Should U.S. News Consider Hospital Openness?
Reader Comments
It is very apropos to quote Supreme Court Justice Louis D. Brandeis who once said 'sunshine is the best disinfectant.' I suggest that a more appropriate alternative to offering special recognition to hospitals that are willing to provide patient safety information would be requiring it as a bare minimum if they are to be included in any ranking of America's Best.
A good idea? Absolutely. Workable? Unfortunately, probably not without a lot of arm twisting.
I'm firmly in Paul's camp in that hospital's should be publicly posting as much of their own quality outcomes and improvement efforts as practical. There are always fallback reasons for not doing so: too risky, not enough time/staff/money, the measures aren't valid, the public doesn't REALLY care or wouldn't understand even if they did, no ROI, etc. Continuous quality improvement as a true driving priority has been more lip service than reality in too many hospitals - it sounds good in marketing materials, but unless there's revenue to be found as a result, it's usually on the back burner vs. other competing board issues.
With CMS' move to MS-DRGs, where physician documentation and coding have a much greater importance in determining patient severity (and thus payments), some hospitals are just now starting to see the light, and bringing physicians, coders, and quality team members to the table together on a regular basis to make sure charting and administrative data matches clinical encounters as closely as possible. The immediate benefits are twofold: better data, and more open communication among doctors, coders and QI staff. Both serve to make the pathway to self-publicizing outcomes less painful.
But in the end, it will take more hospital leaders like Paul willing to buck tradition and put themselves out there, warts and all.
Quality of care
Hospital data is basically useless - hospitals are brick and mortar entities not living, breathing healthcare professionals in whom I put my trust when I enter.
When I chose a surgeon, I want to know his/her infection rates, how many of his/her patients had to be readmitted within 30 days or so because of a post surgical complication, I want to know how many of the procedures he/she has done, since I believe that volume begets experience, and finally I want to know to know that everything the physician will prescribe for me during my stay is appropriate to my needs and not a result of his/her hasty habits. With each intervention the physician orders - whether I need it or not - my risk increases. I want what I need and what I can ONLY get as a hospitalized patient - everything else I want as an outpatient. As Norman Cousins said years ago, "hospitals are safe places to be if you are seriously ill." His statement is more relevant today than it was when he wrote it in 1979.
Right now, the only way I can get some of this information is by following the advice of my mother....if you want to find a good doctor, first find a good nurse.
hospital accountability
I like the idea alot. If I am to be an educated and wise consumer, how am I to know these and other important parameters of a hospital's performance if the information is not "out there."
Hospital Openness
I totally agree, we have the right to know how safe a hospital is and what procedures they may be poor at.
U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since they first appeared in 1990. His reporting on clinical medicine, from the latest cholesterol guidelines to robotic surgery, has been driven by the question: What does this mean to patients? And that is the perspective he brings to his observations and commentaries on the increasing number of programs by hospitals and other healthcare providers to improve care and patient safety.
