Safety rankings: should hospitals care?

The impact on hospitals varies by location

In March, Consumer Reports released new safety scores for 2,591 U.S. hospitals. The magazine is just one of a number of organizations that rates hospitals on safety. Should hospitals care about all these rankings?

If hospitals are worried the rankings will cause patients to go elsewhere, they shouldn't, said Joel Shalowitz, clinical professor and director of Health Industry Management at the Kellogg School of Management at Northwestern University.

"As far as individuals are concerned, publishing these report cards does not seem to make a lot of difference in their choice of which hospital to go to," he said. "There have been a number of studies over several decades that demonstrate this."

For the most part, he said, patients aren't necessarily willing to seek higher quality care if it means more burdensome access. "They don't want to travel and be taken out of their community hospitals for higher quality services somewhere else."

However, any bad press resulting from rankings is sure to impact hospitals, said Tatiana Melnik, an attorney working in the healthcare industry at Melnik Legal in Tampa, Fla. News organizations pay attention to publications like Consumer Reports because it is so well respected, and if the hospital in town is high on the list for mortality or facility-acquired infections, that's going to get noticed.

"Bad press does impact revenue and overcoming bad press is an expensive proposition," she said.

And while hospitals in rural communities may be able to bank on locals not wanting to travel, hospitals in metropolitan areas where there is more competition, may have more to worry about, said Tim DeCou, partner of executive services firm Hardesty LLC's healthcare practice. "(Patients are) going to seek out safety information and want to go with the hospital with lower mortality rates or highest ratings in infection control."

Ultimately, whether hospitals should care about the rankings, most hospitals do care, and they can use the rankings, whether they agree with their ranking or not, to evaluate where they are doing well and where they could improve, said John Bulger, chief quality officer at Geisinger Health System in Danville, Pa.

"The main point is that public reporting is helpful and improves transparency," he said. "The question becomes how should (ranking) be done, and in what ways can we make the information most valuable for patients?" he said.

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