How do you know if the hospital you’re about to enter is among the best in your area?
It’s a straight forward enough question that unfortunately, has no simple answer. The reality is that determining hospital quality is more of an Easter-egg-style hunt for puzzle pieces than it is an absolute destination.
If you or someone you love is scheduled for inpatient treatment, here are some resources available to help you determine the best facility for care, and some things to keep in mind when evaluating the data.
1. Media rankings: U.S. News and World Report and Thompson Reuters both produce an updated list each year of the 100 top hospitals around the country. Each uses different criteria and therefore, come up with a different set of hospitals. You can read about how the lists are compiled here.
In addition to incorporating a host of standard quality measures, these top 100 lists often read like a who’s who of hospitals. Reputation counts for something. Just keep in mind that while a hospital may be listed at the top, it doesn’t necessarily mean it’s the best for the particular treatment you need. Also, there are examples of hospitals that made the list while under investigation for health or safety violations, so it’s important to check other sources.
2. Numbers matter: In the absence of specific quality information, one of the most important things to learn is how many patients both your doctor and hospital see each year with your same condition.
“If you don’t have a lot of other information, especially for surgery, going with volume as a proxy for quality is a pretty reasonable thing to do,” says Ashish Jha, M.D., M.P.H., associate professor of Health Policy at Harvard School of Public Health. “If you have five choices, picking [a hospital] on volume is about as good as you can do unless you have good information about their risk-adjustment outcomes.”
3. The Leapfrog Group, a coalition of large employers interested in purchasing care focused on quality, lists hospital quality information for about 1,800 hospitals throughout the country. In addition to information on specific clinical areas, you can find how many procedures a hospital conducts. Even if your hospital is not accredited by the Leapfrog Group, it’s worth learning what minimum standard it sets for volume and use that to determine if your doctor and hospital are sufficiently experienced in the treatment you need.
4. State health departments: Your state’s health department is responsible for licensing the hospitals in your area and investigating health and safety complaints. Some state health departments are posting the results of their hospital inspections online. Others still don’t.
The type of information you’ll find varies by state, and can include anything from inspection reports, reports of quality, patient satisfaction, infection rates and medical errors.
5. Hospital Compare: You can check the federal government’s website, Hospital Compare, for a hospital’s quality record based on Medicare data collected for five areas: heart attacks, heart failure, childhood asthma, pneumonia and surgical infections.
You can compare up to three hospitals at a time side-by-side to see how each measures against average rates for other facilities within your state and across the country. Patient satisfaction scores are also available, an important measure when it comes to finding a good hospital.
“We have found that hospitals with better patient experience tend to have better quality,” Jha says.
6. The Joint Commission: The Joint Commission accredits a wide range of hospital-based programs and conducts an inspection to re-evaluate a hospital’s performance every three years. All facilities and programs it accredits can be found in its database at www.qualitycheck.org, where you can view the accreditation history of a facility, and how it has performed as compared with other similar hospitals throughout the state and country.
But bear this in mind: 98% of hospitals get a gold star, the Commission’s highest ranking. “If your hospital didn’t get the gold star it’s a red flag, but if it did, don’t stop there,” Jha advises.
Check out the other sites listed above, as well as Consumer Health Ratings, which offers a comprehensive listing of organizations that rate or report on performance, for more information.
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Ashish Jha, M.D., M.P.H., associate professor of Health Policy at Harvard School of Public Health
The Leapfrog Group
The Joint Commission
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