America's 'Best Hospitals' Annual Report Adds Nursing Criteria
By Robert Scally, assistant editor
Nursing has become a more important factor in U.S. News and World Report magazine's annual ranking of "America's Best Hospitals."
This year's 'Best Hospitals' report, which was published in the July 5 issue, added magnet hospital status to its list of criteria and changed another key nursing criteria that is factored into the study from nurse-to-bed ratio to nurse-to-patient ratio.
The 'Best Hospitals' report, published annually for the past 15 years by U.S. News and World Report, ranked 6,012 U.S. medical centers in 17 specialties. Military and veterans' hospitals are not included. The study was conducted for the magazine by the National Opinion Research Center at the University of Chicago.
The 'Best Hospitals' rankings are based on quality of care factors including nurse staffing, magnet hospital status, mortality rate, use of technology, procedure volumes and discharge planning. Of the 6,012 facilities studied, just 177 were deemed of high enough quality to be ranked in even a single specialty.
1. Johns Hopkins Hospital, Baltimore, Maryland.
2. Mayo Clinic, Rochester, Minnesota.
3. Massachusetts General Hospital, Boston, Massachusetts.
4. Cleveland Clinic, Cleveland, Ohio.
5. UCLA Medical Center, Los Angeles, California.
6. (Tie) Duke University Medical Center, Durham, North Carolina.
6. (Tie) University of California, San Francisco Medical Center, San Francisco, California.
8. Barnes-Jewish Hospital, St. Louis, Missouri.
9 (Tie) New York Presbyterian Hospital, New York, New York.
9 (Tie) University of Washington Medical Center, Seattle, Washington.
11. University of Michigan Medical Center, Ann Arbor, Michigan.
12. Brigham and Women's Hospital, Boston, Massachusetts.
13. Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
14. Stanford Hospital and Clinics, Palo Alto, California.
Only14 hospitals made U.S. News and World Report's honor roll, a ranking reserved for centers with very high scores in at least six of the specialties examined. Of the 14 hospitals that made the report's honor roll, six are designated as magnet hospitals.
"We're very pleased with this," Carol Cooke, spokeswoman for the American Nurses Association (ANA), said of the addition of nurse magnet status to the survey's criteria.
"Nursing care makes up a good portion of a patient's experience at a hospital," Cooke said.
Established in 1994, and officially known as the Magnet Nursing Services Recognition Program for Excellence in Nursing Services, the program was created as the result of a study of 41 hospitals by the American Academy of Nursing in 1982. The study identified factors in health care environments that help attract and retain well-qualified nurses, as well as helping to provide high quality patient care with first-rate nursing services.
The ANA's subsidiary, the American Nurses Credentialing Center, is the organization responsible for evaluating hospitals and bestowing magnet status.
As of February 2004, there were 102 hospitals in the U.S. with magnet status, according to the ANA.
In 1994, the University of Washington Medical Center in Seattle, Washington, became the first hospital to receive magnet status and has since been redesignated a magnet hospital twice, said Catherine Broom, ARNP, clinical specialist and magnet project coordinator at the University of Washington Medical Center.
The University of Washington Medical Center made the Best Hospitals honor roll list, tying for the 9th spot out of 14 on the honor roll with New York Presbyterian Hospital in New York City.
Having magnet status paid off for the University of Washington Medical Center by helping to attract and retain quality nurses and other health care staff, improving patient outcomes and helping land the hospital on the 'Best Hospitals' list several years in a row, Broom said.
"It [magnet hospital status] is part of our organization's commitment to quality," Broom said.
Barnes-Jewish Hospital in St. Louis, Missouri, placed eighth on the 'Best Hospitals' honor roll list, in part because of it magnet hospital designation, which it obtained in October 2003.
"For us, quality health care means having quality people," said Patti Crimmins Reda, RN, MSN, director of patient care at Barnes-Jewish.
The St. Louis area is fortunate to have several quality nursing schools and having magnet status means that Barnes-Jewish can attract the best of the best nursing school graduates, Reda said.
Reda said that Barnes-Jewish's commitment to quality nursing care is solidly supported by senior managers such as Sharon O'Keefe, Barnes-Jewish's chief operating officer, who is a former nurse, and Coreen Vlodarchyk, RN, BSN, MSA, the hospital's vice president of patient care services.
The commitment to quality nursing care that helped Barnes-Jewish make the 'Best Hospitals' honor roll has also helped improve patient outcomes as former patient James Henneberry can attest.
Henneberry credits the exceptional care at Barnes-Jewish with saving his life. After Henneberry was diagnosed with a viral heart infection that led to heart failure, he had a left ventricular assist device installed to assist with heart function as he awaited a possible heart transplant, according to a statement from Barnes-Jewish.
A member of the nursing staff discovered a clot and Henneberry underwent additional surgery where it was determined that his heart could recover and a transplant would not bet needed. Henneberry has since completely recovered.
Henneberry recalls the "exceptional professionalism and compassion" of the Barnes-Jewish nursing staff and physicians.
"I was very scared and every single nurse who attended me made me feel a little better about the situation in his or her own way," Henneberry said in a statement. "No matter day or night, each nurse on-duty was helpful, reassuring, personable and professional."
Stanford Hospital and Clinics in Palo Alto, California, which made the Best Hospitals honor roll in 14th place, is actively pursuing magnet status, said Deborah Grant, RN, MBA, associate director of nursing at the Stanford Hospital and Clinics.
"Nursing contributes to the overall excellence by providing excellent patient care while they are in the hospital," Grant said in an e-mail. "Over the last year, as [California's legally mandated nurse-to-patient] ratio's have been implemented, we have implemented a new nursing model that allows the RN to spend more time with the patient."
Stanford has also made it a priority for nursing to oversee and coordinate the care that patients receive while they are in the hospital, Grant said.
"We also have a very strong management team within each of the units that helps mentor, train and guide the staff to achieve their best," Grant said.
To read the complete report, visit the U.S. News and World Report Web site .
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