Not Running A Hospital  

Every year US News and World Report publishes a report of the best hospitals in the U.S. It is widely touted in the media and is a great source of passive marketing for those organizations at the top of the list. Yet the sourcing of the raking numbers is the subject of the small print. Let’s look at the metrics and weighting that result in the rankings.

  1. Survivor score (32.5%) – comparing the number of Medicare inpatients with certain conditions who died within 30 days of admission in 2007, 2008, and 2009 with the number expected to die given the severity of illness.
  2. Reputation (32.5%) – Each year, 200 physicians per specialty are randomly selected and asked to list hospitals they consider to be the best in their specialty for complex or difficult cases.
  3. Other Care Indicators (30%) – These include nurse staffing, technology, and other measures related to qualityof care.
  4. Patient Safety Score (5%) – Harmful blunders occur at every hospital; this score reflects how hard a hospital works to prevent six of the most egregious types.


The # 1 and #2 ranked hospitals had the highest reputation scores while at the same time the lowest safety scores. The #1 hospital for safety was ranked #21 in the survey. How much current data has the publisher seen about the outcomes achieved by hundreds of hospitals and thousands of doctors around the country?  Answer:  None.  Why?  Because there is no current data published on such outcomes. 


The future of health care will be all about outcomes. Individual physician performance and health system reputation will be replaced by organization wide outcome measurements. These measurements will be transparent and available to all and mostly likely will result in a major shakeup of future national hospital rankings.