Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

If you had successful heart surgery at your local hospital but went home without instructions about what to do at home, you might think your hospital failed to provide top-notch care. You would be right, but you probably wouldn't know how to voice your concern.

Although hospitals have asked patients what they thought about their hospital stays, patients' answers have not been available to the public. Not having this information has made it harder for patients to decide which hospitals to use. It has also prevented doctors, nurses, and hospital leaders from knowing what they should do differently to improve care.

Because patients' experiences are an important part of good quality care, I'm happy to tell you that this information is now available for the first time on a public Web site. You can go to the Hospital Compare Web site and learn about the care experienced by patients in about 2,500 hospitals around the country.

By the end of this year, information from most of the Nation's hospitals will be available on the site.

The Web site reports patients' answers to more than two dozen questions about hospital care, such as:

  • How often did nurses explain things in a way you could understand?
  • How often did doctors listen carefully to you?
  • After you pressed the call button, how often did you get help as soon as you wanted it?
  • How often did the hospital staff do everything it could to help you with your pain?
  • How often did the hospital staff tell you what medicine was for?
  • How often were your room and bathroom cleaned?
  • How often was the area around your room quiet at night?
  • Did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
  • On a scale of 0 to 10, what number would you use to rate this hospital during your stay?
  • Would you recommend this hospital to your friends and family?

My agency, the Agency for Healthcare Research and Quality, developed this national survey. When we tested it, my agency got feedback that made it clear that doctors, nurses, and hospitals are doing some things well. But there's more work to be done before quality can truly improve.

For example, a majority (84 percent) of patients said that doctors always treated them with courtesy and respect. Nearly as many (77 percent) said nurses always treated them in this same way. While a basic right, treating patients respectfully and courteously also increases the chances for open, honest conversation between a patient and a physician.

The survey also found that 20 percent of patients said they never received written information about health problems to watch for when leaving the hospital. For example, a patient who just underwent heart surgery needs to know to call the doctor immediately if a fever or rapid heart rate occurs or if medicines that were prescribed to prevent disease from coming back are causing side effects or other difficulties. Having a rapid heart rate or fever could mean the patient has an infection, which is very serious if it's not treated quickly. Many patients stop taking medicines after they leave the hospital because they have a side effect or because they don't know how important it is to take these drugs to completely recover.

We know that a speedy response to a call button or a quiet room at night does not mean you've received the best quality health care, but they are both important to patients. But we also know that when patients are treated with respect and given information they understand, they are likely to play an active role in their health care.

That's a goal that I embrace. It's also the reason why I'm convinced that making this information available to the public will help doctors, nurses, hospitals, and—most importantly—patients. You need to take an active role in your health care. Using this Web site to pick a hospital is one way to do that.

I'm Dr. Carolyn Clancy, and that's my opinion on how to navigate the health care system.

More Information

AHRQ Podcast
New Web Site Helps Consumers Navigate the Health Care System  (Transcript)

Hospital Compare, Information for Consumers

Having Surgery? What You Need to Know: Questions to Ask Your Doctor and Your Surgeon

Quick Tips—When Planning for Surgery

Page last reviewed April 2008
Internet Citation: Your Experience in the Hospital and Why it Matters. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/20080401.html