The Rankings are Out! The Rankings are Out!

by Alexander J. Ghanayem, MD, FAOA

On August 8, 2017, U.S. News and World Report released their
2017-18 Best Hospitals report, and best of all, their top 50 orthopaedic hospitals in the nation.

Clearly a time for stress, anticipation, and then for those lucky enough to make the top 50, jubilation, celebration and a year’s worth of institutional bragging rights. After all, the U.S. News & World Report is the “global authority in hospital rankings.” In earning a top 50 ranking in orthopaedics, one is now in the top 3% nationally of over 1600 hospitals that provide orthopaedic care.

"Covering nearly every hospital in every U.S. community, US News offers deep, rich data that patients can use to help them make informed decisions about where to receive surgical or medical care," said Ben Harder, managing editor and chief of health analysis at U.S. News.

"We know outcomes matter most, which is why U.S. News is committed to publishing as much data as possible on patient outcomes." The report is “designed to help patients make informed decisions about where to receive care.”

To this author’s review, the methodology does seem robust, relevant, and interesting—and I should think so because my institution was ranked.

I called my younger sister, a well-respected pediatric cardiac intensivist to give her the news and do what I’ve been doing since we were kids—brag a little. I thought she would be impressed because she worked at the #5 and now #1 pediatric heart surgery hospitals. Her response what muted. I probed a little bit. “Competition is great, right?” “It makes us work harder to outscore our competitors and draw patients to our institution.” Still, not much of a response.

So, I bit, “Why aren’t you impressed?”

She responded, “It’s great for competition, but I think it may stifle collaboration—and collaboration is better for patient care.”

I just learned something from my little sister.

 We are so focused in being #1, that there may be a price our patients pay as we strive to attain those high marks. Perhaps setting a threshold that once hospitals meet certain robust quality and safety metrics, they are designated without a 1 to 50 rank. There should be no limit on the number of hospitals that can meet that threshold.

If the criteria are robust and high enough, the net result is more hospitals providing higher quality care. Imagine that.

Competition can be good in many areas of our work, social, and leisure life. In health care, collaboration might be better—at least to the quality of care our patients receive from our vast, nation-wide health care system.

The winner when we collaborate: patients. Imagine that.  

Let’s not forget to work together.

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