We were surprised by the Consumer Reports (CR) rating assigned to Hospital for Special Surgery (HSS) for hip and knee replacements, because it is not consistent with our strong track record of patient safety. In fact, the conclusions drawn in the report are contrary to the widespread recognition we have earned by providing exceptional care - No. 1 ranking in orthopedics by U.S.News & World Report 2013-14, top scores from the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality, and the New York State Department of Health, among others.
At HSS, we base our decisions on evidence. To gain a better understanding of CR’s uncharacteristic findings, we conducted our own analysis. After careful evaluation of the available information by our own statistical team, it is clear to us that the methodology fails to take into account the complexity of measuring hospital performance and, in particular, as it relates to the patients in which we specialize. Our analysis shows that the CR rating methodology has a disproportionate negative impact on a specialty hospital like HSS.
Our primary concern is that prolonged length of stay (LOS) is inappropriately used as a surrogate measure of safety. The methodology used by CR is based on the assumption that a patient with a longer-than-expected LOS must have experienced a post-operative complication. Therefore, the report makes the leap that prolonged LOS is automatically a negative result. At HSS, we discharge patients when they are ready to return home safely, not when a statistical model tells us to do so. The CR model did not take into account many of the varied reasons HSS patients may stay in the hospital longer, which include:
Consumer Reports considered none of these factors when rating hospitals. As a result, our surgical safety scores did not reflect the uality of care we deliver. The reality is that HSS delivers extremely high quality, individualized care to a complex and diverse patient population. We have very specific safety criteria and hundreds of quality indicators for surgeries we perform based on experience and long-term outcomes data, which we use to determine when patients can leave the hospital and return home safely. Based on almost any criteria, HSS represents an exceptional hospital for the safe delivery of orthopedic care.
Download HSS Response to Consumer Reports pdf.