DnvrFox

See the review of your hospital - keep it in mind for next bicycle accident or surgery, etc.

https://www.Hospitalsafetyscore.org

Bikey Mikey

Fortunately, for me, the 3 hospitals I've used in my area all rate really, really well on that site.

chasm54

Don't take it too seriously. Note, first, that it excludes critical access hospitals, surgical centres, cancer hospitals. Then look at the methodology they have used to come up with their score. There appear to be only 26 measures, which is a remarkably small number on which to assess something as complex as a major multi-specialty hospital. Only eleven of them are outcome measures - all important, no doubt, but some relating to relatively rare occurences (such as leaving an instrument in a patient post-op) in which very small numbers will make for wide variations in rankings. And I'd take a lot of convincing that some of the non-outcome measures - how much formal team-building training goes on, for example - can be shown to have a strong correlation with good patient outcomes.

Bikey Mikey

Very true.

stapfam

Don't use Hospitals much---They are full of sick people.

To an extent we are tied to THE local hospital over here and like everything around- there are good and bad ones. Very few are bad but they do exist but they are trying to get hospitals to "Specialise" in certain aspects of medicine. So get pregnant Locally and the baby is on its way so you don't go the local hospital 6 miles from here--You go 30 miles to the one that specialises in it. Several Cabbies are now God Parents of the babies born in their Taxi's.

chasm54

Not exactly. What is happening is that services are being concentrated in fewer, bigger centres. They aren't specialist hospitals, in the main. In fact, in the example you mention, the idea is to close small isolated "specialist" maternity units because they are unsupported by the panoply of anaesthesia, intensive care etc. that one needs in a hurry if things go wrong.

In general, when the **** hits the fan, you are much better off spending an hour going to a full-on, comprehensive, multi-specialty centre than having immediate access to an inferior facility that wiill probably need to transfer you anyway and may give you less than optimal treatment until it does. Very few people die in ambulances on their way to hospital. Plenty used to die - some still do - because the hospital they are admitted to isn't able to provide what they need. People who fight to save their small local hospital are, in general, fighting to preserve an inferior and sometimes dangerous service.

DnvrFox

More info:

www.aarp.org/health/healthy-living/info-04-2013/safe-health-care.html

https://www.aarp.org/health/healthy-living/info-04-2013/safest-hospitals.html

chasm54

Except it isn't info, really. It presents very superficial analyses as if they were facts, and encourages people to draw conclusions from them - conclusions that may or may not be justified, given that these are very simplistic distillations of a few datasets that give a very incomplete picture of what is going on and may actually be misleading.

DnvrFox

Likely so, but do a Google on the topic and you can see MANY hospitals now claiming to be in the top 50, or attaining an A status. I would ponder that CMS (USA's Medicare and Medicaid funder and overseer) will be most interested in these results, and, politically, these results will require changes in those hospitals receiving less than an A.

With AARP behind them, these ratings WILL have a BIG impact on hospitals, superficial or not.

Who wants to go to a "C" hospital, no matter how fair or unfair or superficial the rating? Which hospital wants to be rated by a national, very influential, organization - AARP - as a B - F?

JohnDThompson 

Same here! Including the two where I work...

Dudelsack 

I took a look at my area hospitals. The ratings were inversely proportional to the severity of the patient population. The hospital that does all the transplants and other high risk stuff rated low. The hospitals that take care of acute care simple stuff rated high.

Thats not really surprising, is it?

The hospitals that rated lowish provide full service stuff like STEMI and stroke intervention. The ones that rate high, for the most part, didn't.

It's a stupid rating system that will do more harm than good in the long run.

Rowan

Oh dear, we're not suggesting that another statistical analysis in the medical world could possibly be misleading and stupid, are we?

rydabent

A small percentage of people myself included fortunately have nothing to do with hospitals. I will be 75 this year, and have never been in a hospital or had any kind of operation. I have everything I was born with plus 32 teeth. Doctors love to take out things like gall bladders etc, but I managed to stay away from them. Hospitals, even good hospitals have alway been known to give many people all sorts of dieases.

chasm54

Me, quite possibly. Because I know the ratings to be uninformative and have the expertise to know the right questions to ask in order to form judgements about where I might get the best treatment for whatver ails me.

None, obviously. But teaching hospitals and medical schools are pretty influential beasts. I would predict that if they appear to be disadvantaged by these ratings, they will either simply rubbish them - producing streams of data that demonstrate their inadequacy - or start to produce alternative indices of their own.

Assessing the safety and efficacy of hospitals is fantastically difficult, I've spent quite a lot of my life trying to do it, in one capacity or another. It's quite common for specialist units to show up very poorly in this sort of naive exercise, because they get the sickest patients - they are the place to which other doctors refer the patients that are too sick or too complicated. Yet those specialist units are exactly where you'd want to go if you suffered from the relevant conditions.

Rowan

And in an emergency when you aren't able to pick and choose which hospital you want to go to, you have to put your faith in whatever medical facilities, and more importantly, the expertise of the staff to operate those facilities, that are available.

Otherwise, you are probably going to die anyway.

con

I wish I could say my family or myself has never been in a hospital, but I can't. As a matter of fact, withouy hospitals my wife would have died years ago as a result of child birth, or if not then , from her MS she has struggled with for 25 years. Me, I might not be dead, I would just be crippled without knee, shoulder and back surgery. That does not take into account what the heck would have happened to me if my thyroid was allowed to continue into Thyroid Storm!

Yup, we have seen our share of the inside of hospitals and due to that I appreciate the work any group does to help make the experience safer. I don't know how accurate the second rating system is, the AARP one, but I can tell you the only hospital near us, Stanford Hospital was rated at the top and they saved my wife's life when her liver failed due to her MS where as the local hospital (not on the list as a top hospital)in our town did nothing and could not find the problem. The entire experience at Stanford was impressive!

I guess based on my little experience I'm buying into the AARP ratings.

Nice post Denver

DnvrFox

Stanford is an amazing place - my son went to law school there, and we visited often. We love the campus.

As to the ratings - I come into contact with the Centers for Medicare and Medicaid Services a lot in the disability world. It is a powerful agency.

Here is a link to what Medicare is doing about patient safety. I don't know the relationship between the AARP study and what Medicare is doing about patient safety, but this article shows that there is $$$$ in patient safety. This looks remarkably like the AARP info, and it seems they are relating $$ to the type of criteria and results quoted originally in the AARP info above. The hospital associations are objecting to the measurements.

https://www.kaiserhealthnews.org/Stor...Hospitals.aspx

"Medicare has begun publishing patient safety ratings for thousands of hospitals as the first step toward paying less to institutions with high rates of surgical complications, infections, mishaps and potentially avoidable deaths.

The new data, available starting last week on Medicare's Hospital Compare website, evaluate hospitals on how often their patients suffer complicationssuch as a collapsed lung, a blood clot after surgery or an accidental cut or tear during treatment. The measures also include specific death rates for patients who had breathing problems after surgery, had an operation to repair a weakness in the abdominal aorta or had a treatable complication after an operation.

In addition, Hospital Compare is evaluating rates of some specific medical errors, such as giving patients the wrong type of blood, leaving surgical implements in patients' bodies during surgery and falls that occur during their stay.

DnvrFox

Well, congratulations to you.

I wish I could say the same. At one time I could legitimately state that we had been to every emergency room in the Denver area. And northern Chicago. And much of San Diego. When you have children with life-threaening and near death experiences and conditions you tend to go to hospitals and ER's despite their drawbacks (of which there are many). And, I have had several encounters myself, also my wife.

But, you seem to have inherited super-natural genes, so again, my congrats to you - perhaps, better stated, to your parents.

Dudelsack 

If I needed a kidney or liver transplant, I'd go to our D hospital.

cranky old dude

If it weren't for our area hospitals I would be a widower and the parent of at least one less daughter. Thanks to those 'Surgery seeking doctors' that you feel so obligated to insult, both my wife and daughter received the "Life Saving Surgeries" needed to survive geneticly related life episodes.

As a Hospital Courier I travel the halls and offices of every Health Care facility in the county handling railings, door handles, and packages all day long. Short of becoming infected during an invasive procedure good hygene and a strong awareness of the importance of good hygene is considered effective protection from the germs etc. of the sick folks in these facilities.

Congrats. on your run of good luck healthwise, let's hope for your sake that it continues.

chasm54

It's not exactly rocket science to work out that the Stanford University Medical Centre, one of the best-resourced and most eminent hospitals in the world, is likely to be superior to your local hospital when dealing with complex medical problems. That has absolutely no bearing on whether these ratings are meaningful. If you use them to inform your decisions in where to seek treatment, you're going to make a lot of poor judgements.

Patient safety is of course a very important issue. There are lots of things that can be done to improve it, and to minimise the many risks that are intrinsic to running a facility in which one is cutting people open, injecting them with highly toxic substances, placing them in close proximity to hazardous materials and dangerous pathogens, and so on and so forth. Very few of those things are claimed to be assessed as part of this system. Some are: for example, they claim to assess the hospitals risk management systems, though it is not clear how they do that and in my experience, such assessments can themselves vary widely in their thoroughness and accuracy.

But most of what is important with regard to quality of care is not included. They are doing virtually nothing to assess your probability of a good outcome in one facility rather than another. That is not surprising, it is extremely difficult to do and demands a very detailed analysis of the severity of the patient caseload. They have, therefore, merely chosen to measure what they can measure, whether or not it is very important. If you read the article explaining what they are doing, it concedes that the data they are using is limited.

This stuff is very dangerous and, in my view, against the public interest. If funding institutions start to buy into it, and hospitals are forced to respond, what they will do is divert resources into doing the things that will get them a higher rating, even though that might not be - probably will not be - what they should be investing in to make a real impact on the quality of patient care. They will need to tick the boxes, even when they know that they are the wrong boxes. Don't buy into this nonsense.

JanMM

My employer - and caregiver of choice if I am run over by a concrete truck - rated 'A'. That's good to see but not surprising. Part of what I do involves tracking surgical and other data that is sent to CMS. We use the data to see what/how we can improve the care that we deliver and CMS uses the data to verify that we are providing good care. Good care is cost-effective care.

qcpmsame 

Nice thread Denver, as many surgeries as I have had, several were spur of the moment things, knowing the two hospital I use are rated very good. I already had formed that opinion myself from experience, but it is nice to know that they are being watched. One of our hospitals was a Malcom Baldridge Award (not sure if it is still awarded, Commerce Department budget cuts got it I seem to remember) winner a few years back, not a medical thing, but as a member of American Society for Quality and a Quality Engineer, I appreciate what that entails to have been awarded the honor. Personal experience means a lot to many of us, and we aren't all so perfect as to never need medical care, some of us are flawed and will admit it. Trust me, none of the 16 surgeries was elective or done for the joy of being laid open repeatedly.

Bill

Dudelsack 

Very well said. Extremely well said.

One thing that's easily confused: although closely related, quality care and safe care are not synonymous. As I think about the OP, what is being published is safety ratings, which are pretty straightforward, rather than quality assessment, which is much more difficult to quantify.

MikeWMass

In my area they gave A's to one place that I wouldn't send YOUR dog, and a couple of places that (appropriately) transfer their complicated patients as quickly as they can. They gave a C to one of the two major hospitals in the area and an A to another, and many of the physicians and surgeons there are on staff of both of those. I agree that safety and quality are difficult to quantify. However, as we move forward, putting systems in place so that your safety is not solely dependent on which doctor has admitted you requires redesigning how care takes place. Team building exercises are not irrelevant, because they indicate the culture at the institution (assuming that they are really taken to heart and not just done in a pro forma manner). Having said that, I agree that these ratings do not provide a reliable guide to where to go, but they may give some indication of which institutions are keeping up with current thinking in medical safety and, to a lesser extent, quality of care.