Friday, July 26, 2013

Parsing the rankings: More foolishness

Everybody in the industry knows that the rankings prepared by US News and World Report are so flawed as to be meaningless with regard to the things that patients should actually care about.  But each year, hospital PR flacks are given the assignment of describing the latest rankings in a manner that hospital administrators, doctors, and trustees will find satisfying.  US News aids and abets this by providing lots of kinds of rankings, for the hospitals overall, but also for individual specialties.  Even if you don't make the top ten or top 50 overall, you can brag that one or more of your specialties made the top ten.

I heard one such description this morning on our local public radio station.  For years, Boston Children's Hospital has been in a see-saw battle with Children's Hospital of Philadelphia for the coveted number one national ranking.  CHOP won this year.  You'd never know that from the radio ad, though, which stated that BCH has "the largest number of number one rankings" in the US News edition.

Truly, this is pure silliness.  Both institutions are superb, with thousands of committed clinicians and very satisfied patients and families.  Why they feel the need to parse the US News rumors in such a manner as to draw a distinction is beyond me. 

I'm more impressed with hospitals like Children's Mercy in Kansas City, which are engaged in the kind of transformational change that has brought about significant improvement in quality and safety and promises to do more so.

I'd also rather hear about what CHOP and CHB are doing together to improve the quality of care.  In that category, the Ohio childrens hospitals are truly number one. As I have noted:

Now comes a group of children's hospitals that has established a truly audacious goal -- eliminating all serious harm in Ohio’s children’s hospitals.  The coalition, called Solutions for Patient Safety, is described here.  Their vision is to make Ohio the safest place in the nation for children's care.

I can't begin to tell you how exciting and admirable all this is.  These folks are adopting, in a collaborative learning environment, audacious goals, process improvement techniques from other industries, and transparency of clinical outcomes.  There is nothing they are doing that every hospital in the country cannot adopt -- given sufficient leadership.  There is nothing they are doing that cannot be accomplished by consortia of hospitals in other regions.  They are not being forced to do it by government regulators or insurers.  They are doing it because they want to hold themselves accountable to the standard of care in which they believe.

Now, that's noteworthy!


Stephen E Muething, MD said...

Thanks again for featuring the work that began with the Ohio children's hospitals. The work continues to progress and as of this month we are up to 79 children's hospitals working together across the United States. This group includes our friends at Boston, CHOP, Mercy Children's and so many others. We all share our data transparently with each other so we can learn. We are all committed to the "All Teach, All Learn" principle. Every week I hear from children's hospitals excited by the fact that we have agreed not to compete on safety. They can feel improvement accelerating as we truly learn together. Most importantly we are beginning to see reductions in rates of some the hospital-acquired conditions across the network. Keeping those kids safe is why we went into healthcare in the first place.
Keep up the good work.
Steve Muething
Ohio Children's Hospital Solutions for Patient Safety (OCHSPS)

Joleen Chambers said...

The attitude and posture of hospitals that collaborate and excel honestly is so different from those that compete and obscure information. Patients and advocates will do well to support the efforts of hospitals to improve. The others can expect the "stick" of regulatory intervention. We cannot afford the patient harm in their wake!