Hospital negligence

Predicting a Hospital’s Quality of Care

June 27, 2022 by James McHugh, Jr.
Predicting a Hospital's Quality of Care

There are often multiple potential options to choose from for hospital care. Healthcare choices are serious decisions but reliable ratings and metrics for these facilities can be hard to come by. Some patients in need of care and/or their loved ones helping with the search will look to ratings compiled by the federal government agency Centers for Medicare and Medicaid Services (CMS) while others will look to online reviews. Data is showing, however, that these are not as reliable as they should be and therefore patients will seek out and receive care that could be detrimental to their health without even knowing it.

Factors That Can Affect a Hospital’s Quality of Care

Hospital patient satisfaction depends on a variety of factors, including the hospital environment, the quality of care received, and the availability of services. Security, cost, and quality of personal interactions are also impactful. Hospital quality of care factors includes the experience, professionalism, and expertise of medical professionals such as doctors, nurses, and others. It can also include the services and technologies available at a given facility. Hospitals that hire highly qualified staff and use new and more efficient technology will likely have higher levels of hospital patient satisfaction.

Above all, patients want to be certain that a hospital is clean and safe, and that proper disease control procedures are consistently followed. In addition, patients want rooms to be comfortable. Patient interactions with hospital staff can also affect them, including interactions over the phone, in person, and through electronic portals like hospital websites.

The CMS Hospital Rating System Is Flawed

The Centers for Medicare and Medicaid Services provides a rating system of hospitals, which is extremely helpful for patients in determining where they should go to receive care. Many patients select hospitals with a good CMS rating for peace of mind that they will receive quality care, but that might not be the case. At least one comprehensive study investigating the CMS hospital rating system found it was seriously flawed.

The CMS hospital rating system works by analyzing data from seven different categories which each have multiple subcategories:

  • Mortality
  • Safety of care
  • Readmission
  • Patient experience
  • Effectiveness of care
  • Timeliness of care
  • Efficient use of medical imaging

Researchers discovered a flaw in how the CMS system calculates the subcategories of the safety of care. There are eight subcategories under the safety of care, but they are not weighted equally. The majority of the score from this section comes from just one factor called PSI 90, which reflects complication rates for certain surgical procedures. Furthermore, the CMS rating system puts a greater weight on PSI 90 than on other important metrics such as the number of hospital-acquired infections. Not only are the ratings miscalculated, but the model CMS uses also doesn’t properly reflect patient outcomes. The CMS hospital rating system uses latent variable modeling, but this type of modeling doesn’t properly illustrate clinical outcomes in a hospital.

Regardless of a hospital’s CMS rating, all patients have a right to a certain standard of care. When a hospital or healthcare provider fails to meet this standard, they need to be held responsible for any resulting damages. Many people are afraid to file a lawsuit against their doctor or hospital, but doing so is often the only way to correct negligent behavior that could harm additional patients. Hospital malpractice lawyers can help injury victims and their families get answers and ensure this type of behavior doesn’t happen again.

Social Media Reviews Can’t Predict A Hospital’s Quality of Care

In today’s technologically adept world, we often use online tools like social media to give us different insights into businesses we consider using. We look at reviews on Google, Facebook, or Yelp to see if a restaurant we’re considering has good or bad ratings and maybe even read the comments of previous diners. When it comes to the hospitals and doctors’ offices where we plan to be evaluated and treated, patients will check social media platforms to see how the different facilities and providers cared for people. However, is checking online reviews an effective way to determine a hospital’s quality of care? Experts disagree.

According to at least one article, though patients have the option to visit social media platforms for crowdsourced insights into other patients’ experiences, they cannot expect reliable guidance on the quality of care they will receive. Researchers have even compared social media ratings posted by patients with data available from the CMS Hospital Compare website. The insights from the comparison research are especially telling:

  • In terms of patient experience for items such as food, staff friendliness, and amenities, Google, Yelp, and Facebook ratings often align with high Hospital Compare ratings.
  • Social media ratings were not as accurate for care quality and safety when compared with Hospital Compare. Roughly 20 percent of hospitals rated as “best” within a local market on social media were rated as “worst” in the same market by Hospital Compare in relation to patient outcomes.

The results indicate that crowdsourced ratings may only accurately reflect measures of quality most easily observed, not all factors relevant to safe healthcare. While online sites may provide similar information to the government’s data, they are not a substitute for them.

Hospital Compare has its shortcomings including needing to give patients clearer expectations of clinical quality. Of the 57 Hospital Compare metrics, patients must look through at least 46 to find clinical quality and safety. Unfortunately, many of these measures might not apply to their specific situation.

Hospital Malpractice Attorneys

Choosing where to receive medical treatment is a massive decision for anyone and it could greatly affect an individual’s health. As patients, we trust our doctors and nurses to follow the rules. We trust our hospitals to have policies and procedures in place to ensure we are protected from harm. We have a right to expect a professional level of care from all of our medical providers, and we are fortunate to have a high level of care overall in the United States.

If you suffered a significant injury or a loved one died because of a misdiagnosis, delayed diagnosis, failure to diagnose, a prescription medication error, or a birth injury, you should contact a medical malpractice lawyer to discuss your legal options. There is no cost for the initial consultation and your information will be kept confidential.

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