When Washington-area nurses were asked to choose where they would prefer to be patients, the area hospitals they ranked most highly were Georgetown University Hospital, Columbia Hospital for Women, Wasington Adventist Hospital, Holy Cross Hospital and Fairfax Hospital.
On the other hand, they gave low marks to D.C. General Hospital, Capitol Hill Hospital, Virginia's Jefferson Memorial Hospital and Maryland's Suburban and Prince George's General.
The ratings come from a survey of 349 registered nurses in the Washington area conducted as part of a study on hospital care and published today in the magazine Washington Consumers' Checkbook.
The nurses' names were drawn from state licensing lists and lists provided by agencies that supply hospitals with temporary nurses. Besides naming her own choice of hospitals, each nurse ranked the hospitals where she had worked more than five days during the past year on such questions as whether there were enough nurses on duty, whether doctors could be reached in emergencies, and whether equipment was adequate.
Two-hundred twenty-six of the nurses ranked only one hospital, indicating that they were probably full-time employes rather than temporary nurses floating from job to job.
The results reveal dramatically different perceptions of the quality of patient care offered by each hospital. For example:
Sufficient numbers of nurses: Georgetown University Hospital and Sibley Hospital had the highest percentage of "good" ratings. Capitol Hill Hospital and Suburban Hospital in Bethesda scored lowest.
Availability of doctors in an emergency: Fairfax Hospital and Washington Adventist Hospital scored highest.
Capitol Hill, D.C. General, Suburban Hospital and Doctor's Hospital of Prince George's County scored lowest.
Adequacy of equipment and supplies: Washington Adventist, Fairfax and Children's Hospitals were rated best. D.C. General, Capitol Hill Hospital, and Eugene Leland Memorial Hospital in Riverdale got lowest marks.
Communication among staff: No hospital scored high, but Capitol Hill Hospital, D.C. General Hospital, Suburban Hospital and Northern Virginia Doctors' Hospital ranked at the bottom.
Overall, the two problems identified most often were a shortage of nurses and lack of communication between members of hospital staffs.
Of all the categories graded, nurses gave highest marks to the skill of their colleagues.
The survey provoked indignation from administrators contacted at hospitals that received low marks. Several pointed out that the scores were based, in some cases, on responses of only a handful of nurses -- those who had worked at a particular hospital during the past year.
For example, while 50 nurses answered the questionnaire on the Washington Hospital Center and 45 commented on Georgetown University Hospital, only 10 nurses were able to comment on Suburban Hospital and only 15 on D.C. General.
"There are less biased or more objective ways of examining things," said a D.C. General spokesman. "We don't feel that it's all that effective as a consumer guide."
Representatives of a number of area hospitals declined to comment on the survey. Administrators at Prince George's General Hospital and Jefferson Memorial Hospital questioned some findings on their institutions, saying that the periodic patient and employe surveys they conduct are uniformly favorable.
A spokeswoman for Suburban Hospital disputed the opinion of some nurses that doctors there were hard to reach in an emergency. She said the hospital had an effective backup system in case a doctor was unavailable.
She acknowledged that the hospital's nursing shortage and problems with staff communication were areas of concern. "We're doing a lot of changing right now," she said.
A spokesman for Capitol Hill Hospital discounted the report, saying the hospital has been fully accredited by the Joint Commission on Hospital Accreditation and licensed by the D.C. government.
"We believe these are the criteria by which all hospitals should be evaluated," he said.
The survey appears to be the first attempt to rate hospitals by questioning nurses, according to Robert Krughoff president of the Washington Center for the Study of Services, which publishes the magazine.
Krughoff said he hoped the nurses' opinions would provide readers with information that they could weigh along with their doctors' advice in choosing a hospital. He acknowledged that it might be difficult to assess hospitals where few nurses had responded. "It was much easier to find nurses working at some hospitals than at others," he said.