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Shopping for Hospitals

Hospital Compare gives the nation's hospitals a report card for key best practices.

The site is designed to provide objective information about the quality of hospital care, scoring facilities on whether they engage in certain practices that give patients the best shot at getting better.

Hospital Compare, which went live on Friday, reports quality-of-care information for almost all acute-care hospitals in the U.S., around 4200 of them, according to the America Association of Hospitals.

Consumers can locate hospitals by state, county, city or zip code and choose which to compare. The tool shows how they stack up in caring for adult patients with three conditions: heart attack, heart failure and pneumonia.

For example, one of the best practices in dealing with heart attack victims is to administer a beta-blocker drug as soon as the person arrives at the hospital. Yet not all hospitals do this all the time. Consumers can see what percent of the time a given hospital administers the drug

The chosen hospitals are graphed against each other, as well as against the national and state averages.

The idea is not that someone in the midst of a heart attack will log on to decide where to tell the ambulance driver to go.

"People won't wait until they're sick to use it as a resource," said Priscilla Swanson, a quality improvement specialist with OMPRO, an Oregon nonprofit dedicated to improving the state's health care. "If you can compare different hospitals' [practices], it can give an indication of where they stand in their communities." She noted that the rankings were just one way consumers should evaluate hospitals.

Swanson said that consumer use of two similar Web sites, comparing home health care services and nursing homes, was rather light, but that the providers themselves paid attention.

John Todd, and MD and CEO of Stevens Hospital in Edmonds, Washington, said in a statement that when the hospital found itself lacking in one measurement during early 2004, it initiated staff training and dramatically improved internal results in the second half of the year.

"The participating hospitals as well as these umbrella organizations should be applauded for the patient safety and quality improvement efforts that they are making -- and especially for making this information available to the public," his statement read.

Project development began in December 2002, according to Alicia Mitchell, a spokeswoman for the American Association of Hospitals, and the health care facilities were able to access the results at the beginning of 2004, in advance of the launch of consumer access, giving them time to improve. Current rankings on Hospital Compare are based on the second half of 2004, and they'll be updated quarterly.

The online medical resource was developed by the Centers for Medicare & Medicaid Services (CMS), in partnership with the Hospital Quality Alliance.

It's not as easy as consumers might think for hospitals to implement all the best practices tracked by the online report card, Mitchell said. "A lot of steps have been taken, but there are a lot of different folks involved in delivery of care. Changing practices requires the education of nurses and physicians, and that doesn't happen overnight."

Said OMPRO's Swanson, "The first step in making a better health care system is acknowledging there is room for improvement. Hospital Compare helps everybody understand where our health care gaps are."



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