Public and private hospitals are generally run the same ways except for who is the governing body. Private hospitals are either for or not-for-profit and are owned and managed by a non-governmental property. Public hospitals, on the other hand, are owned and administered by governmental bodies.
Bellevue Hospital Center located in New York City, New York is a public hospital which is owned and operated by the city. The hospital has received the “Center of Excellence” accreditation . Based on a Leapfrog Group survey the hospital has apparently taken many steps to ensure the quality of care for their patients. The hospital has taken many measures to manage the quality of care that it gives to its patients. Overall, more than 75% of all inpatient medical orders are placed through their CPOE system in order to prevent errors and supply quality care. The hospital also scores very high in most of the steps which are taken to avoid harm. They receive the maximum score available regarding “effective leadership to prevent errors,” “staff work together to avoid mistakes,” “training to improve safety,” “track and reduce risk to patients,” “handwashing,” “take steps to prevent ventilator problems,” and “correct medication information is communicated.” The hospital did only receive about 75% regarding having enough qualified nurses. The hospital fully meets standards regarding aortic valve replacement, abdominal aortic aneurysm repair, and pancreatic resections and is making substantial progress regarding esophageal resection. As for reducing hospital-acquired conditions, the hospital is not producing as well as other aspects of quality management. They are making significant progress in reducing central-line and urinary catheter infections in the ICE. Bellevue has made some progress in reducing hospital-acquired pressure ulcers and no progress in reducing hospital-acquired injuries .
Vassar Brother’s Medical Center, a privately owned hospital, in upstate New York. There is very little information regarding accreditation or initiatives that the hospital is implementing to ensure the quality of care and management of errors. The Dyson Center for Cancer Care at the hospital did receive a three-year accreditation in radiation oncology .
This hospital also inputs 75% of all inpatient medical orders into a CPOE. Vassar did not score nearly as well on the steps to avoid harm. This hospital scored approximately 75% in the “effective leadership to prevent errors” category, about 80% in “staff work together to prevent errors,” 66% in “training to improve safety,” 100% in “track and reduce risk to patients,” 90% in “enough qualified nurses,” 70% in “handwashing,” 66% in “take steps to prevent ventilator problems,” and 66% in “correct medication information is communicated.” The hospital fully met standards regarding abortive valve replacement and pancreatic resection and made substantial progress in esophageal resection safety but made no progress regarding abdominal aortic aneurysm repair. They also fully met standards of care in reducing hospital-acquired pressure ulcers and injuries, but only made some progress in reducing central-line and urinary catheter infections in the ICU .
A third hospital, also in New York State is St. Peter’s Hospital. This is another private hospital being run by St. Peter’s Health Partners. The hospital is “striving to increase quality outcomes through cutting edge technologies and the implementation of evidence-based practices. We are committed to providing safe, effective, compassionate care to our patients by offering the most advanced treatment options in a unique, caring environment.” St. Peter’s Hospital has been awarded Magnet Hospital for nursing, a top 100 cardiovascular Hospital, Blue Distinction® Award for Treatment of Complex and Rare Cancers, a Designated Heart and Stroke Emergency Center, Women’s Choice Award for Heart Care and Women’s Choice Award for Obstetrics .
St. Peter’s Hospital is working less than the other two to prevent medical errors. Only 50-74% of all inpatient medication orders are being placed in a CPOE system but the ICU is appropriately staffed, and they did receive much better ratings than Vassar in the steps they take to avoid harm. They received maximum scores in all categories except “effective leadership to prevent errors” and “training to improve safety.” The hospital has also taken no steps to manage serious errors. The hospital fully met standards regarding abdominal aortic aneurysm repair, pancreatic resection, and esophageal resecntion. They had made some preogress regarding aortic valve replacement. Regarding hospital-acquired conditions, St. Peter’s Hospital has not yet fully met the standards of care in any of the reportable categories. They have made substantial prograss reducing central-line infections in the ICU, but only some progress in reucing hosptail-aquired pressure ulcers or injuries and there has been no progress in reucing urinary catheter infections in the ICU .
Based on the review of safety initiatives and quality of care I think that both as a patient and a nurse I would prefer the public hospital. In this case, Belleveue is the best equipped to prevent mistakes before they happen and have worked hard to establish procedures when they do happen. The two private hospitals seem to be about equal in the quality of care they provide, with different strong points and weaker ones. Both of these hospitals would benefit by being paid for performance. Incentivizing improvements would help to build a better quality of care.
- HealthQuest. (2014, December 18). Dyson Center for Cancer Care earns accreditation. Retrieved from HealthQuest: http://www.healthquest.org/HQ/News/47.aspx
- Hernandez, E. (2014, June 23). Bellevue Hospital Breast Care Service Achieves “Center of Excellence” Accreditation. Retrieved from New York City: http://www.nyc.gov/html/hhc/bellevue/html/pr/2014-6-23-breastcareservice.shtml
- St. Peter’s Health Partners. (2015). A Leader in Quality. Retrieved from St. Peter’s Hospial: http://www.sphcs.org/body.cfm?id=634
- The Leapfrog Group. (2015). Leapfrog Hospital Ratings. Retrieved from The Leapfrog Group: http://www.leapfroggroup.org/