Published by: Larry Gage on 4/13/2010 12:10:57 PM
So I start over again in my personal quest for high quality, cost efficient, patient-centered care. (48 hours post-accident and trust me, I'll settle for a damn operation to sew my kneecap back together and reduce the pain.) I've sort of gone from the ridiculous to the sublime. After an almost surreal 24 hours as the "last ambulance patient" (I'm thinking of getting a trademark) to arrive at St. Vincent Hospital before its ED closed for good at 10:00 AM Friday (See April 8, 2010 New York Times article, Ambulances to Cease Service to St. Vincent’s). I have found my way to the Hospital for Special Surgery, an affiliate of New York-Presbyterian Hospital and the Cornell Medical School, on the upper east side of Manhattan. HSS is considered by US News and World Report to be the second best orthopedic hospital in the country (just slightly lagging behind the Mayo Clinic). Even cynical New Yorkers consider it “one of the best in the city.”
It's mid-day Monday and "best hospital" or not, just like Friday at St. Vincent, I'm again endlessly waiting in the HSS lobby for patient transport. (This has to be an Achilles heel of patient satisfaction for most hospitals). But what an elegant lobby! Lots of travertine and exotic woods. More Four Seasons than Moscow winter. There's also more than a little history here. HSS first opened its doors on May 1, 1863 at the home of its founder, Dr James Knight, sponsored by his New York Society for the Relief of the Ruptured and Crippled. The Wall of Fame (which they call "A Century of Giving") lists many hundreds of Wall Street tycoons, corporations and prestigious foundations. (I know all this because it embellishes the walls of the lobby, and I have plenty of time to read it...)
Of course, a hospital is only bricks and mortar. The real key will be how they deliver care—not just how they have dressed up the box it comes in. Ultimately, it will be the outcomes realized by the doctors, nurses and other clinicians who practice in a hospital, not just the physical plant or fancy equipment that will determine success or failure under health reform.
But one thing is clear from comparing these two hospitals—a pleasant environment and state of the art technology will also play a role in determining which hospitals close and which are able to survive ultimately to be permitted to demonstrate their "outcomes" performance in the health reform era.