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Commentary

Hospitals Check Their Charts: Rankings Push Them to Improve Care
Steven Pearlstein, Washington Post, 4-20-07

Pearlstein explains why the growing trend toward hospital quality rankings—by both government regulators and private firms—is driving hospital administrators to improve patient care.

To find the best hospital in the Washington region, you may have to drive a bit.

You could go north—not to the famed Johns Hopkins Hospital in Baltimore but to the Baltimore Washington Medical Center in Glen Burnie, Md.

Or you could drive west, over the Blue Ridge to the Shenandoah Valley, where Winchester Medical Center is located.

Those are the only two hospitals in the region that made it onto the list of top 100 hospitals compiled by Solucient, the health information subsidiary of Thomson.

On the other hand, if you consult the Web site of a company called HealthGrades, you might head for two of Inova's hospitals, Alexandria and Fairfax, which boast five-star ratings in three clinical areas.

If you prefer to rely solely on government data, you might go for Shady Grove Adventist Hospital in Rockville or Winchester Medical, or two of the District's university teaching hospitals, Howard and George Washington.

Welcome to the baffling new world of hospital scorecards.

The good news is that the number of organizations trying to evaluate hospitals is growing fast, along with the breadth and sophistication of their analysis. It's all part of the movement toward consumer-driven health care, and much of the information is available on the Web, where you can sort it by region, type of hospital or the particular ailment or procedure you're interested in.

The only way American health care is going to get better and more affordable is with this kind of single-minded focus on protocols known to work. However imperfect they may be, hospital scorecards are crucial to making that happen, creating the competitive "race to the top" that health reformers have dreamed of for decades.

We hope that more rankings focus on risk-adjusted outcomes measures, as opposed to process guidelines, which can penalize hospitals that depart from the norm. Process guidelines, while attractive in theory, may actually penalize hospitals that personalize care regimens for sicker patients or that think "outside the box" and develop innovative new treatment protocols.



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