How to choose a hospital PART 2

I have some additions and clarifications to my previous post.

To the above tips I add:

7) Find out which hospital closest to you has 24 hour cardiac catheterization capabilities. If you have a heart attack, you do not want to go to a hospital that is going to have to transfer you for this critical life-saving procedure. Time is muscle!

8) Pick a hospital with a pre-code team. What is a pre-code team? Usually when a patient "codes" i.e. heart stops or stops breathing, or both, a "code blue" is called where all available physicians who are part of the responding code team converge on the patient, with nurses, and respiratory therapists as part of the team (in many hospitals this is simply the ER doc running like a mad-man or mad-woman to the code). A pre-code team assess patients that are getting sicker BEFORE they code. And prevents them from coding in the first place. Not many hospitals have this. I would select one that does.

Clarifications:

When asking if a there are hospitalists, you need to specify, "Do you have hospitalist in-hospital at night?" (some hospitalists take call from home - odd, I know, but that's why you need to specify).

While academic centers have residents taking care of you at night, you might be wary, but compared to not having anyone there at night, it is preferable. Though I would ideally want a hospital with intensivists (ICU specialists that are there 24 hours) and a pre-code team. And second to that would be having hospitalists overnight. An Academic center would be my third choice. In certain situations, academic centers may be superior - especially for unusual diseases, transplants, and state-of-the-art medical care.

**note**
I would like to thank minako for her suggestion for #7 above. An obvious omission on my part, I'm sure it will not be the last. I welcome your comments and suggestions.

How to choose a hospital

How do you 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, 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:
4)Choose a children’s hospital for your kids.
5)If you have a Neurosurgical Issue, go to a hospital with a dedicated Neurosurgical ICU.
6)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.