Making Sense of US News and Other Ratings

UH has a strategy for success

By Cliff Megerian, MD, FACS, UH Chief Executive Officer

UH Clinical Update | June 2021

University Hospitals is one of the top hospital systems in this country, a group numbering about 5,000 hospitals in all. Historically, we have done exceedingly well in the U.S. News & World Report rankings and those of other rating agencies.

Just a few short years ago, UH was one of U.S. News & World Report’s Top 16 Honor Roll hospitals. Since then, we have grown significantly in size. We also have learned that we have some opportunities in how to continue to perform better in those ratings to be consistent with the excellence that we know we deliver.

U.S. News also has evolved its rating systems, so what was once a largely reputational ranking system now includes details around patient outcomes and patient satisfaction, as well as structural aspects of specialty care.

I asked Nicole Maronian, MD, Chair of the Department of Otolaryngology Head & Neck Surgery, UH Cleveland Medical Center, to lead this effort. She has identified ways for us to be more deliberate around U.S. News’ specific quality reporting, and she is working to educate leaders and clinicians, and the 12 U.S. News specialties about understanding the quality metrics used, and the importance of patient opinion and satisfaction.

“Our North Star has to be our quality overall – and U.S. News & World Report has a complex rating system, of which quality is one of the key and critical components,” says Dr. Maronian. “We need to focus our efforts on what we already do well: We take excellent care of patients.”

“By emphasizing quality outcomes, we will impact the metrics reflected in these rankings down the road.” However, it is important to remember that those rankings lag by three years, because of the complexity of the reporting systems involved.

Under the guidance of Peter Pronovost, MD, PhD, who is UH’s Chief Quality Officer, and our executive leadership team, there is also a renewed focus on patient outcomes and zero harm, which aligns our efforts as a system, and will also move us forward in the U.S. News rankings.

However, we will not see the impact in U.S. News this year or next – it is going to take time to incorporate into the rankings. That can be frustrating when we see positive results now, and want to see those results reflected quickly.

What are some of the key things we are doing? One is specifically focusing on the quality metrics by each of the 12 U.S. News specialties.

“We created a U.S. News dashboard view of how each specialty is tracking in real time,” says Dr. Maronian. “We used to look at this data retrospectively – now we have shifted our angle to a forward-focused stance by using this quality dashboard.”

Also, UH has realigned by identifying quality champions for each of the U.S. News service lines. These clinician-champions have been actively involved in reviews and fashioning solutions toward quality that are unique for each of their specific service lines.

In addition to specialty-specific metrics, hospital-wide metrics are a component of U.S. News reporting, specifically patient experience.  “There is a broad understanding that all of us working together on these hospital-based metrics benefit our patients and have an impact on our U.S. News rankings,” Dr. Maronian adds. “It’s a win–win, for our patients and for UH.” UH Chief Patient Experience Officer Jen Lorenz leads these efforts for UH CMC (at other UH hospitals, it is a combined effort: Lorenz with the COO, CNO and CMO.)

Finally, a component of national reputation is embedded in the U.S. News reporting. UH Chief Marketing Officer Ted Keegan and his team remain focused on assuring our specialty-specific UH Innovations email publication is published three times yearly; it highlights our academic and clinical achievements to our peers nationally.

Mukesh Jain, MD, UH Chief Academic Officer, and his team are in the process of creating and establishing an academic dashboard that will allow each specialty to track publications by specialty, national presentations, and new appointments to national societies, which is an additional component of our national reputation. Collating this information, and building this internally, further will help us to track and publicize our academic success, which will have a positive impact on our U.S. News overall scores.

As Dr. Maronian concludes, “The U.S. News rankings provide a unique vantage point of our care. We believe that if we stay focused on our quality, and our reporting of that quality, that this will have a lasting positive impact on the rankings and ultimately showcase UH CMC as one of the U.S. News Honor Roll Hospitals.”

One caveat: U.S. News & World Report is only one of many, many ranking systems. The common denominator is the emphasis on patient safety and quality of outcomes. We know that we take excellent care of patients every day.

For these reasons, we will be doubling down in the coming years on what we do best, which is providing the highest quality care for our patients, while continually adapting our day-to-day operations to meet the challenges of evolving ranking systems.