Once you walk into the entrance of Johns Hopkins Hospital in Baltimore, you will quickly see all the signs suggesting to you that Hopkins is ranked number 1 hospital in the US by U.S. News & World Report. Hopkins is justifiably happy of achieving that best place year after year, but does it mean anything for patient safety and quality of care?
A recent study in Annals of Internal Medicine confirms that for the 50 top-ranked hospitals, there is very little relationship between their U.S. News rank and any objective measurements of quality of health care. But when the authors ran the numbers, they observed the hospital's subjective popularity among doctors made up 90 to 100 percent of the hospital's overall U.S. News ranking. In other words, the word of mouth recognition of the hospital among medical professionals -- not among patients -- counts for a huge amount of the news magazine's popular ratings system.
Choosing the right hospital is not uncomplicated. But there are some basic guidelines. Concentrate on the brand-name hospitals like Hopkins only if you have an exotic problem that a small number of physicians have ever viewed.
In its 20 years of rating hospitals, U.S. News has never asked a single patient what they think; its ratings of a hospital’s recognition in a specific specialty is based exclusively on what medical professionals in that specialty feel. However now Medicare has started requiring hospitals to have patients fill out a standardized survey when they leave the hospital, and the questions concentrate on a lot of problems that people care about and have a big impact on the quality and safety of their care, such as:
• Did the medical professionals and nurses always communicate well?
• Was the bathroom always clean?
• Was your pain always well-controlled?
• Was the area around your room always quiet at night?
Note that little word “always.” These are things patients have a right to expect – always.
You are going to find that numerous community hospitals do a far better job than the mega-hospitals of taking care of patients in the ways that patients notice. Hospitals that put a premium on patient safety are least likely to create an environment in which medical malpractice may arise.