Every summer, when U.S. News & World Report releases its latest Best Hospitals rankings, it publishes the corresponding methodology, which usually reflects specific changes to one component or another.
The upcoming 2014-2015 rankings are set to release this June or July, and U.S. News & World Report has already announced some important methodology changes. These changes could have a significant impact on hospitals’ scores. Let’s take a closer look at these changes to better understand how they will play a role in the Best Hospitals ranking.
Patient Safety Is More Important Than Ever
First and foremost, the weights of the four key components have shifted. The new methodology weighs Patient Safety more heavily, which will now double to 10 percent of the overall weight moving forward. Process – or reputation – will have less weight, with now only 27.5 percent of the overall weight.
Second, two additional Patient Safety Indexes (PSI) will be included in the scoring—PSI 03 and PSI 08, which respectively capture incidences of skin breakdown (decubitus ulcer) and postoperative hip fracture. Hospitals will want to ensure any internal efforts to reduce patient safety issues include these two PSIs as well. Third, RTI International (the research company that conducts the data analysis for U.S. News & World Report) has announced the possibility of giving credit to hospitals that conduct hospital surveys on patient safety culture.
Lastly—and very important—U.S. News & World Report has announced that the patient safety scoring itself will change. In the past, hospitals were assigned one of three categories: high, modest, or low. In 2014-2015, RTI will calculate the Patient Safety Score as a continuous variable, based on each hospital’s composite score in the eight PSIs. The prior scoring method had hospitals in the 25th and 75th percentiles lumped into the same score of “Modest.” Those hospitals closer to the 25th percentile will no longer benefit from a “Modest” scoring. Instead, their actual variable score will be used, which is likely to bring down their overall ranking. Conversely, those who were in the 75th percentile will benefit from being at the top of the range, and will now receive a higher variable patient safety score.
Collectively, these methodology changes put a much greater emphasis on patient safety, which is not surprising as the entire industry shifts to a value-based system focused on quality and patient satisfaction.
U.S. News & World Report Taps Social Media for Physician Votes
In addition to the reduction of the Process/Reputation Score weight from 32.5 percent to 27.5 percent, U.S. News and World Report has announced it has surveyed board-certified physicians via Doximity.com to vote for their “Best Hospital.” These votes are in addition to the mailed/emailed survey that goes to board-certified physicians on the AMA Master File. It is worth noting that the AMA survey will still account for the majority of the Process/ Reputation Score. However, this change indicates that RTI is evaluating other methods of reaching and surveying a broader mix of board-certified specialists across the country. While some may be concerned that hospitals will attempt to “stuff the ballot box,” RTI International has already stated that they will use best practices to prevent biases in the results.
One thing is certain—healthcare is an ever-changing landscape, and healthcare leadership must evolve or go extinct. Ranking methodologies simply reflect the changes occurring in the industry, so paying close attention to rankings goes beyond your reputation—it goes to the heart of your institution and providing high-quality, patient-focused care.