When it Comes to Patient Safety, Does a Number 1 Ranking Really Correlate to Superior Care?

When you enter the lobby of Johns Hopkins Hospital in Baltimore, you can't miss all the signs informing you that Hopkins is ranked No. 1 hospital in the United states by U.S. News & World Report. Hopkins is justifiably very pleased of attaining that top rated spot year after year, but does it mean anything at all for patient safety and quality of care?

A new report in Annals of Internal Medicine discovers that for the 50 top-ranked hospitals, there is little correlation between their U.S. News rank and any objective measurements of quality of treatment. But when the authors analyzed the figures, they discovered the hospital's subjective reputation among doctors made up 90 to 100 percent of the hospital's overall U.S. News ranking. In other words, the word of mouth popularity of the hospital among doctors -- not among patients -- counts for a huge amount of the news magazine's popular ratings system.

Choosing the right hospital is not uncomplicated. But there are some simple guidelines. Concentrate on the brand-name hospitals like Hopkins only if you have an exotic ailment that not many medical doctors have ever observed.

In its 20 years of rating hospitals, U.S. News has never questioned a single patient what they think; its ratings of a hospital's reputation in a particular specialty is based only on what doctors in that specialty believe. Yet now Medicare has started requiring hospitals to have patients fill out a standardized survey when they leave the hospital, and the questions focus on a lot of problems that people care about and have a massive influence on the quality and safety of their care, such as:

• Did the doctors and nurses always communicate well?

• Was the bathroom always clean?

• Was your pain always well-controlled?

• Was the area around your room always quiet at night?

Note that little word "always." These are things patients have a right to expect - always.

You might discover that quite a few community hospitals do a superior job than the mega-hospitals of taking care of patients in the ways that patients recognize.