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Dubious Data

My U.S. News & World Report arrived, announcing the “best hospitals” in America. I immediately looked to see if my favorite facility here in Chicago had made the list. Only in certain categories in the highly specialized rankings, it turns out. Nevertheless, the article had its intended effect—I read long enough to notice the various advertisements.

Pardon my skepticism, but you will not convince me that it is the duty of American magazines to go about ranking the performance of American hospitals. To me, such surveys are little more than publicity stunts masquerading as serious journalism. Now, if there are indeed “best” hospitals, and they can be ranked, in order, like so many movies’ box office volumes, then should there not be, by extension, a corresponding list of the “worst” hospitals? My fickle reporter mind insists on going to these facilities and imagining what the place looks like. I bet U.S. News would not be in the waiting room.

The fact is, hospitals have enough trouble trapping their own quality and performance data, let alone having enough data to stack themselves against the competition (not that any hospital administrator would countenance such an undertaking). Hospitals struggle to collect and present ongoing data for current admissions, scrambling to fill the void with software that enables lab results viewing, medication reconciliation, and physician order entry. Truth is, the modern hospital is such a collection of services, skills and staff that it virtually defies meaningful measurement—particularly given the woeful condition patients present.

It reminds me of a chief information officer I visited in person for my ongoing Behind the Wires series. For two consecutive years, his hospital had been named in the “most improved” category in one awards category. Pondering the unlikely scenario of how a hospital could be most improved two years running, he said, “We must have been pretty far behind to begin with.”

His statement was both an admission of his hospital’s need for enhanced clinical IT and a dismissal of such surveys of the “best” hospitals, which continue to entice readers, advertisers—and even hospitals. I’ve spotted big sandwich boards proclaiming various prizes displayed in hospitals’ lobbies—they usually tout “best,” not “most improved.”

—Gary Baldwin