Hospital Quality


The hospital (or surgery center) you choose matters. This is especially true if you need high risk surgery or medical treatment after a life-changing diagnosis.  Research on patient outcomes continues to show that hospitals that do a higher volume (greater number) of high risk surgeries or treat serious medical conditions tend to have better patient outcomes.

This is not only about the skill of the surgeon, although that is critically important.  It's also about their intensive care unit (ICU), whether they have specially-trained doctors called 'intensivists' on staff, and whether their ICU is staffed by highly trained ICU nurses.  ICUs are often the first place a patient is transferred to if they have complications after surgery or medical treatment. (note: The Leapfrog Group below rates hospital on their ICU staffing for this very reason)

When you think about it, we often go to directly to a pediatric specialty hospital if one of our children has a serious diagnosis. We do that because we know the staff is highly skilled at treating children.  Much the same, some hospitals are more highly skilled at treating adult conditions too.

If you use a few different websites (not just one) below, you’ll begin to get an idea of trends for where the high-quality performers are. It's also important to discuss your options with your doctor and insurance provider.

These are three reputable resources that explain the importance of doing your homework and choosing a hospital or outpatient surgery center wisely:

(1) Choosing The Right HospitalThe Leapfrog Group

(2) Booklet on Choosing a HospitalThe Centers for Medicare & Medicaid. 

(3) Choosing The Right Surgery Center, The Leapfrog Group

Read More

Resources

The sites below provide a variety of information on hospital quality.  No one site is perfect. The important thing is to do your research, compare information from different sites, and compare your hospital with others in NH and those in other states. After a while, you’ll begin to get a picture of common trends and where they stand in comparison to other hospitals in their quality and safety ratings. 

CMS Open Payment System
The Centers for Medicare & Medicaid posts payments made to teaching hospitals (and physicians) from Pharmaceutical companies. This may present conflicts of interest that patients may want to consider and/or discuss with their hospital administration or medical providers.  They have an easy-to-use search tool by hospital and physician name or location.

Hospital Compare 
This is The Center for Medicare and Medicaid’s (CMS) website with information about the quality of care at over 4,000 Medicare-certified hospitals, including over 130 Veterans Administration (VA) medical centers, across the country. Medicare tracks hospital quality data on complications like bedsores, falls, surgical errors, infections, sepsis, blood clots, mortality, and others. You can enter a zip code and compare up to three hospitals side-by-side.

The Leapfrog Group 
Leapfrog is considered by many as 'the gold standard' for measuring patient safety in American hospitals. They issue an in-depth voluntary hospital survey for hospitals to complete each year.  However, not all hospitals choose to participate. They also issue hospital safety grades, which are not voluntary so you can look up most all acute care hospitals. Their safety grades are based on a variety of hospital patient safety measures like complications after surgery, infections, medical accidents and others. This link explains the difference between their Safety Surveys & Safety Grades and how they measure hospital quality.

Leapfrog Hospital & Surgery Center Safety Grades
All hospitals receive grades with the exception of small rural hosptials (also known as 'critical access' hospitals), children's and specialty hospitals like cancer centers)

Leapfrog Hospital & Surgery Center Survey Results 
Note: If you look up a hospital's survey results and it says 'declined to respond', that means the hospital's patient safety department declined to fill out the Leapfrog Safety Survey.  

The Northern New England Cardiovascular Disease Study Group , A heart surgery registry of all patients who have had surgery in the five facilities listed below. You can compare surgical volume (# of surgeries each facility does), complication and mortality rates. They also have decision aids and other resources on the top menu bar.  Discussing this data with your Cardiologist or Surgeon can help you make an informed decision. 

Dartmouth Hitchcock Medical Center (Lebanon, NH) 
University of Vermont Medical Center (Burlington, VT) 
Maine Medical Center (Portland, ME) 
Catholic Medical Center (Mancheseter, NH) 
Concord Hospital (Concord, NH)

National Thoracic (Heart & Lung) Surgery Registry
A public registry compiled by The Society of Thoracic Surgeons. They use a 3-star rating system to rate hospitals across the country on surgical outcomes. It includes surgical complications & mortality (death) for specific types of cardiac, lung, and esophageal (on the esophagus) surgery. 

Why Not The Best
The site is designed for healthcare professionals, but some information may be helpful to patients.  A regional map shows states’ performance on things like mortality rates for specific medical conditions.

US News & World Report Magazine Hospital Rankings
A magazine that has published hospital rankings for many years.  Unlike similar publications, their rankings are not based on patient or physician reviews, but on quality measure data.  This link  explains how they arrive at rankings and what measures are used.

 

Tips

patient tip icon Go to our Diagnosis Page for more information on options to consider for second opinions.

patient tip icon  Read about why employers like WalMart are encouraging their employees to travel to hospital Centers of Excellence for high risk surgery or second opinions.

patient tip icon Keep a notebook with your sources of information and write your questions and concerns down. Or bring your laptop right to your appointment with your saved resources.  That way you can set up a time to discuss your findings with your healthcare provider and have a good discussion.

patient tip icon Don’t forget to check with your insurance company about which hospitals, doctors or surgeons your specific plan covers, as well as limitations to your coverage.  For more information about healthcare costs and insurance coverage, go to our page on Healthcare Costs.

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