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U.S. News rankings just one way to measure hospitals, experts say

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David Knowlton said he dislikes how reputation factors into the U.S. News survey.
David Knowlton said he dislikes how reputation factors into the U.S. News survey. - ()

The U.S. News & World Report hospital rankings released this week put a spotlight on a few top-ranked hospitals in the state and nation, many of them larger hospitals in busy metropolitan areas. But hospitals that don't make the list have other ways of competing for patients and getting their message across, experts said.

U.S. News said it combined objective hospital data — including death rates and patient safety scores — with surveys of more than 9,500 physicians to compile its annual ranking of 5,000 hospitals in 16 adult specialties, from cancer to urology. Several New Jersey hospitals ranked in the top 50 nationwide in one or more specialties, including Hackensack University Medical Center,  Morristown Medical Center, Robert Wood Johnson University Hospital, AtlantiCare  and Kessler Institute for Rehabilitation.

Hospitals that are not nationally ranked in a specialty, but scored in the top 25 percent, were recognized as high-performing.

David Knowlton, chief executive of the New Jersey Health Care Quality Institute, said he’s not a big fan of the U.S. News survey because of the weight it places on hospital reputation, based on the physician survey.  He said the survey “is going out and asking doctors what their opinion is, and doctors may or may not have an opinion, and it can easily become popularity.”

But he said U.S. News “has a very wide bandwidth and a lot of people see it, so it influences a lot of people.”

Knowlton urges consumers to look at how hospitals perform on the Leapfrog Group analysis of hospital safety data, and other hospital safety reports.  

“In a hospital, safety is the issue,” he said. “What hospitals are asked to do is create an environment in which talented medical professionals can practice safely. They are responsible for your care after the medical professional has done his or her job.”

And he said outcomes depend both on the hospital and on the clinician providing care.

“Where you are going to get better from whatever ails you — cancer or cardiac or whatever — that’s really defined by the medical practitioners: the doctor, the therapist, the nurse who is providing your care. Once they are done, you want to know the hospital keeps you safe while you recuperate. The hospital has lot more interaction with you and the nursing staff has a lot more interaction with you.”

So when a patient is shopping for a hospital: “You look for safety: that is what we try to do with the (Leapfrog) safety score. For outcomes, you look to the doctor: the surgeon, the treating oncologist.”

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Several Barnabas Health hospitals received high-performing specialty designations from U.S. News, including Newark Beth Israel Medical Center, which was ranked 10th in New Jersey overall; the survey also recognized high-performing specialties at Clara Maass Medical Center, Monmouth Medical Center and Saint Barnabas Medical Center.

Barnabas Health said it is proud to be recognized by U.S. News and said: “There are many other well-respected organizations that also offer national ratings based on quality and patient satisfaction.  Barnabas Health hospitals have also been recognized by Leapfrog, HealthGrades, Thomson-Reuters, the Joint Commission, Becker's and Inside New Jersey, among many others.  Our individual services and programs also receive national accreditation.”

Capital Health ranked 21 in New Jersey overall and was recognized by U.S. News as high-performing in nephrology.

Spokeswoman Jayne O’Connor said: “There are so many of these ‘rating’ lists now, it’s no wonder consumers are confused. The rating lists all use different data and methodologies to determine the final scores or rankings, and consumers typically don’t have the time or desire to analyze what went into them. Some of these methodologies can produce unusual ratings. For example, we were once named a best hospital on one list for a program that we don’t offer.  Likewise, it is often hard to figure out how the rankings can shift dramatically from year to year — such as going from an A to C then to A.”

O’Connor continued: “The overwhelming majority of patients rely on word of mouth or recommendations from physicians and friends and family to make their decisions about which hospitals and physicians to use, and so that is where hospitals will concentrate their efforts to get their message out.  Most important for us is providing quality care and service to each patient because then they’ll recommend us to everyone they know. Similarly, it is important to build that reputation with your physicians so they’ll want to use our hospital and recommend us to their patients.”

How influential is U.S. News? O’Connor said, “Because the U.S. News list has been around so long and is so well known, it is nice to make its list, but I don’t think hospital marketers would say that it alone can make or break a hospital’s reputation.”

She said Capital Health encourages patients to consider hospital performance data, which is available from the Hospital Compare website of the Centers for Medicare and Medicaid Services.

And, she said, “For us, the special accreditations and certifications — such as those from The Joint Commission, American College of Surgeons, National Accreditation Program for Breast Centers, etc. — we receive is very important for consumers to know about, as they typically mean that we use best practices and evidence-based medicine and have met or exceeded very high standards of care.”

Valley Hospital in Ridgewood was ranked 15th in New Jersey by U.S. News, which cited it for three high performing specialties.

Spokeswoman Megan Fraser said: "It is important to remember that, to a great degree, people seek their health care locally, and the number of people who travel to New York for their care has, and continues to, sharply decline. Our community is highly educated and discerning. We make every effort to tell our constituents that, as a result of Valley's quality care and service, they need not leave the area for the best physicians and award-winning care." 

She said Consumer Reports ranked Valley one of the top 15 hospitals in the nation for cardiac care in its August issue, and Valley has been cited by Healthgrades among the top 10 percent in the country for maternity care and gynecological surgery, and among the 100 best hospitals nationwide for cardiac and orthopedic surgery.

Fraser said: "While our quality care is a given, we also know that people choose Valley for the service we provide. For more than a decade, we have been honored by J.D. Power for providing an Outstanding Patient Experience. We are also a Magnet recognized hospital, the nursing profession's highest honor."


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