US News....why not?

[ButIwantneuro]

---

Members do not see this ad.

There is often the talk that US News rankings don't necessarily correlate with quality of resident training. However, if we are to make the generalization that Hospitals are run by residents...and US news ranks hospitals....then doesn't US News indirectly measure resident training?

Thoughts?

 

[typhoonegator]

Hospitals are not run by residents. Hospitals are run by administrators. Patient care services may be "run" by residents, but patient care metrics are poorly tracked by USNews. Residents don't pull in NIH money, nor do they ensure the hospital has nursing Magnet status, nor do they push to make sure the hospital has a brand-new cyclotron in the basement. Quality and safety initiatives are not put forward by residents. Residents don't meet with donors, aren't responsible for public relations, or advertising, or getting that new building erected with private rooms and next-generation ORs. Those are the things that USNews cares about.

While you may think residents run the show because that is what you see every day, the strategic initiatives that are well-covered by the USNews ranking system are the result of well-focused (and well-financed) administrative efforts.

And lots of meetings. Outlook calendars full of meetings.

 

[ButIwantneuro]

I slightly disagree. While magnet status and cyclotron and etc...are important, it is still the residents (and nurses/ancillary staff) that run the place. The following is from the
US News website, methodology section. At least 37.5% of the rankings (survival and safety) seems to be a direct result of resident quality (though one can say 37.5 is not that much....)


"Survival score (32.5 percent). A hospital's success at keeping patients alive was judged by comparing the number of Medicare inpatients with certain conditions who died within 30 days of admission in 2008, 2009, and 2010—the three latest years for which data are available—with the number expected to die given the severity of illness. Hospitals were scored from 1 to 10, with 10 indicating the highest survival rate relative to other hospitals and 1 the lowest rate. Software used by many researchers (3M Health Information Systems Medicare Severity Grouper) took each patient's condition into account.

Patient safety score (5 percent). Harmful blunders occur at every hospital; this score reflects how hard a hospital works to prevent six of the most egregious types. Injuries during surgery and major bleeding afterwards are two examples of the six categories of medical mishaps that were factored in. A hospital among the top 25 percent in this regard earned a score of 3, those in the middle 50 percent scored a 2, and those in the lower quartile scored a 1.

Reputation (32.5 percent). Each year, 200 physicians per specialty are randomly selected and asked to list the hospitals they consider to be the best in their specialty for complex or difficult cases without considering location or expense. To reduce the possibility that year-to-year shifts in physician perspective will skew the rankings, U.S. News each year bases the reputational score on the combined results of three years of surveys. The figure published for each hospital is the average percentage of specialists in 2010, 2011, and 2012 who named the hospital. (In the four specialties where rank relies only on reputation, hospitals were ranked if they were cited by at least 5 percent of physicians who responded to the most recent three years of U.S. News surveys.)

Other care-related indicators (30 percent). These include nurse staffing, technology, and other measures that have been found to be related to quality of care. The main source was the American Hospital Association's 2010 survey of all hospitals in the nation."

 

[AlternateSome1]

Even if you were to assume that Survival Score and Patient Safety Score have a perfect correlation with resident training (which I think is far from the truth), almost the same percentage of the score results from a popularity contest, "Reputation". Factors which are more important to resident training would be: faculty support and mentorship, didactics, research opportunities, resident satisfaction, fellowship placements, and the variety of conditions seen.

 

[maddog2020]

Also remember that hospitals are not training programs. Importantly, residents in a given program may train at 2 or 3 different hospitals (each of which may be ranked separately by US News). Individually, these hospitals may not be at the top of the rankings but taken together, they provide a very outstanding training experience. As an example, one hospital may be considered a world-class trauma center but doesn't have much research. Another hospital in the program may have a well-recognized epilepsy program. Further, the residents may have access to research and an Alzheimer center that is associated with the medical school but not with any of the hospitals. So the US News focus on hospital metrics only tells part of the story.