an analysis of audited 2014 statements for 366 freestanding hospitals, single-state health systems and multi-state health systems, representing 86 percent of all Moody's rated healthcare entities. Children's hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.

Maintained bed occupancy: 63.3 percent
Operating margin: 2.6 percent
Excess margin: 5.7 percent
Operating cash flow margin: 9.6 percent
Return on assets: 4.5 percent
Cash-to-direct debt ratio: 151.2 percent
Cash-to-comprehensive debt ratio: 108.3 percent
Debt-to-capitalization ratio: 33.7 percent
Debt-to-total operating revenue: 36.7 percent
Three-year operating revenue CAGR: 5.1 percent
Three-year operating expense CAGR: 5.2 percent
Annual operating revenue growth rate: 5.2 percent
Annual operating expense growth rate: 4.6 percent

Current ratio: 2.0x
Cushion ratio: 19.3x
Annual debt service coverage: 5.0x
Maximum annual debt service coverage: 4.6x
Debt-to-cash flow: 3.1x
Capital spending ratio: 1.1x

Cash on hand: 205.8 days
Accounts receivable: 49.5 days
Average payment period: 64.6 days
Average age of plant: 10.8 years

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