You research the pros and cons and shop around before you buy a car—so why not compare local hospitals in case you, or someone close to you, becomes ill or has an accident? Lack of accessible information may have discouraged you from taking a close look in the past, but the Centers for Medicare & Medicaid Services (CMS) reports hospital error rates on its website. The information is right there at Medicare.gov/HospitalCompare/search.html, making it easy to see how the various medical centers in your area stack up against each other. So what can you find out?

ADVERSE EVENTS: MORE COMMON THAN YOU THINK
Hospital-acquired conditions (HACs) are also called “never events”—because they are serious problems that people develop in the hospital that should seldom, if ever, happen as long as proper procedures are followed. As an example, according to the Department of Health and Human Services’ Office of the Inspector General, 13.5% of hospitalized patients on Medicare experience preventable adverse events such as falls and infections. That’s clearly way more than “never”…and way too many.
The CMS tracks hospitals’ rates on these eight “never events”…
  • Foreign objects. Yes, it really is true—sometimes surgeons accidentally leave a sponge or clamp in a patient’s body.
  • Air embolism. Without proper care and attention, a dangerous air bubble may develop in your bloodstream. This can happen with a central IV line and during vascular procedures.
  • Mismatched blood. Hospitals occasionally administer the wrong type of blood in a transfusion.
  • Severe pressure sores. If you can’t move around independently and caregivers don’t help you shift position frequently, you can develop painful and potentially life-threatening pressure sores, what most people call bedsores.
  • Falls and injuries. Without proper assistance, a simple trip to the bathroom may result in a fall and a debilitating injury.
  • Vascular catheter-associated infection. This is a blood infection from catheters—small tubes that are used to treat heart disease or other disease and carry a risk for sepsis.
  • Catheter-associated urinary tract infections. Catheters also are used to help patients urinate, and infections are a common complication.
  • Uncontrolled blood sugar. Signs of poorly controlled blood sugar range from confusion, anxiety and sweating (low blood sugar or hypoglycemia) to headaches, blurred vision and fatigue (high blood sugar or hyperglycemia). This is a concern for hospital patients with diabetes and also for others—for instance, those for whom the stress of hospitalization is too much. Pregnancy can cause short-term hyperglycemia as well.
After reading through that list, are you ready to take yourself to just any old hospital? I didn’t think so. It’s clearly a good idea to track error rates, notes E. Wesley Ely, MD, MPH, a professor and specialist in pulmonary and critical care medicine at Vanderbilt University Medical Center—but, he adds, it’s something that needs to be done very carefully for the benefit of both patients and the hospitals themselves. For example, it’s reasonable and helpful to hold hospitals responsible for mistakes such as transfusing the wrong blood type or leaving a foreign object in a patient during a surgical procedure—but it’s not helpful to automatically blame hospitals when patients develop delirium after surgery, as the CMS originally proposed, because delirium is not always preventable. Fortunately, the CMS reversed its position on this condition, says Dr. Ely.
WHAT YOU NEED TO KNOW BEFORE YOU GO
To increase your odds of a safe and successful hospital stay, become an educated consumer…
Check hospital ratings. Visit CMS’s website and read about hospital errors. You’ll find the incidence rate for each of the eight HACs in the nation’s 4,700 hospitals. That is how many times an HAC has occurred per 1,000 discharges. At Medicare.gov/HospitalCompare/search.html, you also can learn how satisfied other people were with their hospital stays…how closely hospitals followed best practices of care…how many people died within 30 days of hospitalization for a heart attack, heart failure or pneumonia…and 30-day readmission rates for these conditions.
Don’t pay for their mistakes. Medicare does not pay for treatment of conditions that result from hospitals’ mistakes, and you don’t have to either. If you develop any of the eight above conditions in the hospital, you can’t be charged for the resulting necessary treatment, according to the Deficit Reduction Act of 2005.
Work with caregivers as a team. For best results, Dr. Ely urges families to communicate closely with doctors, nurses and other health-care professionals. Provide caregivers with a complete list of all prescription and over-the-counter medications and supplements that the patient takes so that nothing gets overlooked in an emergency. This is particularly important so that doctors can avoid drug interactions with new medications they might prescribe. Ask questions about the risks and potential benefits of treatment options, and speak up about any other concerns, such as a patient being sedated too deeply or for too many days. As well-meaning as most health-care professionals are, the demands of their jobs mean that a patient’s quality of care isn’t necessarily automatic.
Safer at home. Dr. Ely also encourages you to keep talking to your hospitalized loved ones so they remain as oriented and aware as possible…so that they get out of bed sooner…recover and come back home where they belong. It’s much safer there!