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Evanston Hospital, the flagship of the NorthShore University HealthSystem, has long been considered one of Chicagoland’s premier health centers. Founded as a six-bed “Emergency Hospital” in 1891, amid a deadly outbreak of typhoid fever in Chicago and its neighboring towns, the hospital kept going and growing after the emergency ended—adding one of the earliest obstetrical units in the area, then a nursing school, a cancer center, an advanced trauma unit, and a teaching affiliation, at first with Northwestern University and later with the University of Chicago’s Pritzker School of Medicine. In the 1920s and ’30s, an Evanston physician-researcher helped perfect the vaccine for whooping cough; in the ’90s, the hospital opened a center for medical genetics; at the start of the millennium, it was among the first in the nation to adopt a systemwide electronic medical records system.
But what do you discover when you look beyond Evanston’s august history to the hard numbers? How does it stack up today when measured against the competition in unforgiving metrics such as how many of its patients have to be readmitted for complications, or the number who acquire a new predatory infection in the hospital?
The results are incontrovertible: The 109-year-old health center is, well, still a great hospital. In fact, for 21 years, the centerpiece of NorthShore’s five-hospital network has excelled in objective measures that often reveal striking weaknesses in other well-regarded institutions. Evanston isn’t just reputationally good, it’s actually one of the nation’s best-performing hospitals—at least on the basis of 11 criteria that factor in everything from clinical outcomes to patient experience, operational efficiency, and financial health (see our methodology here).
That’s the aim of the Fortune/IBM Watson Health 100 Top Hospitals List: to cut through the perception juggernaut—a “prestige bias,” if you will, that often helps some hospitals with loftier reputations and more ample funding appear better than they truly are, even as it hides the hard-won successes and steady performance of lesser-known systems.
On this year’s list are names you might expect. Two California stalwarts, for instance—Stanford Hospital and UCLA Medical Center—are indeed among the country’s best-performing teaching hospitals when measured on clinical outcomes and other objective criteria. But then you might be surprised to learn that St. Joseph Mercy Ann Arbor Hospital also has world-class stats where it counts. It boasts a remarkably low rate of risk-adjusted patient mortality, according to government figures. That’s true both while patients are undergoing treatment in the hospital and after they’re sent home. Average lengths of hospital stays, meanwhile—again, adjusted for the severity of the illness—are lower at St. Joe’s too. So is the average inpatient cost (by a lot). No wonder patients themselves give the Michigan hospital consistently high marks in the long-running HCAHPS (or, familiarly, “H-caps”) survey conducted by the Centers for Medicare & Medicaid Services (CMS).
Alonzo Lewis, who joined St. Joe’s operations department four years ago and became the hospital’s president in March—just a few weeks before the COVID-19 caseload peaked in Michigan—is a big believer in using data to drive continuous improvements. “We have a thoughtful, process-driven approach to our analyses,” he tells Fortune. “The aim is to get to the root cause” of what’s working or not working, and you see that in the data. But blind focus on the metrics themselves doesn’t necessarily lead to better outcomes, he cautions. For Lewis, the organization has to be driven by something larger. “Our mission calls us to be a transforming healing presence,” he says, and “the engagement of our physician leaders and their teams to this goal is second to none.”
Engagement has likewise been the mantra at Silver Cross Hospital, in New Lenox, Ill., which has been a standout in patient satisfaction for years (and in the top 100 ranking for eight of them). All told, Americans spend upwards of 180 million days a year as an inpatient in a community hospital such as Silver Cross—so a focus on patient experience shouldn’t be an afterthought.
This year, Fortune and IBM Watson Health also included a key measure of financial health, given the precarious finances of many hospitals. Consider that at least 22 hospitals and health systems filed for bankruptcy in 2019, according to an analysis by Becker’s Hospital CFO Report. That was before the coronavirus put unprecedented stress on health care facilities across the U.S. Weak hospital finances ultimately mean instability and, as we’ve seen in the ongoing pandemic, that can lead to layoffs of physicians, nurses, and other critical care staff.
“COVID-19 has challenged the global community and has created massive disruption across the entire health system,” says Kyu Rhee, MD, MPP, the chief health officer at IBM Watson Health, which took on this comprehensive analysis of more than 3,000 nonfederal U.S. hospitals and more than 300 health systems when it acquired Truven Health Analytics in 2016. The ranking itself dates back nearly three decades, to 1993.
“And while it’s safe to say that there’s no playbook for a pandemic of this magnitude,” adds Rhee, a former top official in the U.S. Department of Health and Human Services, “it’s clear that hospitals—from small rural institutions to large teaching hospitals—have stepped up in innovative ways to support patients and communities. I believe we have much to learn from this group as we reinvent our health system.”
Read on to discover this year’s top 100 hospitals in the U.S., which we’ve broken down into two main lists—teaching hospitals and community hospitals—and five sublists based on size.—Clifton Leaf, Editor-in-Chief, Fortune
Fortune/IBM Watson Health 100 Top Hospitals
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