So what can be done? Sehgal suggests that steps could be taken by the magazine to "improve" its ranking system. "One is to either eliminate or greatly reduce the role of reputation in the rankings. The second is to add other factors that are important but aren't currently in their ranking system such as patient satisfaction," he says.
Ultimately, though, it's up to consumers to find out what works for them—a point both Sehgal and Comarow agree with. Sehgal suggests that consumers could take a four-step approach toward finding a quality hospital that meets their needs:
- First, they should look at multiple sources of information, instead of relying on a single rannking.
- Second, they should focus on the aspects of quality of care that are most important to them—instead of looking at a composite index. "For example, some consumers might be interested in the nurse-to-patient ratio at a particular hospital. They might be interested in how satisfied other patients have been with their care," Sehgal says.
- Third, they should seek out a hospital that has a lot of experience taking care of other people with the same condition that they have. "That's important because there's been a lot of studies that found that hospitals with higher volumes have better outcomes for specific procedures and conditions," he notes.
- Fourth, they should consider visiting the hospital to see "what it is like with their own eyes and talking to the other physicians, nurses and staff," he adds.
How much reputation should be used in hospital ranking is unclear, but certainly these scores should not be based on popularity. Patients are using these lists to make choices—and they should not be created lightly.
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Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at firstname.lastname@example.org