In a recent report by U.S. News and World Report, the U.W. Medical Center was ranked 11th overall among all U.S. hospitals. In certain areas, its ranking was even higher: 4th in rehabilitation medicine, 6th in oncology, and 10th in diabetes. Nationally, the highest ranking hospitals were Mayo Clinic in Minnesota, Johns Hopkins, Massachusetts General, and UCLA.

The report, just released, ranked nearly 5,000 hospitals in 16 adult specialty categories using surveys from more than 9,500 physicians. Hospitals that are consistently featured high up on the list are seen as some of the best in the nation.

The rankings were based on physician surveys of hospital quality, and those views may be based on research and scholarly publications as much as on direct patient care. What happens to a patient while in the hospital may have little relation to the quality of research done by senior faculty members. Indeed, much of the care in a teaching hospital is done by residents and by nurses, although faculty members may supervise that care. Residents are graduates of medical schools and are doctors, but they are doing specialized training at a teaching hospital such as the U.W.

In our experience, most of the medical malpractice cases we handle against the U.W. or Harborview involve poor decisions by first year residents, nurses, or technicians. Another common area of liability has to do with systems errors, such as failure to have procedures for follow-up of adverse tests or imaging results. As with any large medical institution, patient decisions can be less than optimal when there are numerous providers involved in a particular patient’s care. In teaching hospitals, there are often numerous residents involved, many of them making recommendations or issuing orders. The more “hand-offs” of care between providers, the more room for mistakes to occur.