YESTERDAY'S ARTICLE ABOUT A CONSUMER SURVEY OF HOSPITALS SHOULD HAVE INCLUDED SIBLEY MEMORIAL HOSPITAL AS AMONG THOSE IN THE REGION OFFERING THE BEST MEDICAL CARE. THE HOSPITAL'S NAME WAS ERRONEOUSLY LEFT OUT OF THE LIST AND NEWS RELEASE SUPPLIED BY WASHINGTON CONSUMERS' CHECKBOOK, WHICH CONDUCTED THE SURVEY. (Published 10/7/87)
More than 4,500 physicians, nurses and patients, responding to a consumer survey, have rated Children's Hospital, Johns Hopkins Hospital and Fairfax Hospital as offering the best medical care in the region, while also giving high marks in "pleasantness" to Children's, Malcolm Grow Medical Center and Loudoun Memorial Hospital.
The survey, published in the current issue of Washington Consumers' Checkbook magazine, examined a wide range of medical services and rated 44 area hospitals on the quality of nursing care, skill of physicians, surgical and obstetric performance and hospital food. The magazine also compared daily rates for semiprivate rooms and, for Maryland hospitals only, published data comparing the ratio of deaths to total number of cases.
While cautioning that its survey should not be considered a "definitive" study, the consumer magazine said it found "a high degree of agreement" among doctors and nurses in ratings of medical service and said that the information could be useful in selecting a hospital. Also, according to the magazine, patients' ratings were similar to those of doctors and nurses on the nonmedical questions that all three groups were asked to judge.
The Checkbook article cited certain limits on its data, including possible biases of physicians and the fact that hospital death rates do not reflect deaths that might occur after discharge. But the consumer publication noted that hospitals with the lowest death rates tended to receive relatively good ratings for medical care.
The 10 hospitals rated highest in medical quality were Johns Hopkins in Baltimore, Children's, Fairfax Hospital, Georgetown University Hospital, Washington Hospital Center, the National Institutes of Health Clinical Center, Shady Grove Adventist Hospital, Columbia Hospital for Women, Arlington Hospital and Bethesda Naval Hospital.
The survey did not give each hospital a specific, overall score.
For pleasantness, including the quality of food and cheeriness of hospital rooms and staff, top ratings went to Malcolm Grow Medical Center at Andrews Air Force Base, Children's, Loudoun Memorial, Shady Grove Adventist, Columbia, Sibley Memorial Hospital, Fair Oaks Hospital (formerly Commonwealth), Northern Virginia Doctors Hospital, DeWitt Army Hospital, Mount Vernon Hospital and National Orthopaedic Hospital.
According to the survey, D.C. General Hospital, Leland Memorial Hospital, Hadley Memorial Hospital, Veterans Administration Hospital, Prince George's General Hospital, Greater Laurel-Beltsville Hospital and Southern Maryland Hospital were rated among the lowest in providing quality medical care. D.C. General, Prince George's and Southern Maryland also were rated among the least pleasant.
The magazine's "death rate index" for hip replacement, colon surgery for cancer, stroke and heart attack cases was supplied by the Maryland Health Services Cost Review Commission.
Maryland is one of the few states to compile such data, and it showed that Johns Hopkins Hospital had the lowest number of deaths compared with the number of cases, while Leland Memorial and Southern Maryland had the highest, according to stastics in reports from 1983 through 1986.
At Children's yesterday, the Consumers' Checkbook article was circulating throughout the hospital and officials were "delighted" with the survey results, according to a spokeswoman.
"It's a very satisfying feeling," said Beverly Jackson.
But at Leland Memorial, spokeswoman Lynelle Smith said the survey gave an unfair portrait of hospital care and was flawed because smaller hospitals such as Leland have a smaller case sample to draw from and were probably rated by a smaller group of doctors, nurses and patients.
"This can really accentuate any type of variation," she said. "If there are only two to three deaths difference, it can make enough difference to really make us look awful."
Robert Krughoff, president of Washington Consumers' Checkbook, said the survey, the second and most comprehensive published by the magazine, "gives consumers a starting point, a point of discussion as they are talking with a doctor about where that doctor is sending them."
It should also, he said, "advance everyone's understanding of what we mean by hospital quality and the problems in measuring that quality."
The magazine received survey ratings from 437 physicians, more than 2,000 nurses and more than 2,000 consumers/patients.
Scores for hospitals with fewer than 10 ratings were not included in the survey.
Hospitals were rated on the quality of laboratory services, the quality and quantity of nurses, the quality of operating room services, the overall skill of physicians, the pleasantness of rooms and food, and the quality of communications and coordination among the administrative, physician, nursing and support staffs.
Johns Hopkins, not considered an area hospital, received few specific ratings from survey respondents. But the facility was included, Krughoff said, after receiving more positive and "most desirable" ratings than any other hospital outside the area.
For major surgery on adults, according to the survey, Georgetown, Sibley, Washington Hospital Center, Holy Cross Hospital, Johns Hopkins and Fairfax were "consistent favorites."
Children's, Georgetown, Johns Hopkins and Fairfax received high marks for surgery on children, while Columbia, Sibley, Holy Cross and Alexandria were rated highly for having the most uncomplicated delivery of babies.
The ratings by physicians ranged from a low of minus 100, which several hospitals received in certain categories, to a high of 100, also a score attained by several facilities.
The article also showed a wide difference in costs.
The daily rate for a semiprivate room, for example, ranged from $179 at AMI Doctors Hospital and Southern Maryland Hospital Center in Prince George's County to $484 at George Washington University Hospital.