Return to Virginia Business - November 2002

by Marjolijn Bijlefeld

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While driving on a Richmond street recently, Wayne H. Davis passed a billboard that trumpeted the skills and services of one of that city’s hospitals. If he tried bragging like that back at the Shenandoah Valley area hospital where he works, Davis thought to himself, local people “would think we were nuts. They’d ask, ‘Who are you telling that to?’”
It’s not that the 255-bed Augusta Medical Center in Fishersville, where Davis is communications director, has nothing to boast about. It’s one of five Virginia hospitals this summer to make the 2002 U.S. News & World Report “best hospitals” list, winning recognition in three areas — digestive disorders, geriatrics and hormonal disorders. That’s not bad for a small hospital. Still, the only local hoopla for the award was a nice note to the staff from the CEO, and a press release that wasn’t even picked up by local newspapers. “They were apparently unimpressed,” says Davis.

Maybe Augusta didn’t get much mileage from the award, but Virginia’s other honored hospitals relish the bragging rights. And why not? The U.S. News listing started with 6,045 hospitals and culled it down to the 50 top-ranked hospitals in 17 specialties. A total of 205 hospitals made the 2002 list. Hospital brass say the honor helps them recruit quality doctors and staff, attract patients and win referrals from physicians — all of which is good for the collective ego, community confidence and the hospital’s bottom line. There are other nationwide hospital rankings done, but none tops the brand-name recognition of U.S. News, says David W. Wright, vice president of marketing and strategic development for Inova Health System. “It is one of the most prestigious and important recognitions American hospitals can receive.”

Virginia has its share of winners on this year’s list. Sentara Norfolk General Hospital was recognized for its cardiac care. University of Virginia Medical Center in Charlottesville made the list in 10 categories (see chart), while nearby Martha Jefferson Hospital was included for its respiratory disorders care. Inova Fairfax Hospital in Falls Church earned a spot for its treatment of hormonal disorders, which include diabetes and thyroid conditions.

For the most part hospitals made a big deal out of the listing. Inova Fairfax Hospital had banners made, put an ad in The Washington Post and threw a party for its employees. Its award-winning treatment program helps Type II diabetics manage their disease through classes, consultations with nurses and nutritionists, support groups and community programs. At U.Va., the medical center framed 10 copies of its ad touting the recognition and gave one to each of the winning departments. Some departments have even framed the U.S. News cover and article and hung it on the wall for visitors to see. “People walk up to those pages and say, ‘I’m going to tell my brothers and sisters that mom’s getting good care,’” says Maureen Wellen, director of marketing and communications at University of Virginia Health System.

If the rankings give comfort to patients and families, they give hospital administrators a nice recruitment tool. Inova’s Wright says the recognition helps attract ambitious doctors who want to align themselves with nationally recognized institutions. It also helps keep the ones that they have. “Our physicians feel extra special when we get this ranking, because part of it comes from other physicians,” Wright says.

The ranking builds a hospital’s reputation, yet reputation alone can’t push a hospital on the list. The final score is based on a variety of factors, including reputation, mortality and a group of care-related factors such as nursing and technology. “The numbers are there or not,” says Mark Foust, chief marketing officer at CJW Medical Center in Richmond, which did not make the 2002 U.S. News list. “It’s not a popularity contest.”

Hospitals can’t really even influence how the scoring systems assess their reputation. Each year, 180 randomly selected physicians in each of the 17 specialities are asked to rank up to five hospitals in their field, and then the final results reflect a three-year average. “You can’t monkey with the results,” says U.Va.’s Wellen. “If you look at the ranking, you’ll notice that many hospitals make the list even with a zero reputational score.”

Still, the rankings aren’t everything. For the most part, people need local health care regardless of reputation. The rankings may have more sway in attracting patients who will be undergoing long-term or intensive therapy, says Lynn Holder, vice president of cardiac/vascular/transplant services at Sentara Norfolk General Hospital. “Most people are not going to get in their car and drive to the Mayo Clinic,” she says.

Some Virginians are fairly lucky and don’t have to drive far to reach a highly ranked hospital. A number of the state’s 86 hospitals have been recognized for excellence by organizations other than U.S. News. Inova Fairfax and Sentara Norfolk were listed by Modern Maturity magazine in the top 50 hospitals in the country—Inova Fairfax was 24th and Sentara Norfolk was 44th. Sentara Norfolk was also named as one of the top 100 hospitals for the fourth year in a row by Solucient, a benchmarking firm that ranks hospitals nationwide. Other hospitals named by Solucient in recent years include Carilion Roanoke Memorial Hospital and Winchester Medical Center in 1999 for their cardiac bypass surgery programs. Also cited by Solucient for excellence in a specialty were Lynchburg’s Centra Health for cardiovascular care in 1999 and orthopedics in 2000, and Riverside Regional Medical Center in Newport News for cardiovascular care in 2000. Most of the Virginia hospitals on this year’s U.S. News list have been named by Solucient as well. “What feels really good is to be in more than one list,” says Holder.

CJW’s Foust agrees with that. Although not on the U.S. News list, the hospital got high ratings from Solucient and HealthGrades. It has used those rankings in its television advertising, billboards, print and Internet and direct mail advertising. Nationally recognized rankings, for most, are the stuff of dreams for hospital marketing. “This is a message that resonates with all core constituencies, including patients and employees. They take great pride in knowing they’re among the best,” says Foust.

One Virginia hospital was among the best of the best. The 541-bed U.Va. medical center’s fifth-place ranking for hormonal disorders puts it just behind renowned institutions such as the Mayo Clinic, Massachusetts General Hospital, Johns Hopkins Hospital and Brigham and Women’s Hospital. The center is taking a lead in new diabetes research: Earlier this year, U.Va. established the Center for Cellular Transportation, the first pancreatic islet cell isolation facility in the state. The goal is to make insulin-producing cells that could be used to reverse or prevent complications in Type 1, insulin-dependent diabetics.

Hospital representatives say they’re not usually surprised by the rankings. “It validates what we know internally,” Holder says. Sentara, a 569-bed hospital, has received its share of recognitions for its heart program. Its heart transplant center is one of just 140 in the nation. In August, hospital surgeons performed their 200th heart transplant. The heart program was also cited as the only one in the state to receive top marks across the board in a report issued by Virginia Health Information earlier this year. The hospital’s heart and heart surgery program has been on the U.S. News list three of the past four years. The hospital tracks its own mortality, quality and cost data so “we think we know how well we’re doing. But this opinion gives us a national benchmark,” she says. Plus, “It’s an ego boost to the staff.”

Yet occasionally, the listing does come as a surprise. Martha Jefferson Hospital, a 176-bed community hospital, squeaked onto the list for the first time ever, at number 50 in respiratory disorders. That makes Charlottesville the only community twice-blessed. The hospital takes an aggressive approach toward respiratory problems, and gives therapists the leeway to more quickly treat patients based on standing orders developed by the pulmonologists. “Not every community hospital does that,” says Ann Nickels, communications director at the hospital. “It reflects the good relationship between the physicians and the therapists.” The staff also works extensively with respiratory patients so they can better control their conditions once they’re discharged.

Even though the medical staff, employees and volunteers buzzed about the listing when it was first released, Nickels says there’s no pressure to make the list again next year. The U.S. News ride is great while it lasts, but it’s not a driving force for hospitals. Do the right things and the recognitions will come, Nickels says. “We had no idea we were going to be on it this year. If we’re not next year, it doesn’t mean we are not as good as we were.”

Return to Virginia Business - November 2002