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How To Choose A Hospital

Step 6. What is The Hospital's Quality/Safety Record?

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As Consumer Reports stated: "Bad things happen in all hospitals, but they happen a lot in some."  

This section first lists various rating organizations. It then provides information about particular areas which are included in the ratings.

To help compare hospital performance, there are report cards/ratings issued by various organizations, Before you look at the ratings, be aware when reviewing information that unique conditions can skew the results. For example, a really great hospital may have a high mortality rate because it gets the most difficult cases.

Some of the more popular report cards/ratings are the following:

  • Medicare: www.medicare.gov/hospitalcompare/search.html offsite link compares hospitals with respect to treatment of heart attacks, heart failure, pneumonia and surgical infections. Results are based on information voluntarily submitted by hospitals.
  • Hospital Safety Score (www.HospitalSafetyScore.org offsite link) assigns letter based grades based on 26 safety measures and standards. The site was created by the employer based, nonprofit, Leapfrog Group which has a goal of reducing preventable medical mistakes..
  • Joint Commission on Accreditation of Health Care Organizations issues reports on quality at: www.qualitycheck.org offsite link
  • U.S. News. Hospital rankings are specifically designed for people with critical health concerns. According to U.S. News, their mission is to identify the hospitals with the greatest expertise and experience in treating medical conditions that greatly compromise quality of life, or life itself.http://health.usnews.com/best-hospitals offsite link
  • www.healthgrades.com offsite link, is a report service that offers minimal basic information for free. Click on "hospitals."
  • Consumers' Checkbook, provides ratings of 4,500 acute care hospitals for a fee. The guide provides a comparison of death and "adverse outcome" rates for major types of cases; doctors' ratings of hospitals in areas such as high-risk adult surgery; patients' ratings and ratings of hospitals on key patient safety measures. See: www.checkbook.org offsite link
  • Hospital Safety Score assigns easy to understand grades to more than 2,600 hospitals based on a variety of safety measures and standards. To check a hospital, go to www.HospitalSafetyScore.org offsite link

You can also check with your state's health department to determine whether there are complaints against a particular hospital. To locate the health department in the state of interest, go to http://www.cdc.gov/mmwr/international/relres.html offsite link. In the pull down box, find the state. Then click "go."

Accreditation

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is the nationwide authority that surveys hospitals. JCAHO determines whether a hospital keeps or loses accreditation based on its meeting certain health and safety requirements.

Although accreditation is voluntary, most hospitals go through the process.

Surprisingly, 1 out of 4 hospitals fail to win accreditation.

To locate hospitals that meet the patient safety and quality standards set by the organization, go to: www.qualitycheck.org offsite link. To learn more about JCAHO, see: www.jcaho.org offsite link

The National Cancer Institute designates certain facilities as comprehensive cancer centers offsite link.

Experience

The old adage "practice makes perfect" certainly seems to be true when it comes to medical care. Repeated studies confirm that in the case of specialized medical care and surgical care for a complex problem, the more experience a hospital has with the necessary procedures, the better the results will be.

Infection Control

The rate of infections acquired in a hospital are ttechnically called the hospital's rate of "nosocomial infections".

About one in twenty patients gets sick from their stay in the hospital. Hospital-acquired illnesses are a major concern, especially since one-third to one-half of acquired infections are preventable and some infections acquired in hospitals are becoming resistant to treatment.

To obtaininformation about infection control, ask the hospital, your doctor, and/or contact your local department of health. Every accredited hospital has an infection control committee which generally includes doctors and nurses, and often a hospital administrator. Their reports are usually available upon request.

Nursing Staff

The number of nurses on staff in relation to the number of patients can directly impact patient care, for example with regard to medication error, and post-surgical complications such as pneumonia, blood clots, and infection.

Specialty Departments

Medical conditions do not always exist in isolation. Related and/or unrelated complications may occur in the hospital. Managing these problems requires a multidisciplinary team approach with doctors from several specialties.

Quality of care is generally higher in hospitals that use a multidisciplinary team approach to treating serious illness.

Range of Diagnostic and Treatment Options

There may be more than one way to treat your medical condition. The hospital should be equipped for the treatment option agreed to by you and your doctor.

If your condition is the least bit out of the ordinary, or lacking viable treatment options, check to see whether the hospital conducts research into the cause and treatment of your illness through clinical trials offsite link. Clinical trials provide access to the most up-to-date treatments which are not yet approved for general use.

Referral Network

If a hospital does not have the staff and/or services necessary to treat a complication or problem that occurs while you are in the hospital, it will have to transfer you to another facility. Find out what arrangements a hospital has with other hospitals.

Is your primary care doctor affiliated with the hospital?

Doctors cannot work in a particular hospital unless they are affiliated with that hospital.

Your primary care doctor is important to your care in a hospital because he or she knows you and your history. Specialists tend to focus on their particular area instead of the whole patient.

If your doctor is not affiliated with a hospital, ask the specialist who will be in charge of your care to keep your primary care physician updated on a daily basis. If he or she is not willing to do so, ask a friend or family member to do it for you.

Word of mouth/Social Media

Word of mouth and social media can give you an idea about what actually goes on in a hospital on a day-to-day basis. Of course this type of information is anecdotal (what happen to one or a few people) and is not necessarily representative of reality.

In addition to social media such as Facebook and Twitter, try to speak with people in health care. Also ask people in your support group or others with your condition about their experiences with the different hospitals in your area.

  • Were they treated as numbers or individuals?
  • Were they treated as partners in their care?
  • Were all tests and procedures discussed ahead of time or did doctors just show up for them?
  • How about the cleanliness of the place? The noise level?
  • Which emergency room worked best for them?

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