Inova Fairfax Makes a List Of the Top 50 U.S. Hospitals

Northern Virginia's largest hospital also is one of the America's best, according to health-care ratings released yesterday that list Inova Fairfax among the nation's top 50 hospitals.

The data-driven list by HealthGrades America is based on mortality and complication rates in handling 26 common procedures and conditions over a six-year span.

"This is a personal passion of mine -- quality and safety," said L. Reuven Pasternak, chief executive officer at Inova Fairfax. "Quality and safety is something everyone here lives and breathes every day."

Thirty of the top 50 hospitals on HealthGrades' list are concentrated in just four states -- California, Florida, Ohio and Pennsylvania. The top-rated hospitals included a few large institutions -- such as Inova Fairfax and Cedars-Sinai Medical Center in Los Angeles -- and many mid-size or smaller hospitals.

Notably absent were several hospitals -- including Baltimore's Johns Hopkins Hospital -- that appear on most lists of the nation's best.

The list is the 11th annual study produced by HealthGrades America, a private company that collects and markets data on hospitals and doctors, providing online information to consumers and consulting services to medical institutions. HealthGrades used 110 million hospitalization records to determine how frequently death or complications occurred when hospitals dealt with 26 procedures or conditions, including heart attack and pneumonia, and a wide range of surgeries and body part replacements.

"The goal is to identify those hospitals that performed well across the board," said Samantha Collier, chief medical officer for HealthGrades. "They performed at the top of their class year after year after year."

Collier said that, large or small, the common characteristic of the successful hospitals was that "it didn't happen by chance."

"It definitely starts with a visionary CEO, and one whose actions and behaviors are consistent with their vision," she said. "Even in hard economic times, quality is their strategy."

Stephen Moore, executive vice president for quality and safety at Inova Systems, said intense involvement by a diverse board membership, rigorous distribution of data within the Inova system, and a nurse-driven management model contributed to Inova's success.

"We're taking the health data and applying all the information we should to the care of the patient," Moore said.

Pasternak said the data management system reveals common errors and supervisor deficiencies that need to be addressed.

Inova Fairfax is the 833-bed flagship hospital of the Inova Health Care System. It is home to the only Level 1 trauma center in Northern Virginia, making it a destination for the critically injured.

HealthGrades is among a handful of entities that have responded to public clamor for medical guidance by evaluating, rating or ranking doctors and the nation's more than 5,000 hospitals. Solucient, a health data subsidiary of Thomson-Reuters, also markets rating information, and the magazine U.S. News & World Report publishes an annual list.

Each organization uses its own criteria for passing judgment, resulting in wide variance from one list to the next in those who receive top grades. For example, missing from HealthGrades' list are many of the hospitals that normally come out near the top in most ratings. Besides Johns Hopkins Hospital, they include the Mayo Clinic, the Cleveland Clinic, UCLA Medical Center and Duke University Medical Center. None of the hospitals ranked in the top 15 by U.S. News made HealthGrades' top 50 list.

"There are many academic centers that didn't make the list," Collier said. "That always calls into question the validity of this sort of list.

"I'm sure Johns Hopkins may be scratching their heads," she said, "but perhaps their outcomes in these 26 procedures wasn't as good."

A spokeswoman for the hospital did not return calls yesterday.

Collier said the HealthGrades list provides a window based purely on outcomes: "Did a patient live or die? Did they have complications?"

Collier said the reputations of many major medical centers are based on expertise with specialties and the overall scope of their work, beyond the 26 procedures and outcomes that fed into the statistical analysis.