How to choose a hospital

This is a hard question for most people as the “Quality guidelines” are very subjective. But we have choices in which ER to visit or which hospital to have scheduled surgery. If you call 911 you can INSIST on your choice hospital.

Do some research and call an administrator of the hospital in your area. Ask them these questions:

1. What is the nurse to patient ratio in the ER and on the floor? Obviously the lower the better. Want to catch a sneaky administrator in a lie? Then call the actual ER/Floor and ask one of the Nurses there what the ratio is THAT DAY.
2. Who takes care of me at night? Meaning the doctor. YOUR doctor will be asleep. But someone is going to be managing your care if you have problems overnight. Many hospitals, even “good ones,” even some transplant hospitals, have NO ONE in the hospital overnight except the ER doc and (sometimes) the OB for Labor and Delivery. And the ER docs only come in the event of cardiac arrest. THE BEST hospitals have ICU Intensivists (Doctors who specialize in ICU care) on 24 hours a day, early response teams to prevent severe adverse events and Hospitalists (doctors who only admit and manage patients in the hospital). While it is nice to have your own doctor, who knows you, to take care of you in the hospital, they don’t do you much good if they are home sleeping when you get sicker.
3. What is your nosocomial infection rate? In other words, how many people who enter the hospital get an infection FROM the hospital. In some hospital ICUs it can be as high as 90%. You don’t want to be at that hospital.

OTHER TIPS:

• Choose a children’s hospital for your kids.
• If you have a Neurosurgical Issue, go to a hospital with a dedicated Neurosurgical ICU.
• Go to a Level 1 Trauma Center for your major trauma (Bad Car Accidents, Stabbings, Shootings, Falls from a height). This is usually your local County Hospital or University Hospital. If the ambulance Paramedic tells you they are “Diverting” you to a trauma center NEVER insist on your “favorite hospital.” It could be a fatal decision.
• If you have hospital based insurance like Kaiser that limits where you can go, make sure you go straight to a Kaiser hospital. If you don’t you can suffer for a number of reasons: 1. It takes longer to get admitted because the ER doc needs to get Kaiser approval that can take upwards of an hour 2. You might have to get transferred to a Kaiser hospital for admission which delays your care 3. If you get transferred you can’t take any ambulance — you need a Kaiser ambulance, which also can take hours to arrange, therefore delaying care. 4. If you get permission to stay in that non Kaiser hospital, they won’t have your records which could delay your care or lead to duplicate testing (this is true for all patients who go to a hospital that is different than their usual)
• If you are pregnant and in labor, go to the hospital where your doctor works. Otherwise, you will get a doctor who knows nothing about you and your pregnancy, and despite what you may think, this can make a difference in the care you receive.