What Makes a GREAT Hospital?

What factors most influence the quality of patient care? Having the most skilled physicians? The best electronic medical records? The most advanced technology?

I have worked in many clinical settings with a variety of work cultures, and those that encourage communication, accountability, and smooth operations and organization make it easiest for physicians to provide the best patient care. In settings that have multiple "layers" of on-call doctors, for example, it may take an hour or more to find the doctor who is "responsible" for a given patient, and this doctor rarely knows anything about the patient in question, making communication complicated and allowing for less than ideal patient care. In other medical environments, the culture may be to "outshine" your colleagues and demonstrate that you know more than they do or to "point a finger" if something goes wrong. In both of these situations, the culture does not support optimal patient care

An article in the New York Times eloquently discusses these issues and also reviews the findings of a recent Annals of Internal Medicine article that studied what factors influenced the mortality of patients with heart attacks at top- and low-performing hospitals. The results of this study are not surprising to a practicing physician and echo what I have observed in my own practice. Indeed, the investigators observed that an institution with well organized operations and protocols, clear communications among providers, and a supportive environment result in better patient outcomes.

For graduating residents contemplating what job offer to accept and for patients deciding at which hospital to receive care, evaluating a hospital's culture is not always easy, however, and often can be discovered only by spending time in the actual environment.

Click Here to read the article.