America’s Best Hospitals Award Methodology
The Women’s Choice Award has identified America’s Best Hospitals across our nation to help women make smart healthcare choices. Our goal is to simplify your choice of hospitals as we understand how this critically important decision can impact you and your family. Being treated with the proper level of care impacts your health, well-being and healing so our goal is to identify those hospitals that have demonstrated the highest level of quality care to their patients, with a special focus on the female experience.
Being named and recognized as a hospital of choice among women is an honorable achievement as it represents the strongest and most important consumer message in today’s healthcare marketplace. Considering that women account for 90% of all healthcare decisions for her and her family, being a hospital of choice women trust is commendable.
Our methodology is unique in that it is the only national list that simplifies a women’s choice when selecting a hospital. Our understanding of what matters most to women when selecting a hospital is based on surveys of tens of thousands of women, as well as research conducted in partnership with the Wharton School of Business on what drives the consumer experience for women vs. men. This research led us to understand that we cannot separate clinical performance from patient experience. Furthermore, all of the methodologies below take into consideration the female recommendation rating based on patient feedback.
America’s Best Hospitals for Patient Safety Methodology
The America’s Best for Patient Safety award identifies those hospitals that have had a low incidence of problems arising from surgical errors, and infections. The hospitals that report their frequency to The Centers for Medicare and Medicaid Services (CMS) are ranked for each of the eleven measures. Here is the complete list:
- Deaths among Patients with Serious Treatable Complications after Surgery
- Collapsed lung due to medical treatment
- Serious blood clots after surgery
- A wound that splits open after surgery on the abdomen or pelvis
- Accidental cuts and tears from medical treatment
- Serious complications
- Central line-associated blood stream infections (CLABSI)
- Catheter-Associated Urinary Tract Infections (CAUTI)
- Surgical Site Infection from colon surgery (SSI: Colon)
- Methicillin-resistant Staphylococcus Aureus (MRSA) Blood Laboratory-identified Events (Bloodstream infections)
- Clostridium difficile (C.diff.) Laboratory-identified Events (Intestinal infections)
Hospitals can be eliminated from consideration for the following:
- Not reporting on at least 4 of the surgical complication measures (1-6) or 4 of the infection measures (7-12),
- Having a below average patient recommendation rating,
- Ranking in the bottom 5% for any one of the measures,
- Not implementing surgical checklists.
For the remaining hospitals, we averaged their rankings for all the measures (weighted slightly toward surgical errors as a result of our women’s survey) and cut off our award list with those that averaged in the top third nationally. This resulted in a list of 311 hospitals that earned the 2015 America’s Best for Patient Safety Award.
America’s 100 Best Hospitals for Patient Experience Award Methodology
The America’s 100 Best Hospitals scoring process is unique in that it is the ONLY national list that focuses on female patient satisfaction. The process begins with scores derived for each hospital in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) database. The score takes a subset of the questions HCAHPS uses that research and experience shows are more important to women than to men. Weight is applied to each of those questions to adjust for relative importance to arrive at a numerical score. The scoring is totally objective and uniform. The best 100 scores in each of the 4 size categories determine the America’s 100 Best Hospitals for Outstanding Patient Experience award winners.
America’s Best Hospitals for Obstetrics Award Methodology
The America’s Best Hospitals for Obstetrics scoring process is unique in that it is the ONLY national list that is evidence-based and focuses on female patient satisfaction. We identify those hospitals that offer obstetric services that also ranked above the national average for HCAHPS recommendations (Definitely would recommend), then gave additional credit for those having a NICU on-site. Hospitals that had very low rates of early elective deliveries (0-1%) were also boosted, but hospitals could be severely penalized for very high EED rates (14% or more). Additional credit was given to hospitals that we ranked above the national average for Patient Safety. The resulting list was cut off to limit the award to the top 371 or 15% of eligible hospitals.
America’s Best Hospitals for Heart Care Award Methodology
The America’s Best Hospitals for Heart Care scoring process is unique in that it is the ONLY national list that focuses on female patient satisfaction. These hospitals are determined first by identifying hospitals that offer a minimum number of cardiac and/or vascular services. Only hospitals that perform well clinically with regard to heart care measures, and also have a high recommendation rate, a measure that is very important to women in choosing a hospital, are selected. Data, made available by Medicare is then utilized in a method that is totally objective and uniform. No subjective considerations are used to determine the award winners. The process resulted in 353 hospitals receiving the award out of a population of over 4,600 facilities.
This method uses data released by Medicare in July 2013 that covers the four quarters ended September 30, 2012. Only those hospitals that supplied data regarding the Outcome of Care Measures were considered. The Outcome of Care Measures used were:
a) Death within 30 days of admission for heart attack
b) Death within 30 days of admission for heart failure
c) Readmission within 30 days for heart attack
d) Readmission within 30 days for heart failure
The top 25% of those hospitals are then identified based on an average ranking over those four measures. The resulting hospitals were screened based on their recommendation score from HCAHPS* data for the same period. As this is the single most important consideration used by women in selecting a hospital for themselves and their family, the only hospitals included were recommended by four out of five patients surveyed. A final screening was done to eliminate any hospital that had an abnormal CLABSI** rate as reported by Medicare.
* HCAHPS – Hospital Consumer Assessment of Healthcare Providers and Systems
** CLABSI – Central Line Associated Blood Stream Infection
America’s Best Hospitals for Orthopedics Award Methodology
The America’s Best Hospitals for Orthopedics ranking process is unique in that it is the ONLY national list that emphasizes female patient satisfaction. The best hospitals for orthopedics are determined first by identifying hospitals that provided comprehensive orthopedic services, indicating a minimum number of arthroscopy, joint replacement and spine surgery services, as well as offering onsite MRI and physical therapy. Those full service hospitals were then judged on their HCAHPS results for patient recommendations and post-operative recovery instructions, measures that are very important to women in choosing a hospital. Hospitals could be disqualified for abnormally high rates of surgical complications and infections. Data made available by Medicare is utilized in a method that is totally objective and uniform. No subjective considerations are used to determine the award winners.
America’s Best Breast Centers Award Methodology
America’s Best Breast Centers award recipients have all met the National Accreditation Program for Breast Centers (NAPBC) standards from the American College of Surgeons. They also carry the Seal of the American College of Radiologists as a Breast Imaging Center of Excellence (BICOE), and score above the national average on the Centers for Medicare and Medicaid Services patient recommendation measures, or their equivalent.
America’s Best Hospitals for Emergency Care Award Methodology
Hospitals (including critical access facilities that report to CMS) earn the Emergency Care award if they consistently rank among the best of the 3,800 hospitals reporting on their Emergency Department’s performance. They were judged on the following Emergency Department performance measures reported by the Centers for Medicare and Medicaid Services:
- Average number of minutes before outpatients with chest pain or possible heart attack got an ECG
- Average time patients spent in the emergency department, before they were admitted to the hospital as an inpatient
- Average time patients spent in the emergency department before they were seen by a healthcare professional
- Average time patients spent in the emergency department, after the doctor decided to admit them as an inpatient before leaving the emergency department for their inpatient room
- Average time patients spent in the emergency department before being sent home
- Average time patients who came to the emergency department with broken bones had to wait before receiving pain medication.
- Percentage of patients who came to the emergency department with stroke symptoms who received brain scan results within 45 minutes of arrival
- Percentage of patients who left the emergency department before being seen
Each of these measures is weighted according to a survey of over 1000 women on their relative priority. They are listed above in their order of importance.
Hospitals that fell below the bottom 25th percentile for patient recommendations are eliminated from further consideration. For each ED measure, the top 25th percentile and the top 50th percentile are determined for all hospitals reporting the measure. Hospitals that ranked in the top 25% nationwide for a measure received points according to the measure’s relative importance. Hospitals that ranked between 25% and 50% received half points. Points are totaled for all measures for each hospital. Those hospitals with total scores that put them in the top 10% nationally earn the award.
America’s Best Hospitals for Cancer Care Award Methodology
Hospitals were selected for the America’s Best Hospitals for Cancer Care award from those that have received accreditation from the American College of Surgeons Commission on Cancer (ACS/CoC) as either
- a National Cancer Institute (NCI) Designated Comprehensive Cancer Program,
- a Comprehensive Community Cancer Program,
- an Integrated Network Cancer Program.
- an Academic Comprehensive Cancer Program.
Those selected hospitals were then given a score based on their patient recommendation rating from the Centers for Medicare and Medicaid Services’ (CMS) Hospital Consumer Assessment for Healthcare Providers and Systems (HCAHPS). The hospitals could then be elevated in the rankings if they offered on-site chemotherapy, radiation or hospice. NCI designated programs were additionally elevated for their cancer research activities. Cancer Centers could also be penalized for having high infection rates.
America’s Best for Extended Care Award Methodology
The Extended Care award was given to those facilities that have 25 or more residents, and have received at least 19 combined stars in the four categories in the Centers for Medicare and Medicaid Services (CMS) five-star rating system. The CMS rating categories are:
- General Staffing
- RN staffing
- Quality rating
- Inspection survey rating
Recipients must also have:
- Medicare certification
- Full sprinkler systems
- No recent history of penalties or fines.
Only 400 facilities were awarded out of over 15,000 across the nation.
America’s 50 Best Hospitals for Stroke Care
The America’s 50 Best Hospitals for Stroke Care scoring process is unique in that it is the ONLY national list that is evidence-based and focuses on female patient satisfaction. The process begins with identifying which hospitals are accredited as an Advanced Primary Stroke Center (some are Advanced Comprehensive Stroke Centers) by the Joint Commission. Then, our high standards require that the center meets clinical and patient level data that qualifies them as excellent clinically with high patient recommendations.
Hospitals that earned the award have met our criteria in the following areas:
- The time from emergency department arrival to head CT scan
- The time from first symptoms to receiving thrombolytic therapy
- Provision of stoke education for patient and family before discharge
- Patient recommendation scores above the national average
- Comparatively low mortality rate
America’s Best Stroke Centers
Hospitals earning the 2015 America’s Best Stroke Centers Award must be accredited by the Joint Commission/American Heart Association Comprehensive Stroke Center Certification. The Comprehensive Stroke Center Certification recognizes centers that meet high standards for stroke care as determined by the American Heart Association/American Stroke Association. To receive advanced certification, Stroke Centers must meet disease-specific requirements, clinically specific requirements and expectations which include:
- Use a standardized method of delivering care
- Support patient self-management activities
- Tailor treatment and intervention to individual needs
- Promote the flow of patient information across settings and providers, while protecting patient rights, security and privacy
- Analyze and use standardized performance measure data to continually improve treatment plans
- Demonstrate their application of and compliance with clinical practice guidelines published by the AHA/ASA or equivalent evidence-based guidelines
In order to be accredited as a Comprehensive Advanced Stroke Center, the center must meet additional requirements.
In addition, publicly available data from the Centers for Medicare and Medicaid Services (CMS) and patient recommendation ratings data were included when assessing each hospital’s clinical performance.
Accountable Care Organizations
The Women’s Choice Award recognizes Accountable Care Organizations (ACO) that have achieved the highest standards of care. These groups and the providers within them work to empower patients and share the mission and vision of the Women’s Choice Award. Our research based standards are the only evidenced-based award that combines both clinical and patient experience results most highly regarded by women. Our methodology is transparent, and uses only objective data; no self-reported information is included in our research. This makes the Women’s Choice Award the gold standard; a beacon for women as they make.
To determine eligibility, our research department selected 17 data points from the 33 items reported to the Centers for Medicare and Medicaid Services (CMS) by 220 ACO’s to CMS as part of the Medicare Shared Savings program. We compared ACO’s nationwide to identify the highest ranking organizations in key areas such as patient/caregiver experience, care coordination and prevention. The ranks were then averaged, with additional weight given to the measures that women we surveyed said are most important to them (doctor communications and shared decision making). The top ACOs earned the award.
Women trust the Women’s Choice Award in selecting their hospitals and services within them. Creating the Women’s Choice Award for Accountable Care Organizations is the next phase in our mission to empower women to select the best physicians and organizations for her that share her concerns and ideals for achieving the best healthcare for her and her family.
Remember our goal is to empower women, which happens through the sharing of information, and our corporate award recipients fund our programs which include a free consumer advocacy, educational resources, and donations to women’s causes and events.
Ladies, help us celebrate those hospitals who have earned the Women’s Choice Award by congratulating them and rewarding them with your business and referrals! Together we will continue to raise the standard of healthcare.
Being recognized as a hospital of choice among women takes the commitment of leadership and staff and ongoing devotion to providing every patient with optimal care. These hospitals will serve as an example to all hospitals while setting new standards of healthcare excellence for women, their families and their community.