Hospital Hazards

Is the U.S. deceiving itself about the quality of its hospitals?

"I am sure we have, as we glibly brag, the highest quality of hospital care on earth," Dr. Anthony J. J. Rourke told 2,000 hospital staff members in Atlantic City, N.J. last week. "But we also have a quality of care which I had thought went out with the leeches and purges."

Rourke, onetime president of the American Hospital Association and now a hospital consultant in New Rochelle, N.Y., based his jeremiad on a set of figures from the joint commission (representing such groups as the A.H.A. and A.M.A.) on accreditation: of 1,385 hospitals in the U.S. and Canada inspected last year, one-third failed to pass. That is, by commission standards, the medical staff may have been inadequately trained, or possibly the hospitals showed high death rates from operations, poor anesthesia departments, high maternal mortality, too few or ill-trained nurses, sloppy records, or poor physical plants.

Of the 463 hospitals flunked, 283 won provisional accreditation, meaning that they got credit for an effort to improve themselves. But 180 failed outright. "This means," said Dr. Rourke, "that our patients in this group [of 1,385 hospitals] have one chance out of three of landing in a hospital which does not meet the minimum standards of safety and quality."

These were all general hospitals. Mental institutions, said Dr. Rourke, are even worse: only a bare handful are fully accredited.*

Dr. Rourke hopes public opinion will force substandard hospitals to upgrade themselves or shut down. "I wish it were possible," he added, "to hang a scarlet letter above the admission desk of every provisionally approved hospital in the U.S. and Canada. Nonaccreditation, by my standards, [is] criminal, while provisional accreditation marks a grave misdemeanor on the part of those responsible."

* Of 596 private and public institutions, only 100 state hospitals have yet been inspected by the accreditation commission; of these, less than a dozen are now fully accredited.

This file is automatically generated by a robot program, so reader's discretion is required.