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Picking the right hospital can save your life

  • Story Highlights
  • Research hospitals in your area to find the best care for specific illnesses
  • The more a hospital performs a procedure, the better the results in most cases
  • Specialty training for hospital staff often can result in better patient outcomes
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By Elizabeth Cohen
CNN
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Empowered Patient is a regular feature from CNN Medical News correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.

ATLANTA, Georgia (CNN) -- Chuck Toeniskoetter says he's alive today because of a nurse and a paramedic who came to his aid when he collapsed one snowy day high atop a mountain.

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Studies are now finding that not all hospitals are created equal for every medical emergency.

They didn't administer CPR. They didn't give him life-saving drugs. They didn't treat him at all. What they did was get him to the right hospital.

The helicopter ambulance pilot wanted to take Toeniskoetter to the closest hospital. But the nurse and the paramedic suspected he'd had a stroke and urged the pilot to go to a certified stroke center, 15 minutes further away.

"They stood on the runners of the helicopter and were relentless with the pilot," Toeniskoetter remembers. "They saved my life."

At Sutter Roseville Medical Center in Roseville, California, Toeniskoetter received TPA, a drug that dissolved the clot in his brain. It's likely that at the other hospital -- the one the helicopter ambulance pilot wanted to take him to -- he wouldn't have received TPA.

Studies are now finding that not all hospitals are created equal for every medical emergency. Whether it's a stroke, a high-risk birth, or a heart attack, the research says it's worth doing whatever it takes to get to the right place. "A lot of people think hospitals are all the same," said Dr. Samantha Collier, chief medical officer at HealthGrades, which ranks hospitals. "They're not."

Consider this:

  • A new study in the Archives of Internal Medicine says heart attack patients have a higher chance of surviving if brought to one of U.S. News & World Report's Top 50 hospitals for treating heart problems.
  • A study earlier this year in the New England Journal of Medicine finds very low birth weight newborns are more likely to survive if treated in a high-level neonatal intensive care unit that takes care of a large volume of very low birth weight babies.
  • So how can you know which hospital is right for your medical needs?

    Research hospitals on the Internet

    "If we're going to spend hours on the Internet doing research before we buy a car, we should spend at least as much time researching hospitals," said Collier.

    Her company's Web site, healthgrades.com, ranks hospitals by specialty, as does The Leapfrog Group. You can find out the best place to get hip surgery in Topeka, Kansas, or the best place to have a baby in New York City.

    JointCommission.org lists hospitals that have certification for various medical specialties. Hospitalcompare.hhs.gov has detailed information about procedures performed at different hospitals.

    Ask the right questions

    If the information isn't available on the Internet, you'll have to call the hospital's quality office. Collier says ask about volume; hospitals that perform a high number of a given procedure -- heart bypass surgery, hip replacement -- usually have the best results, studies show. Leapfrog and HealthGrades have information about what constitutes high volume for various procedures.

    Staffing also plays a key role. "Let's say I'm having a surgery where it's highly likely I'm going to have a stay in the intensive care unit," said Suzanne Delbanco, CEO of Leapfrog. "Your risk of dying in an ICU drops 40 percent if the doctors working there are 'intensivists,' which means they have specialty training in critical care. Ask if they have that kind of staffing."

    What about an emergency?

    It may sound strange, but it's possible to anticipate many emergencies.

    Experts recommend thinking about what emergencies are most likely to happen in your family. Perhaps your mother has a heart condition, or perhaps you have a high-risk pregnancy and are at risk of having a premature baby.

    Art Caplan, a bioethicist at the University of Pennsylvania, says the first step is to find out where an ambulance would take you if you dialed 911. If you want to go elsewhere, you might be out of luck. Often you can't persuade an ambulance driver to go to a stroke center if you've had a stroke, or to go to a children's hospital if your child is injured.

    But you can be an informed consumer and check with emergency service providers in your area to find which hospital you'd be taken to and see whether you'd be able to negotiate a different destination.

    After Chuck Toeniskoetter's experience, he started the Stroke Awareness Foundation, to help others choose the right hospital if they've had a stroke.

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    When he thinks about how the nurse and the paramedic argued for him to go the extra 15 minutes to the stroke center, he says he'll always be grateful.

    "Those were the shortest 15 minutes of my life," he says. E-mail to a friend E-mail to a friend

    Elizabeth Cohen is a correspondent with CNN Medical News.

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