As an alumnus of the Johns Hopkins School of Nursing, a former employee of the The Johns Hopkins Hospital, and someone who works in quality and safety, I know the caliber and quality of education and care that is provided in these institutions, attributes not adequately captured in national rankings. So I am compelled to provide clarification on the article Strength in Numbers: Nurses Behind the No. 1 Ranking (Fall/Winter 2013).
It is not accurate to imply, as the article does, that nursing is the reason for the No 1 ranking. This is not an indictment of the writer but more a message to draw attention to a flawed methodology so that my colleagues across the country in organizations that are both ranked and unranked can have informed conversations with our peers and those who entrust us with their care about what these rankings really mean.
A few quick points about the U.S. News & World Report methodology:
- The purpose of the USN&WR survey is to identify the best medical centers for the most difficult patients—those whose illnesses pose unusual challenges.
- The data are three years behind, so this year’s rankings are based on data from around 2009-2011.
- There are four scoring domains: reputation (based on physician surveys); mortality; patient safety (based on the AHRQ Patient Safety Indicators); and other care-related indicators (RN-to-patient ratio, patient volumes, and some items from the AHA survey from 2011).
There are so many components that go into the rankings. The weighting is heavily influenced by provider recommendations and reputation of the organization, and the methodology is complex. So it is difficult to suggest a direct relationship to the clear drivers behind the No. 1 spot.
Leslie Mason, RN, MSN, Accel. ’99
Chapel Hill, NC
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