What Are America's Best Hospitals?

What are the best hospitals in the country, and where are the best specialists? Those questions are answered every year by the editors of U.S. News & World Report, which has been ranking American hospitals annually since 1990.

This year's list, unveiled yesterday, mentions 173 hospitals, and of those, only 18 were put on the list's "Honor Roll" because they excel in several areas. (To read the list, click here or use the directory to the left of this story.)

If you don't live near any of the major hospitals that made the cut, what does the list mean to you? How can you use the information to get better treatment? The Saturday Early Show spoke with Avery Comarow, the U.S. News editor who compiles the list.

Q: How do you go about choosing America's best hospitals from among the more than 5,000 you screened? What's the elimination process?

Comarow: We look at how often hospitals do certain procedures. We ask specialists in 16 fields which hospitals are the best, which have the best reputations, within their specialties. We look at hospitals' death rates and patient-care statistics, like the number of nurses they have. And we put them through a screening procedure.

How did you arrive at the number 173?

Comarow: A lot of hospitals pop up in more than one specialty area — the very best, as many as 15 specialties out of the 16 we check. One hundred and seventy three is just the number that shakes out — it's entirely statistical; no opinions, except the specialists' judgment about which are the best in their fields.

Say you know in advance you will be hospitalized, for surgery or other treatment, but it can't be in one of these best hospitals. Based on your experience picking the best, how do you choose?

Comarow: The key question is numbers. If you're facing surgery, you want to ask both the doctor and the hospital how many of these procedures were done in the last year — what their track records are on death rates, recovery rates, infections, and so on. And ask them, how did you do with patients like me — with my own kinds of complications?

And if you find out the doctor or the hospital did whatever the procedure is eight times in the past year, that's too few, especially if you're talking about relatively common procedures like bypass surgery. You want triple digits. The best surgery is routine surgery — and it doesn't become routine unless you do it a lot.

Your report also offers tips on dealing with hospitals, including how to avoid hospital-acquired infections, which kill thousands of patients every year. Can you summarize this for us?

Comarow: The most important things are to be vigilant to all the ways you can pick up infections — and to take certain steps to avoid them. Make sure anyone who touches you disinfects his or her hands. A hospital is inherently unclean: lab coats, doctors' ties, everything can carry bacteria. But especially the hands.

Don't worry about making a fuss. You can even keep some disinfectant on your bedstand, and ask doctors and nurses, "please, if you don't mind, clean your hands first." Be nice about it, but firm! To keep yourself from infection, you need vigilance and a certain mindset — you don't have to leave it up to the hospital.