Behind UH Cleveland Medical Center's Ear, Nose & Throat Institute’s Top 20 Ranking in U.S. News

UH Clinical Update | October 2022

As we first reported in July, University Hospitals Cleveland Medical Center was once again recognized as a Best Hospital by U.S. News & World Report. For 2022-2023, UH Cleveland Medical Center ranked in four of 15 adult specialties and it ranked third among all hospitals in Ohio.

Our Ear, Nose & Throat Institute ranked the highest of all our specialties – it was 17th in the country.

Nicole Maronian, MD, Chair, Department of Otolaryngology- Head and Neck Surgery and the Richard W. & Patricia R. Pogue Leadership Chair in Otolaryngology-Head and Neck Surgery at UH Cleveland Medical Center, is quick to point out that the rankings this year are based on a retrospective view of data collected from 2018-2020.

“I’m very excited and very proud of my team,” she says. “To look at the pandemic years included in this survey, and for the team to have performed so well, is really remarkable to me.”

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

Over the last several years, Dr. Maronian was tasked with leading UH’s effort in identifying ways for the system to be more deliberate around U.S. News’ specific quality reporting. She and her external reporting team have been working to educate leaders and clinicians in the U.S. News ranked specialty areas about how the quality metrics are used, and the importance of quality outcomes and patient satisfaction.

Here, Dr. Maronian explains the new structure that undergirds the U.S. News assessment.

“It’s important to realize that there are several domains. One is a structural domain, based primarily on a survey by the American Hospital Association; there is also a process domain based on our national reputation, which is about how well our peers know us.

“There is a patient satisfaction domain, which is a hospital-based metric, not an individual-specialty based metric. And there is a patient outcome domain, which focuses on the quality of care we deliver and document.”

That last domain includes both the medical complexity of the patients and their conditions, the outcomes for patients, as well as a consideration of how many were discharged back to their homes.

“That’s an important metric because in this one area, we are fully aligned with U.S. News. We, too, want our patients to do well, and to return them back to their normal homes and environments,” Dr. Maronian says.

“For ENT, this improvement in rankings reflects an improvement in patient outcomes over the years, which is always good to see, but it also points specifically to some efforts in the background which are focused on the documentation of our patients’ conditions, and the identification of patients’ comorbidities.” This is an increasingly important component for our UH specialties to focus on, as our patient complexity rises.

ENT established a specific clinical documentation review of all of its discharges, an effort led by the department’s Director of Quality, Nicole Fowler, MD. This requires weekly review of all discharges to ensure that a patient’s complexities are identified, which might mean high blood pressure, smoking, diabetes, and so on. All will be reflected in the medical chart, which then offers a more well-rounded picture of the patients that we care for.

Awareness of those additional co-morbidities helped ENT clinicians further the improvement in patient outcomes.

Dr. Maronian emphasizes that UH does very well in the U.S. News ranking overall.

“There are thousands of hospitals in this ranking, and we are still in the top percentage overall. To get into the top 20 is not easy. We have really focused our U.S. News efforts emphasis on the quality component of the ranking – which is the expertise, care and outcomes of our patients.

“Every department is deserving, and overall UH is doing well and will continue to improve in these rankings,” Dr. Maronian says.