Saturday, March 19, 2011

The Search for the Very Best Hospitals

I am easily satisfied with the very best.

Winston Churchill (1874-1965)

Two Items caught my attention this week,

• A March 16 Press Release, “U.S. News & World Report and Castle Connolly Collaborate to Help Consumers Find the Best Hospitals and the Top Doctors.”

• A March 17 New York Times article“What Makes a Hospital Great? “ By Pauline Chen, MD.

I am not a disinterested reader.

For the last ten years, I have been on the Medical Advisory Board of Castlr Connolly’s “Top Doctors ®” publications. The Castle Connolly Top Doctors selection process begins with online surveys of physicians in both academic and private practice positions across the U.S. They are asked to nominate physicians they consider best in their respective areas of medicine. Once these professional peer nominations are processed, a unique, physician-led research team carefully reviews the credentials of every physician being considered for inclusion as a Castle Connolly Top Doctor. This review includes, among other factors, scrutiny of medical education, training, hospital appointments, administrative posts, professional achievements, and malpractice and disciplinary history. Doctors do not and cannot pay to be included in any Castle Connolly listing or guide.

I have followed U.S. News and World Reports annual publications announced the best hospitals in the U.S. The U.S. News Media Group is a multi-platform digital publisher of news and analysis, which includes U.S. News & World Report, the digital-only U.S. News Weekly . The media group ranks colleges, graduate schools, hospitals, nursing homes, and more.

I am also interested because my upcoming book, with a tentative title of The Health Reform Maze, will soon be published by Greenbranch Publishers.

In the section of hospitals, I say:

“The centerpiece of the American health system are American hospitals and the physicians who use them as workshops. Hospitals account for 31% of health costs. The health reform envisions lowering of costs and improving care through new organizations creating collaboration between hospitals and doctors by having government pay for bundling services between the two. These collaborative organizations, called Accountable Care Organizations (ACOs) have their up and down sides and their supporters and distractors.”

The controversy surrounding ACOs is beyond the scope of this blog. But the search for the best hospitals is not. In her New York Times piece, Dr. Chen cites a study in this week’s Annals of Internal Medicine (“What Distinguishes Top-Performing Hospitals in Acute Myocardial Infarction Mortality Rates”, in which the authors conclude,” High-performing hospitals were characterized by an organizational culture that supported efforts to improve AMI care across the hospital. Evidence-based protocols and processes, although important, may not be sufficient for achieving high hospital performance in care for patients with AMI.”

In other words, it isn’t electronic medical records, superstar physicians, adherence to protocols, high-tech equipment, or data on re-admission rates that make a hospital great, it’s the culture - how people communicate and support each other and the organization – that counts. The organizational culture is what makes hospitals the very best.


kelvin said...

the best hospital were they take care the patients well that should be the best hospital should be treated much ....thank you....

Neurologists said...

really its best hospital for healthcare and also like your health book "Health Reform Maze" its the best.

madhavi said...

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