What Makes a 'Top' Hospital? Great Nurses, Most Definitely!


What Makes a 'Top' Hospital? Great Nurses, Most Definitely!

By Katy Allgeyer
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This summer, we were reminded what it means to be rated “the best” when we watched world-class athletes go for the gold in Beijing at the Olympic games. Sometimes the TV interviews gave us a glimpse of the bronze and silver athletes medalists who revealed their true feelings of disappointment at not coming in gold. Never mind that all Olympic athletes are part of an elite group … still, they crave to be the best of the best.

RNs are similar to those elite athletes in many ways. In order to become a nurse in the first place, the level of passion, commitment and dedication has to be higher than that of other professions because nursing requires giving so much of yourself to the job. So in a sense, if you’ve already gotten your nursing degree, you’re already in the Olympics, career-wise — you’re saving lives. Of course as an Olympian, you want to practice your skills at the highest level.

Hospital administrations crave to be ranked the best, too. In the highly competitive healthcare field, consumers have a choice of where to spend their healthcare dollars. Hospitals are busy places where medical mistakes can —and do — happen. Medical mistakes cause more deaths each year than car accidents, breast cancer and AIDS. It’s in every hospital’s best interest to find out where the mistakes are being made and to correct them. Rating and comparing hospitals to others in the community and the nation may provide the impetus to make those improvements happen.

Concern for the bottom line is a component of any hospital facility’s decision-making policy. Being designated a top-performing hospital that provides excellent clinical care has been proven to bring fiduciary benefits to the hospital as well as public acclaim. So it’s safe to assume that striving to be the best hospital is really a win-win-win situation: The patient wins with better overall healthcare, the hospital staff wins by being associated with that top healthcare, and the hospital gains prestige, which can lead to increased revenues.


Since there are a large number of different organizations —both profit and nonprofit — preparing their own quality rating reports, there can be some confusion involved for the consumer (or RN) who is researching how to find the top rated facility in their area. Furthermore, a hospital that receives a high ranking in one service may not rate so strongly in another. Also, the ratings companies are not always consistently comprehensive in which services they rate, so evaluation standards vary. There is even an online guide to rating the healthcare ratings that gives free listings of sources for hospital quality ratings and “Best Hospital” lists (www.consumerhealthratings.com).

The United States Department of Health & Human Services compares hospital performance on measures for heart attack, heart failure, pneumonia and surgical infection prevention using standardized ratings on all hospitals. The participating hospitals volunteer for rating and the information goes beyond the scope of only Medicare patients. Go to www.hospitalcompare.hhs.gov to find their Hospital Compare Guide for current rankings in all states plus Puerto Rico. Be sure to check information on other states in order to glean valuable insights on comparable services.

One of the largest and most comprehensive ratings companies is the publicly traded company HealthGrades. They print an annual “Top 50 Hospitals” report each February covering hospitals nationwide. HealthGrades also hands out awards for “Distinguished Hospitals for Clinical Excellence (DH-CE).” You can review rated hospitals (five-star through one-star) and compare the outcome of more than 30 diseases and procedures at their website www.healthgrades.com. These ratings are based on an independent analysis of clinical outcomes that does not allow hospitals to opt-in or opt-out for evaluation.

Another independent ratings source is Leapfrog Hospital Quality Ratings at www.leapfroggroup.org. The Leapfrog Group works with medical experts to identify solutions that will improve hospital quality and safety, and it has designed a survey that hospitals can voluntarily use to evaluate their performance.

HealthInsight developed its “Quality Awards” for those hospitals, home health agencies and nursing homes that meet their quality criteria based on national overall rankings of services and procedures. Go to www.healthinsight.org for more information and to view hospital ratings.

Since 1990, the trusted US News & World Report magazine has been publishing its own ratings list of top hospitals. So has Consumer Reports magazine. Their lists can be found under www.usnews.com and www.consumerreports.org, respectively.

The Joint Commission Accreditation organization has been around for more than 50 years. Their accreditation is a nationally recognized seal of approval for hospitals that meet their high performance standards. To see which area hospitals are accredited and how the compare in ratings, or to apply for accreditation, view their website at www.jointcommission.org.


According to HealthGrades, to be awarded the “Distinguished Hospitals for Clinical Excellence” title, a hospital must consistently provide the highest quality care across the board in all specialties it offers. The rankings reflect patient survival rates, fewer major complications as a result of procedures done, and patient satisfaction, to name just a few of the evaluation criteria.

In Southern California, Beverly Hospital in Montebello made the HealthGrades DH-CE list. So did Glendale Memorial Hospital and Health Center in Glendale, Huntington Memorial Hospital in Pasadena, UCLA Medical Center in Los Angeles, Glendale Adventist Medical Center in Glendale, and Cedars-Sinai Medical Center in Los Angeles. There are 30 California hospitals that ranked in the DH-CE category.

Community Hospital of San Bernardino received a five-star rating from HealthGrades for clinical excellence in maternity care. The five stars put CHSB in the top 15 percent of all hospitals within 17 states that HealthGrades has evaluated for maternity services. CHSB had almost 51 percent fewer maternal complications among women who had vaginal births compared to poor-performing hospitals, and 76 percent fewer complications for women undergoing cesarean section births.

“We are extremely proud to receive this recognition from HealthGrades! We deliver more than 250 babies each month, and it’s wonderful for our patients to know that they are delivering in a hospital that’s nationally recognized for the quality of its care,” said Diane E. Nitta, chief nurse and executive, vice president of operations.

In Arizona, the Mayo Clinic Hospital in Phoenix and Scottsdale Healthcare in Osborn, Scottsdale joined Del E. Webb Memorial Hospital in Sun City West as the three top Arizona hospitals to make the DH-CE grade according to HealthGrades ratings.


Nurses truly are the nuts and bolts of a thriving medical center and frequently have the most face time with patients.

“Achieving clinical success is a result of the healthcare team owning what happens with patients, knowing their outcomes with a passion for improving them, and individually holding themselves accountable for providing perfect care,” said Gwen Matthews, RN, senior vice president, Patient Care Services, at Glendale Adventist Medical Center in Glendale, California.

Glendale MemorialMary Lynne Knightsen, senior director of nursing at Glendale Memorial Hospital and Health Center, in Glendale, California, shared with us her views as to how RNs help hospitals achieve top ratings. Knightsen said, “The nurses at Glendale Memorial Hospital play an integral role in helping us achieve top hospital ratings. Our nurses are the face of the hospital for our patients, so not only do they strive to provide topnotch care but they provide it in a caring and compassionate manner. Our nurses also participate in evaluating the quality and safety of care provided as part of our ongoing performance improvement process. We value our nurses for all of their efforts, and we work hard to provide an environment in which they can excel.”


Scottsdale HealthcareKeith Jones, Public Relations Director at Scottsdale Healthcare in Osborn, Scottsdale, Arizona said, “Scottsdale Healthcare recognizes that nurses are the key to quality care. Our shared governance system includes a Nurse Quality Council. The Council’s primary goal is to promote evidence-based practice in a safe, patient-centered and collaborative environment. We also developed the Scottsdale Healthcare’ Investment in Nursing Excellence (SHINE program). SHINE is a reward and recognition program designed to enhance and nurture professional growth in RNs. SHINE nurses enhance care at the bedside.” A Magnet designated hospital, Scottsdale Healthcare regularly evaluates itself on nationally endorsed performance measures and voluntarily provides information to outside agencies that help monitor quality in healthcare.


Childrens Hospital Medical CenterMAGNETS ATTRACT

In California, Children’s Hospital of Orange County’s Vice President of Patient Care Services and Chief Nursing Office Dana Bledsoe, MBA, MS, RN, NEA-BC, made a statement to us about what steps were taken to make CHOC a top-rated hospital that also has Magnet status:

“Children’s Hospital of Orange County made a conscious decision in 2001 to aggressively respond to the IOM report, ‘To Err is Human’ and developed a five-year IT Strategic Plan that aligned with the hospital’s strategic plan aimed at creating and implementing the infrastructure to standardize care delivery and reducing error.”

Ms. Bledsoe goes on to state that CHOC has approximately 70 percent of their medical records automated and are among less than 10 percent of hospitals using CPOE. When asked what role nurses play in CHOC’s top hospital status, Bledsoe told us, “Nursing is at the heart of patient care and equally played a pivotal role in our journey toward automation.”

She said that bedside caregivers were essential to the development, testing and implementation of the electronic medical record keeping. Additionally, children’s hospitals have a unique relationship that includes a well-established network and a willingness to share information to advance the care of children nationally.

Ms. Bledsoe concludes, “The success of children’s hospitals in achieving Magnet status speaks to the role that nursing plays within the organization.”

Childrens Hospital Los AngelesChildren’s Hospital of Los Angeles also achieved Magnet status. Steve Rutledge, director of communications at CHLA, told us, “We were recently ranked number 9 in the US News & World Report magazine rankings and we were nationally ranked in all six of the specialties they ranked in that survey. I believe only five percent of all hospitals earn Magnet status which is quite an honor for our nurses and the hospital.”


In Arizona, Debra Pendergast, MSN, RN, CNAA is the Chair, Division of Nursing/Associate Administrator of the Mayo Clinic Arizona. Ms. Pendergast said, “Almost of our Mayo Clinic Arizona workforce are nurses. Nurses are attracted to Mayo Clinic because of the professional match of values. Nurses want to work in environments where the organization really does put the needs of the patient first. Putting the needs of the patient first means having environments Mayo Clinic(patient care areas) where nurses are empowered to participate, create, and design the way nursing care is delivered.

"This means that there is an expectation that nursing staff be involved in decision making and function as both true team leaders and team members of highly functioning multi-disciplinary teams. This can best be expressed in our mission statement: Transform, Teach and Practice the Nursing of Tomorrow in an Environment of Intentional Caring and Healing.”


While the Olympic Games only come around every two years, healthcare professionals compete in a daily arena dealing with life and death situations. Providing excellent healthcare is an achievement every day.

This article is from workingnurse.com.

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