Caitlin Whyte (Host): This is Community Connect presented by Tampa General Hospital. I'm Caitlin Whyte. Joining me today is Rocco DeCicco, Senior Director of Strategic Programs and Global Medicine at Tampa General Hospital. Rocco, welcome to our program.

Rocco DeCicco, MBA, MCIS: Thanks for having me. It's a pleasure to be here.

Host: Absolutely. And to start us off, can you briefly explain the US News Best Hospitals rankings?

Rocco DeCicco, MBA, MCIS: Yes. So US News, is a publication, that ranks a lot of different industries, including healthcare and hospitals. The rankings actually are going to come out soon in July, and this will be the 35th year of US News rankings. The reason they created it in the first place was really to help patients who are experiencing some kind of life threatening or rare condition and need a hospital that excels in treating complex high risk cases. Now they look at things specialty by specialty, meaning, they rank oncology, they rank gastroenterology, they rank heart and vascular care. So, as I say, specialty throughoutour discussion, that's, that's what I mean there. So they rank a number of different specialties. In this coming years assessment, they'll assess more than 4,500 hospitals and probably about only 1800 or so will meet the eligibility criteria.

And then last year, 160 hospitals achieved a top 50 national ranking in at least one of those specialties that I mentioned. So it really focuses on complex care for a long time. In recent years, they've brought on a new measure of where they're looking at common procedures and conditions. So there are about 20 that they assess, you know, are routine sort of things like stroke care, COPD, heart attacks, et cetera, et cetera.

Rocco DeCicco, MBA, MCIS: So at this point, US News has moved from only assessing hospitals for complex care in different specialties to also assessing hospitals for more common procedures and conditions.

Host: Wonderful. Well, Rocco, why should our community care about these rankings? Why are they so important?

Rocco DeCicco, MBA, MCIS: If you or a family member or friend or are in a situation where you're looking for a hospital that treats a very complex or rare condition that you're dealing with, these rankings can serve as a good place to start researching, and get some guidelines,but also since they've introduced these more common procedures and conditions; you could also look up how your local hospital does. If you're dealing with, something more common like stroke care, COPD, things like that. Obviously, if you're in a situation where someone is experiencing a stroke, you are going to be looking for somewhere local to go and it's good to know who does very well at performing some of those more common procedures too.

But especially in the cases where you're dealing with something rare or complex, US News rankings can serve as good guideline for patients and consumers.

Host: Now, what types of metrics does US News assess to arrive at these rankings?

Rocco DeCicco, MBA, MCIS: There are a lot of metrics. I, I won't get into the, the nitty gritty of all of them, but typically they fall into four different categories. One is outcomes. The main outcome measure is mortality. So meaning you know, for these complex cases, in some cases they bring a high risk of mortality.

So how many of your patients died in performing these cases? Versus what would be expected for something as complex as that condition. Another bucket would be structural metrics. And this really looks at what is available at your hospital that would provide better care. For example, do you have a list of advanced technologies that US News looks at in different specialties?

So, for cancer, for example, they want to know if you have kind of the highest level of radiation oncology treatments. They look at a patient services bucket, which could be, you know, anything from, does your hospital provide genetic counseling? Do you have translators on staff, things of that nature.

Also in that bucket, they look at accreditations from external organizations. Again, I'll choose cancer, but there are a number of awards that you can get such as National Cancer Institute Excellence Designation, or COC accreditation, Commission on Cancer. And you kind of like get extra points if you have some of those.

And they also look at your hospital's staffing ratios. Are you a trauma center? They also look at a bucket called patient volume and they really look at that for those specific complex cases because, you know, it's kind of assumed that if you do more of these cases, you build experience. More experience often leads to better patient outcomes. So they care very much of, do you do a lot of these highly complex procedures. And then lastly, there's an expert opinion component, which is really about the reputation of your hospital in these different specialties. And that is essentially US News partners with a group called Doximity who goes out and surveys physicians in a specialty and basically says, if you had to send any of your patients to a hospital for heart and vascular treatment; who are the five top hospitals you would go to? And experts in that specialty vote on that. So meaning if you're a physician who specializes in heart and vascular care, you cannot vote for oncology. You can vote for only your own specialty.

And then US News adds all that up and comes to a composite score in each specialty. And then the rankings are basically top 50 hospital scores in the country. And then beyond that, it's top 10% of all hospitals assessed. And then beyond that, you don't get an award.

Host: Well, let's talk about our hospital. How well does Tampa General Hospital perform in these rankings, both on a state and national level?

Rocco DeCicco, MBA, MCIS: TGH has had a great year. As I mentioned, rankings come out in July, so, we're in last year's rankings right now. We achieved a second hospital in Florida ranking, which means we're number two in the state. This is up from being ranked number four in Florida the previous year.

 So this was a huge accomplishment for us. And, nationally, in those specialties that I had mentioned, we are ranked top 50 hospital in the country in eight of those specialties. So remember that's broken out by oncology, gastroenterology and GI surgery, heart and vascular care, et cetera, et cetera.

This is the most top 50 rankings that TGH has achieved in 12 years. And also I mentioned those common procedures and conditions. We were also rated high performing for those which is high performing is the highest you can get in 15 of those, out of the 20 that they assess. And that is an improvement from having achieved 12 high performing for procedures and conditions the previous year.

So, we were very happy with our rankings and like I said, the new rankings are coming out soon and we expect to do great again.

Host: Wonderful. And are there any other hospital ratings or rankings that the community should be aware of?

Rocco DeCicco, MBA, MCIS: Yes, absolutely. There are a number of organizations that assess hospital quality and rank hospitals and rate hospitals on different things. Some of the more common ones that consumers may have heard of are Leapfrog, Center for Medicaid Services or CMS, does their own assessment.

There are groups like Health Grades and, and actually there are a lot more coming out now. For example, Newsweek is doing hospital rankings. There's a group called Becker's Hospital Report, which is kind of a hospital industry journal, and they do assessments of different hospitals. The main ones that TGH looks at really areUS News, obviously. We also look at Leapfrog. Leapfrog really focuses a lot more on patient safety results than US News does. When I talk about patient safety, I'm talking about things like infection rates within the hospital, infections that were acquired while the patient was in the hospital.

 And then measures connected to that, like hand hygiene, you know, are all your clinicians or all your nurses and your support staff keeping proper hand hygiene practices along with national guidelines. So Leapfrog really focuses on that safety angle. The CMS, the Center for Medicaid Star Ratings has five different components.

 There is a mortality component similar to US News. There is a safety component similar to Leapfrog. They also look at readmissions meaning when you left the hospital, did you have to come back for some reason? They look at patient experience as reported by patients, and they look at was the care provided timely and effective?

So, TGH looks at all these things. What TGH's real I guess true north, we call it, that our internal hospital quality team looks at is something called Vizient Academic Medical Center Benchmarks. Essentially what it is, is those CMS rankings looked at by the top academic medical centers in the country.

So there's a group of 118 hospitals that TGH essentially compares ourselves to on these five different categories. Our quality group is amazing and there's a huge focus at TGH on quality. And there, weekly, monthly meetings where we go through each of those components and say, okay, how are we doing compared to this 118 cream of the crop hospitals, academic medical centers, and we continue to improve year over year. I think we're in the top 10th, percentile right now for the mortality category. And I think we're 30% overall. And, you know, when you think about that, we're comparing ourselves to the top academic medical centers in the country, to be able to say that of that 118 hospitals we're in the top 30%. That's a huge accomplishment for us. And, it's a huge improvement from the last couple years and continues to get better and better. So, like I said, there's a lot of them out there. Uh,so patients really need to take the time to look at each one of thoserankings agencies and say, okay, what's most important to me or my family member, and how should I assess this? What should I be basing my research on when I'm looking for a hospital to go to for care?

Host: That has been Rocco DeCicco. For more information, please visit tg.org/defining-medicine.

If you enjoyed this episode, please be sure to like, subscribe, and follow Community Connect presented by TGH on your favorite podcast platform. I'm Caitlin Whyte, and this is Community Connect, presented by Tampa General Hospital. Thanks for listening.