On The Wards » Hospital

With the national push toward electronic medical records, there have been active efforts to upgrade clinical data and systems software. At some institutions, an effect of this transition is the migration from the traditional voice dictation systems or paper clinic notes to a typed electronic record.

A recent study at the University of Toronto Faculty of Medicine sought to evaluate the overall quality of electronic discharge summaries (EDS) compared to their traditional dictated counterparts. The measure for quality was based on a 100-point visual analogue scale rating the satisfaction of primary care physicians (PCPs) who receive the discharge summaries. Other endpoints studied included the satisfaction of house officers using either system (again, using a 100-point visual analogue scale), adverse outcomes after discharge (combined emergency department visits, readmissions, and death), and patient understanding of the discharge details.

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Although the core business of the U.S News & World Report franchise is the delivery of mainstream news, it is best known for annual rankings of the best colleges, graduate schools, and hospitals. Like clockwork every July, the magazine just released today its rankings for the best hospitals in the United States.

The overall ranking is based on the sum of points assigned to a hospital’s top-tier specialty services. A hospital gets 2 points for each specialty ranked “at or close to the top” when compared to its peer hospitals. They receive 1 point for each specialty that is ranked lower.

Topping the list this year, and for the nineteenth consecutive time, is the Johns Hopkins Hospital in Baltimore, Maryland. The hospital has 3 specialties ranked as the top in the nation, including Urology, Rheumatology, and Otolaryngology (Ear, Nose, and Throat). It also has 10 other specialties within the top-three rank. Its closest rival, the Mayo Clinic in Rochester, Minnesota, also has 3 first-ranked specialties, including Endocrinology, Gastroenterology, and Neurology/Neurosurgery. The remaining few contenders on the list may have at most one or two top-ranked specialties. The Ronald Reagan UCLA Medical Center, which has now taken the third spot since 2007, and the title “Best in West [Coast]” for the 20th consecutive year, leads the nation in geriatric care. The top 7 institutions on the list has not changed since last year.

Drum roll for the top twenty-one (#10 and #11, #17 and #18 below are tied) …