tag:blogger.com,1999:blog-32053362.post8194705620153170301..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: US Rumor and Hospital ReportPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-32053362.post-50692747497245488342011-09-19T04:44:12.376-04:002011-09-19T04:44:12.376-04:00Hi... I suggest to rate hospitals by end users rev...Hi... I suggest to rate hospitals by end users reviews.. We are working in this way with our social media: www.blabladoctor.com. Is the first social media where hospitals are full integrated in.. So is possible to post a comment, or rate through widget.. i invite you take a look... and sure we wait your comments.Jacqueshttp://www.blabladoctor.comnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-69168087243300035202011-08-07T16:24:14.799-04:002011-08-07T16:24:14.799-04:00At least you have something to talk about, even if...At least you have something to talk about, even if it bitterly criticized. In Greece, there is no rating whatsoever of hospitals so neither doctors have data to decide whether it's better to work in one hospital or another and far less patients, who go in a hospital not knowing anything about its performance. Would like to have some kind of performance evaluation and rankings, even if not very accurate, that would serve as a first triage of HCPs.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-47206517198803223942011-08-05T18:35:55.136-04:002011-08-05T18:35:55.136-04:00Years ago they did a study asking lawyers to rank ...Years ago they did a study asking lawyers to rank Law Schools and included Princeton Law School on the list. Princeton Law had a GREAT reputation in the study - ranked high. But Princeton doesn't have a law school. http://en.wikipedia.org/wiki/Princeton_Law_School<br /><br />They call this the halo effect where something takes on the positive attributes of things it is associated with, whether or not it actually is good itself(or even exists at all)<br /><br />These kinds of surveys are bogus.clsmtnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-78043021384130153692011-08-05T07:56:40.462-04:002011-08-05T07:56:40.462-04:00From Twitter:
Nicely done. I rank hospitals by # ...From Twitter:<br /><br />Nicely done. I rank hospitals by # of twitter followers.@ewideranoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-820880734079369292011-08-05T07:26:20.456-04:002011-08-05T07:26:20.456-04:00Shows how insidious the whole thing it, right?Shows how insidious the whole thing it, right?Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-58189242445444748942011-08-04T22:11:29.824-04:002011-08-04T22:11:29.824-04:00Actually you last commented in April of 2010 not f...Actually you last commented in April of 2010 not four years ago. At that time you wrote "Given the importance attributed to the U.S. News ranking, this article is bound to raise concerns. I know that the folks at the magazine have worked hard over the years to make their rankings as objective as possible, and it will be interesting to see their response to Dr. Sehgal's critique."<br /><br />I am concerned about your comment "little to be gained" as it suggests that one should speak their mind or be transparent only when there is personal or professional benefit to be gained. Your comment that they "work hard" could seem self serving especially when your hospital was included relatively high in their listing at the timeAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-79941601422957107942011-08-04T22:02:23.479-04:002011-08-04T22:02:23.479-04:00From The Health Care Blog:
Eric Tremont says:
Ex...From The Health Care Blog:<br /><br />Eric Tremont says:<br /><br />Excellent post. Anybody who closely examines the U.S. News methodology will realize that much of their survey rankings are based on dubious (“junk” might be a better word) science. Furthermore, I recall seeing at least a couple of peer reviewed published studies which found no statistical association between the U.S. News hospital rankings and rankings based on objective measures of health outcomes. I just wish the hospital industry would not cooperate with the U.S. News racket—it does not help when those hospitals that have received high rankings shamelessly plaster billboards all over their towns celebrating their ranking.<br /><br /><br />tim says:<br /><br />Nobody in the hospital executive suites thinks those rankings mean anything. They play along because they have to. They spend huge dollars to splash their USNWR ranking in advertising not because they think it is meaningful, but because the public does, and a real comparative advantage — what you might honestly use to distinguish your product — is nearly impossible for hospitals to articulate. (Like banks.)<br /><br />Every newspaper in the country has learned they can sell advertising to hot dog stands the week they rank the hot dog stands. We have a regional business newsletter that collects “data” on medical offices in our specialty and then ranks the group practices based on their one page survey. They also happen to offer discounts on advertising in that edition for medical group practices.<br /><br />All of the writers for these articles know very well they are intentionally blurring the line between journalism and sales.Eric and timnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-77475821643965934372011-08-04T14:48:56.112-04:002011-08-04T14:48:56.112-04:00In follow up to nonlocalMD's comments:
Overhea...In follow up to nonlocalMD's comments:<br />Overheard at an academic medical center after the recent USN&WR rankings were released:<br /><br />Strategic Planning Manager: "You guys did better this year, but we need to find a way to improve your reputation score."<br /><br />Rank and File MD: "None of our patient safety scores are at the top level. Perhaps our attention should be on that instead of reputation?"<br /><br />SPM: "I would agree with you. However, the issue is that patient safety accounts for 5% of the score while reputation accounts for 32.5%."<br /><br />R&FMD: "So, maybe we should consider this an invalid measure and stop paying atention to it -since they consider reputation six times more important than patient safety?"<br /><br />Crickets: chirpingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-39363197172887643692011-08-04T14:11:40.266-04:002011-08-04T14:11:40.266-04:00Paul - Thanks for taking the time to research and ...Paul - Thanks for taking the time to research and expose the reality of reporting at the level of US News... Truth is that at any level it is difficult to pull the trigger on another institution and not expect the reverse full disclosure. Even with the level of transparency which you tried to create and did create while CEO at BI I'm sure there were and still are troubling issues which couldn't be brought to light.<br /><br />FInally, there continues to be many technological roadblocks which prevent all institutions from aggregating and sharing completely transparent data, but these are being broken down one by one.<br /><br />Best wishes -Jameshttps://www.blogger.com/profile/17128036766530412198noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-63417115905587331252011-08-04T11:54:37.263-04:002011-08-04T11:54:37.263-04:00Shimon;
Your efforts are laudable, as it is impor...Shimon;<br /><br />Your efforts are laudable, as it is important to find a way to engage the power of a critical mass of everyday citizens (past, present and future patients) in this effort. <br />However, I think an aspect of Paul's post which has not been addressed, is the adverse effect these rankings have on shaping hospital behavior - that is, modifying specific practices and processes solely to achieve a better ranking.<br />To the extent that these meaningless rankings can be made less publicly influential, the more influence and attention will be rendered to efforts such as yours. So I see these two efforts as complementary rather than competing.<br /><br />nonlocal MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-87866443829828527522011-08-04T11:54:23.982-04:002011-08-04T11:54:23.982-04:00Paul,
This should serve as an eye opener for hospi...Paul,<br />This should serve as an eye opener for hospital execs that often gloat over these rankings or overemphasize their value.<br />Recently a colleague and me were very surrpised to find a hospital we have consulted with on the list. <br />This suburban washington DC hospital, on the inside looks like a train wreck both with the infrastructure(lacking proper equipment in critical service lines like the OR) and management(zero accountability).<br />This hospital has been financially in the red and yet retains its CFO with a substantial bonus for 5 years in a row. <br />The nurse to patient ratio is 1:7/8and the working conditions are atrocious on some units for nurses. One of the physicians even called it a mom and pop shop describing how it's run.<br /><br />And yet they were on US News and world report. And it really surprised us. We then went about discussing how this whole report is a bit of joke. Now with your clinical dismantling of their methodology we stand validated.<br /><br />Hospital Execs: Please take a lesson out of this and stop focussing on publicizing our US News Rankings. Instead focus on the voices of your patients, staff and physicians to really solve a problem.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-47304074766979054762011-08-04T11:53:54.456-04:002011-08-04T11:53:54.456-04:00US News, Health Grades, Castle Connelly and others...US News, Health Grades, Castle Connelly and others create these rankings as revenue raising opportunities. They sell licensing rights to the hospitals and practitioners who make it onto their lists, giving them the right to publicize the fact that they have been highly ranked. The whole thing seems kind of, well, rank to me.Theresahttps://www.blogger.com/profile/17319294001151668919noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-77350214404650531742011-08-04T09:09:58.043-04:002011-08-04T09:09:58.043-04:00Hi Paul,
Taking off the gloves to take on US News ...Hi Paul,<br />Taking off the gloves to take on US News and World Report may make you feel better but unlikely to change the outcome of the value of current healthcare services delivered in US hospitals. There are hundreds of state, foundation, for profit web sites with hospital ratings including patient safety information available to consumers and patients. The challenge is to make healthcare institutions, especially those receiving public money, accountable. In my opinion, civic engagement of "citizens" with their local hospitals is the more effective way to go. It can start with "demanding" reliable outcome and safety information on hospital web sites.(Perhaps based on The Informed Patient Institute criteria) There are many challenges to this kind of approach, however if more of us take off our gloves and direct our energies to where the problem is, we can influence what hospitals do in reporting their outcomes, and all the benefit to improved care and cost that will likely come out of it.<br />Our group Citizens4health is embarking on such an effort. I invite you and your readers to consider this approach. We hope to launch our efforts in the next few weeks. I will be happy to keep you posted on our public reporting initiative. For an early description, pre public, of our initiative check out <a href="http://www.citizens4health.com/accountability-and-transparency" rel="nofollow">our web site</a>. <br />Thanks,<br />Shimonshimonhttp://www.citizens4health.orgnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-62623466349247396272011-08-04T06:12:30.705-04:002011-08-04T06:12:30.705-04:00From Facebook:
The data is flawed because no one ...From Facebook:<br /><br />The data is flawed because no one has defined the processes of patient care (in systems science that is the first step, otherwise the outcomes measures are close to worthless, and as you point out in this case they can be significantly biased). None of this is reality. Thank you for taking off the gloves- this kind of honesty is critical to our future.Brucenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-46042360181438879872011-08-03T22:05:51.828-04:002011-08-03T22:05:51.828-04:00Ahem, thanks for being open and frank. The rating...Ahem, thanks for being open and frank. The rating of schools have long be criticized for similar (and other) reasons. People seem to like the rankings, which I guess is fine, but they have not much more value than which fashion designs are "in" today or some such what I consider nonsense (but some people enjoy following).Curious Cathttps://www.blogger.com/profile/05269438998983808916noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-86193238417455604442011-08-03T21:21:57.673-04:002011-08-03T21:21:57.673-04:00Thanks so much for taking off the kid gloves.
I&#...Thanks so much for taking off the kid gloves.<br /><br />I've always thought the 5% patient safety component was an embarrassment.<br /><br />Basing a hospital's ranking on their reputation is such circular logic, it makes my head spin.<br /><br />As I drive around the Dallas-Fort Worth area, there are different billboards from three (I think, maybe it's four) different hospitals that all trumpet how they are the best in North Texas, based on some different methodology that's likely just as flawed.<br /><br />They're all the best hospital, but none of them are the best they can be.Mark Grabanhttps://www.blogger.com/profile/07953086531083611251noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-88352269942528255652011-08-03T21:12:35.709-04:002011-08-03T21:12:35.709-04:00Thank you!
Two things matter: outcomes and exper...Thank you! <br /><br />Two things matter: outcomes and experience. We are still learning how to really measure outcomes, how do deal with the data, how to process, analyze and share it.... until we have a true clearinghouse for quality, aren't all of the rankings and reports snake oil? <br /><br />Experience, of course, is another matter - although I'm hopeful social sites will shed light on experience the way amazon rankings reflect people's perceptions of product quality. At least they can be a driver for change inside organizations. <br /><br />Thanks Paul - glad someone stood up and said this!Nick Dawsonhttp://www.nickdawson.netnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-2690266364790528202011-08-03T20:55:42.419-04:002011-08-03T20:55:42.419-04:00From Google+:
Amen! Glad that you took the glove...From Google+:<br /> <br />Amen! Glad that you took the gloves off. These hospital rankings are virtually worthless. But it is probably a very popular issue, so we're bound to see it reappear over and over again.Howardnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-87279561094975343662011-08-03T20:44:47.211-04:002011-08-03T20:44:47.211-04:00From Twitter:
Amen Paul! It's about time some...From Twitter:<br /><br />Amen Paul! It's about time someone shed light on this@Namaste555noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-20597648583520430452011-08-03T20:43:46.692-04:002011-08-03T20:43:46.692-04:00I wonder what percentage of medical as opposed to ...I wonder what percentage of medical as opposed to surgical inpatient admissions could be competently handled by most community hospitals and all teaching hospitals. I suspect the number is quite high. Surgical procedures lend themselves more readily to outcomes measurement. If the brand name hospitals with the big reputations are no better than most others when it comes to the relatively uncomplicated cases that probably account for most of the procedures, insurers should have an economic interest in making that information available to both the public and to referring doctors. It should be a golden opportunity to create some countervailing power against the famous hospitals that command high rates because of their market power and not their care quality.Barry Carolnoreply@blogger.com