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27 QUALITY IMPROVEMENT & MEASUREMENT CareChex: Top 10 quality hospitals for overall hospital care 2019 By Alyssa Rege Q uantros, a performance analytics company, released the CareChex 2019 rankings for hospital and health system quality and patient safety Oct. 23. e rankings benchmark the clinical quality, patient safety and performance of nearly all acute care hospitals and health systems in the U.S. Here are America's top 10 quality hospitals for medical excellence nationwide in overall hospital care for 2019, as ranked by CareChex: 1. Hospital for Special Surgery (New York City) 2. SSM Health St. Mary's Hospital-Madison (Wis.) 3. St. Luke's Boise (Idaho) Medical Center 4. Mercy Hospital Oklahoma City 5. Chester County Hospital (West Chester, Pa.) 6. St. Mary's Regional Medical Center (Reno, Nev.) 7. Naples (Fla.) Community Hospital 8. Asante Rogue Regional Medical Center (Medford, Ore.) 9. Mercy Hospital Springfield (Mo.) 10. Mayo Clinic Health System Eau Claire (Wis.) n San Antonio hospitals report better trauma outcomes after ambulances stock blood for transfusions By Harrison Cook S an Antonio paramedics now carry whole blood in their ambulances to perform transfusions on trauma patients, and some local hospitals are reporting better outcomes as a result, according to EMS1.com. The San Antonio Fire Department modified seven ambu- lances to include high-tech coolers and warmers to store the blood between 1 to 9 degrees Celsius. Paramedics can also remove the coolers and warmers to perform blood trans- fusions in a different location, if necessary. The ambulances share a blood supply with local medical helicopters, which were equipped with the transfusion equipment before the ambulances. Whatever blood is not used is given to local hospitals. This simple transition has increased life-saving by twofold, according to C.J. Winckler, MD, deputy medical director at the San Antonio Fire Department. Mr. Winckler said stocking whole blood on the medical helicopters raised the trauma survival rate from about 20 to 30 percent to "as high as 70 percent." He said he expects the ground ambulances to achieve a similar result. "Both Brook Army Medical Center and University Hospital [are] seeing better outcomes. Patients are arriving a little less sick, and then the resuscitation required in the trauma room is less," Randi Schaefer, MSN, RN, a former Army trauma nurse and research director for the Southwest Texas Regional Advisory Council, told EMS1.com. n Hospitals that use accrediting organizations don't have lower death rates, study finds By Kelly Gooch A study published in The BMJ found no associa- tion between U.S. hospitals that get accredited by independent organizations such as the Joint Commission and lower death rates. The study — led by Cambridge, Mass.-based Har- vard University researchers — also found only a slight association between hospitals accredited by an independent organization and reduced readmis- sion rates for 15 common medical conditions. Researchers said they did not find evidence that patients who pick a hospital accredited by the Joint Commission receive any healthcare benefits com- pared to those who pick a hospital accredited by a different independent organization. The study examined 4.2 million hospital admis- sions for 15 common medical and six common surgical conditions among patients age 65 and older. Admissions were recorded at 4,400 hospitals, including 2,847 hospitals accredited by the Joint Commission, 490 accredited by other independent accrediting organizations and 1,063 reviewed by a state survey agency. "The lack of meaningful differences in outcomes between accredited and state survey hospitals suggest that a closer examination of the benefits of private accreditation would be useful," the study authors concluded. n