Do the Best Hospital Ratings Mean Better Care?

There is no doubt whatsoever that hospital rankings matter to patients. Today, with the help of modern technology, patients do their own research online before choosing a doctor / hospital. They take into account several factors such as doctors within their area, skills and expertise, insurance coverage, and more. 25% of patients change hospitals based on “top hospital” rankings and over 60% change hospitals when they learn about low ratings. “There’s been this big movement for the last 20, 25 years of improving transparency and developing quality measures and making them available through these rankings. A lot of money, a lot of time has been invested in building this kind of infrastructure” says Gary young, director of the Northeastern University Center for Health Policy and Healthcare Research.

However, the problem with hospital ranking systems is that each one uses different data and criteria to calculate its scores. For instance, Leapfrog Group gives each hospital 1 of 5 letter grades based on patient safety, while Consumer reports uses a scale of 0 to 100 to rate hospital safety. Moreover, U.S. News and World Report focus on medical specialties that patients visit to be treated for complex medical conditions, while HealthGrades focus on patient outcomes as a result of different illnesses and surgeries. “The rankings aren’t always consistent. Only a small percentage of hospitals rank at the high end of those rankings across those different rankers” notes Young.

Therefore, due to the fact that every institute measures hospital quality in a different way, it causes major contradictions in classifications. While a hospital that is ranked 1st and one that is ranked 100th on a list shows a fairly significant difference, is there really a difference between a hospital that ranked 1st one year and 2nd the next? “Any system that does try to put hospitals or providers into categories should do it using the very best scientifically sound methods as possible. It’s a very complex set of concepts, quality and safety. So it’s a lot to ask to really, accurately characterize hospital quality and put it in a five star system” says Elizabeth Mort, Mass General’s senior vice president of safely and quality.

U.S. News 2017-2018 analyzed data from 5,000 medical centers and the responses of over 30,000 doctors from conducted doctor surveys. In order to assist patients in limiting their search for hospitals that could best meet their requests, U.S. News ranked best hospital performance among 16 adult specialties. The factors that were taken into consideration include patient safely, survival rates, hospital reputation, and specialized staff. Each hospital received points (20 being the highest) based on their performance in nine procedures and conditions. Those that received the highest ranking made the “Best Hospital Honor Roll”.

Hospital ratings help patients in comparing hospitals within their area so that they can choose the one right for them. Moreover, the ratings alert patients on any particular concerns they may have so that they can take necessary steps towards preventing such problems. The average patient has access to a significant amount of information about hospitals from hospital reviews on websites such as Yelp. Therefore, these online reviews are likely to affect their decisions about where to seek treatment. “It’s not clear that consumers pay attention to medical rankings, instead relying heavily on word of mouth, opinions of friends and family, and physician referrals” says Young. While hospital rankings can help patients, they can also be difficult to sort through and some find that a more useful approach is prioritizing patient experiences.

When a patient researches a hospital online, they form an impression of them. The fact of the matter is that patient experiences trigger expectations. Expectations are based on other patients’ experiences and they are strong because individuals trust the experiences of others. They might not discover a reason why those patients would lie about their experiences so they believe them. In such instances, two things might happen. Either hospital rankings increase due to patients’ positive experiences or they decrease due to negative reviews. In both instances, a cycle of positive and negative hospital reviews form. This, in turn, is how the number of patients ends up affecting hospital ratings. When a hospital has a great deal of positive reviews, this leads patients to believe that they offer high quality service and therefore, they are often chosen over those with bad reviews. When it comes to an emergency situation, most individuals will not sit down and Google “best hospitals”. That is, they will not avoid hospitals with a few negative reviews that are within their area at a time of crisis. However, they will always be swayed more towards ones that have been portrayed in a more positive light through the experiences of others.

Here are four ways in which hospitals can increase their rankings and grow their reputation in a positive way to boost patient loyalty:

• Communicate clearly and concisely – Communication among both healthcare professionals and patients is vital for solidifying relationships and building credibility. There are several tools and strategies that can be used to improve communication with patients – follow up calls, interpretation services, and more. “To reinforce important information to patients, staff should both write instructions and repeat them verbally, giving patients time to respond with questions” says Elizabeth Chabner Thompson, a patient advocate and founder and CEO of Best Friends for Life Co.
• Provide effective patient education – Teaching and educating patients by providing quality services is one of the most important aspects in medicine. Hospitals often use educational videos and written instructions to highlight the importance of certain conditions, medications, treatment plans, and follow-up plans. The more involved that patients are in their hospital care, the better they will be able to care for themselves once they return home – putting them at ease during discharge.
• Collect information on patient experiences and act in accordance with the findings – Patient experiences say a lot about the positive and negative aspects of a hospital. They target the precise drivers of patient satisfaction. Not only do they stress how the patients feel but they also stress the changes that are necessary for improvement.
• Ensure positive patient experiences – Small gestures can make a great difference. For instance, the behavior of healthcare professionals can greatly impact patient experiences. A positive patient experience increases patient satisfaction, thereby increasing hospital ranking. “Everyone [in the hospital] has so many things to accomplish, and it's easy for patients to feel that they're rushed. Even something simple like when you go in to speak to a patient, sit down as opposed to standing. It might take the same amount of time, but the impression is not rushed. The impression is that you might have spent more time when really you haven't” says Ruth Ragusa, vice president of organizational effectiveness and performance improvement at the hospital.

Patients have a great deal of influence over hospitals’ demands. This is why it is vital for hospitals to continue to provide quality care and increase patient satisfaction. Patient satisfaction, in turn, leads to higher hospital rankings. It’s a cycle that keeps repeating. “It is important for every organization that serves the public to give the customer their best possible service. For a hospital, it is more than just a business imperative. Hospitals and other health care providers have a special role of serving patients and their families at some of the most challenging and critical times of their lives. Creating a soothing environment; engaging patients and family members in care decisions; enabling patients to have the support of family members and other loved ones at these times of great stress and ensuring they feel supported, informed and engaged is not only the right thing to do, it has been shown to promote healing” says Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association.