Tuesday, November 21, 2017
Health

Best hospital ratings evaluate health care, not amenities

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Not long ago, I went to visit a friend at a hospital in Georgia.

A valet stood ready to whisk my car away. A stop at the gift shop for flowers nearly turned into a spree, they had so many wonderful tchotchkes on display. The glass atrium was full of light, soft music and chic furnishings, like a fancy spa hotel. Near the elevators stood a life-sized, cut-out image of a chef who promised to delight the palates of the most discerning patients.

I was feeling very impressed as I went up the elevators to see my friend.

She was lying in bed, paralyzed by a stroke, fed through a tube. She clearly wanted to sleep, but a fire alarm blared intermittently for hours, despite the lack of a fire. I thought of taking her downstairs where it was so pretty and peaceful, but she was in no condition to be wheeled around.

Her sister had asked me to make sure she was getting daily physical therapy. I found a nurse, who told me there was no therapy on weekends.

A few hours later, I glanced at the gift shop on my way out, studied the chef poster and no longer felt so impressed.

I thought about all this the other day when Consumer Reports came out with its annual hospital ratings. On a 100-point scale, the highest score in the nation, a 78, went to a small hospital in Maine. No Tampa Bay area hospital hit the 60-point mark. Some were far below. The Georgia hospital with the chef scored a 54.

Consumer Reports was interested in things like hospital-acquired infections, surgical deaths, readmission rates and radiation exposure, not ambience.

There are many hospital ratings out there, and this one is not without its critics. Still, it gives one pause.

American consumers are a demanding bunch, and hospitals want our business. Numerous surveys show people care about being cared for in pleasant, even high-end surroundings, and who can blame us? Medical quality can be a mystery. Good food and soothing amenities are easier to judge.

Anyway, it might seem reasonable to assume that hospitals already know about basics like controlling infection and are doing all they can in that regard.

But last week also brought this news from the New England Journal of Medicine: On any given day, about 1 in 25 patients in U.S. hospitals has at least one infection they got in the hospital. In 2011, this added up to about 648,000 patients with 721,800 hospital-related infections — such as pneumonia, surgical-site infections, bloodstream infections due to a central catheter and gastrointestinal infections like the tough-to-defeat C. diff.

Imagine that — getting sicker in the place you went for healing.

The report also noted that progress in fighting infection has been made, so surely this is not an insurmountable task. Indeed, local hospitals told the Tampa Bay Times that they are hard at work on the problem when we reported on the Consumer Reports ratings.

But it isn't solely a job for hospitals.

If consumer demand for amenities has had such an impact on hospitals, perhaps the patient safety movement also could get a boost from informed consumers.

Even if you aren't planning to be in a hospital anytime soon, why not do some homework, just in case? Check out multiple hospital ratings web sites, and pay attention to how they are compiled and who's paying for it. Talk to doctors and nurses, friends and family about their hospital experiences.

Make sure everyone involved in your care and that of your loved ones knows that safety matters to you. Ask your doctors and hospital what they are doing to fight infections.

Ask for and follow instructions for your own care, both before and after surgery. Such as? Well, for starters, stopping smoking, taking your medication as directed, eating right, keeping medical appointments, staying alert to signs of infection. Get a friend to take notes at your doctor visits. Ask about anything you don't understand.

There are lots of books geared for consumers, such as Safe & Sound in the Hospital, by Karen Curtiss.

There's nothing wrong with a few frills at the hospital to help make a stressful time more pleasant for patients and visitors. But they shouldn't be the priority.

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