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Checklist: 20 Ways to Identify the Local Hospital That's Best for You
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You might not have access to one of the country's 50 best hospitals, which tend to be located in major metropolitan areas. So how do you pick the local hospital that's best for you?
Because different health plans and different doctors are affiliated with different hospitals, consider choosing a hospital before you settle on a primary-care physician or personal health plan. Likewise, spend the time to pick your hospital before you become injured or sick. That way, the choice is up to you—not the healthcare providers with whom you might be aligned.
Even if you're already part of a health plan or if you have a longstanding relationship with a particular physician or specialist, you still have some research to do. Because most health plans and doctors are affiliated with several hospitals, you should have at least several hospital options to sort out.
Perform these 20 checks to pick the right hospital for you:
QUALITY OF CARE
1. Check on hospitals' accreditation status—determined by an organization called the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The hospital itself should tell you whether or not it is accredited—and whether its accreditation is "conditional" based on ongoing improvements. The hospital also should tell you when it was accredited; JCAHO reviews each hospital every three years.
Note: JCAHO accreditation is not a guarantee of quality care, and hospitals do not have to participate in the accreditation process.
For information about a specific hospital, use the Quality Check database on JCAHO's Web site or call JCAHO at (630) 792-5000.
2. Determine which local hospitals are teaching hospitals—and consider whether that's important to you. Teaching hospitals serve as research and training facilities that are more likely to boast expert specialists and the latest technology and techniques. Keep in mind that you may not need fancy treatment, nor want all the extra attention from all the doctors-in-training.
3. Ask your primary-care physician and any specialists about the local hospitals that they use. Why have they aligned with particular hospitals? What are the strengths and weaknesses of each facility? Here's a revealing question: Which hospital(s) do the doctors themselves use when they or their family members are sick?
4. Determine whether local hospitals provide specialty care for conditions that you currently have, as well as conditions that you might develop. (Consider your family's medical history.) How many procedures of the kind that you need (or might need) has the hospital performed?
Also, check in with certain specialized healthcare organizations for their insights. For instance, quality cancer care may be a top priority for you. If so, call the American Cancer Society to identify the local hospitals that specialize in cancer care.
5. Find out the percentage of each hospital's doctors that are board-certified. This statistic will give you a general sense of a hospital staff's collective level of expertise, as board certification requires extra training and exams.
6. Check on the quality of each hospital's nursing staff. One way to measure nursing quality is the ratio of registered nurses (RNs) to licensed practical nurses (LPNs). RNs can perform a wider range of professional services. The national average is about 4 RNs for every 1 LPN, according to the American Hospital Association.
7. Find out the nurse-to-patient ratio, which will help to determine how much attention you get from caregivers throughout your hospitalization. Usually, it's one nurse for every three to six patients, according to the American Hospital Association. (In intensive care units, it's more like one nurse for every one to two patients.)
8. Seek outcomes data such as death rates and frequency of complications. If your doctor or health plan doesn't have such data handy, ask the hospitals' PR departments for it. Caution: Outcomes data needs to be "risk-adjusted" to reflect the fact that some hospitals treat sicker patients than other hospitals.
9. Find out if local hospitals use computerized order-entry systems. With an order-entry system, doctors order prescriptions electronically—as opposed to writing them down on paper. As a result, the computer is able to identify possible drug interactions, and the process also eliminates errors in interpreting physicians' handwriting.
PATIENT SERVICES
10. Find out if each hospital has an ethics committee or ethics consultant to help physicians, patients, and families deal with difficult decisions such as end-of-life care.
11. Find out how the hospitals handle patient complaints. Does the hospital have a patients' "bill of rights"? What about some sort of a patient ombudsman? You might even go so far as to ask for formal complaint data—the number of complaints lodged in the last year and the results of the complaint process.
12. Learn about the follow-up services that hospitals provide after your discharge. For instance, will the hospital provide training for self-care at home? Is the hospital associated with home-care agencies or other facilities necessary for your ongoing care—or will you need to coordinate these services yourself?
13. Determine how local hospitals might support your friends and family. What are the visiting hours? Will the hospital help out-of-town guests to secure nearby overnight accommodations?
COMFORT AND CONVENIENCE
14. Ask friends, family, and colleagues about their experiences with local hospitals. This is a great way to get firsthand information about the comfort of patient rooms, the attitude of hospital staffers, the quality of food, and other critical comfort issues.
15. Find out if private rooms are available—and at what cost—if you think you'll want one.
16. Determine if the hospital can handle any special diet requests.
17. Consider the ease of the commute to and from various local hospitals. How long will it take to get there in an emergency? Can you get there via public transportation? Is it easy to find parking?
18. Schedule tours of your local hospitals. That way, you can get a feel for the size and comfort level of patient rooms, the amount of courtesy the staff exhibits, and the ease with which you can navigate the facility as you move from exam rooms to patient rooms.
19. Find out whether local hospitals offer education programs for members of your community. Attend such programs to see how comfortable you are with the staffers representing the hospitals, as well as with the information they provide.
COST
20. Determine how much it will cost you for various expected and unexpected services at each hospital. How much for a bed in a semi-private room? How much for a bed in the intensive care unit (ICU)? What are the costs for specialty procedures—and associated services—that you might need? If you have insurance, find out how much of these costs it will cover for you.
Sources:
• Consumers' CHECKBOOK's Guide to Hospitals, which rates more than 4,500 hospitals nationwide. It also contains tips on how to get the best care in a hospital. (The related Consumers' CHECKBOOK's Guide to Top Doctors lists more than 15,000 specialists in major metropolitan areas rated highest by their peers.) Each publication costs $19.95. To order, call (800) 839-7283, or send a check to Consumers' Checkbook, 733 15th St. NW, Washington, DC 20005. You also can order the book—or sign up to use the data online—at www.checkbook.org
• American Hospital Association. The AHA's site provides a comprehensive list of links to other healthcare organizations, including many medical specialty associations that can help you find the best local facilities for specialized care.
• Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The organization's Quality Check database lets you view accreditation results for specific hospitals.
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