This news piece, America’s Best Hospitals: The 2009-10 Honor Roll, originally got my attention because I hoped someone might be actually be paying attention to the things that make a real difference in our national debate about health care.
Unfortunately, it looks like more of the same.
This survey looks at things like technical capability – what kinds of specialty procedures these hospitals can perform, and their general reputation and then ranks them accordingly.
But where are we asking about the basics?
Which hospitals kill or injure the fewest of their patients? What is the rate of post-operative or other opportunistic infection? How about medication errors? These are the things that all hospitals should be “getting right” and yet the evidence is overwhelming that most don’t. Further, nobody seems to be paying attention to it except tort lawyers.
Now take a look at this post on Steven Spear’s blog, and especially the Paul O’Neal commentary that he links to.
Tell me what makes a “good” hospital?
These hospital rankings seem pretty useless. I heard some medical leaders complaining about it this week and they had a good point.
When “reputation” is a basis for ranking, that’s a self perpetuating cycle.
Reputation –> Ranking
Ranking –> Reputation
Hospitals with undeserved reputations, those with great names, but high cost and poor quality, won’t be forced to improve.
Imagine if Consumer Reports ranked cars based on reputation. Would Toyota be on the top of that list forever, regardless of performance?
Also, it’s a bit unfair to say “nobody” is looking at it. Just not enough…
There are some hospital leaders who DO get it. The media is very very slow to catch up.
I acknowledge that I sometimes take license to use absolute terms to drive home a point and agree that the mainstream media, in general, seems pretty slow to to engage meaningful critical thought.
I read some the links in the article but I did not see references to primary sources of “hospital problems.” Is it common knowledge that there are significant issues with infections, wrong medications, falls, etc? If not, do you know where the primary sources are?
Try a Google search on the terms [preventable deaths hospitals].
In the USA we are looking at about twice the absolute numbers as deaths in automobile accidents. Then consider:
There are a lot more people – hours spent in cars every day than there are in hospitals.