How well can we identify the high-performing hospital?

Michael Shwartz, Alan B. Cohen, Joseph D. Restuccia, Z. Justin Ren, Alan Labonte, Carol Theokary, Raymond Kang, Jedediah Horwitt

Research output: Contribution to journalArticle


Sharing lessons from high-performing hospitals facilitates quality improvement. High-performing hospitals have usually been identified using a small number of performance measures. The objective was to analyze how well 1,006 hospitals performed across a broader range of measures. Five measures were developed from publicly available data: adherence to processes of care, 30-day readmission rates, in-hospital mortality, efficiency, and patient satisfaction. For a subset of hospitals, the authors included two survey-based assessments of patient care quality, one by chief quality officers and one by frontline clinicians. In general, there was little correlation among the publicly available measures (r ≤.10), though there was notable correlation between objective measures and survey-based measures (r =.23). Hospitals that performed well on a composite measure calculated from the publicly available measures were often not in the top quintile on most individual measures. This highlights the challenge in identifying high-performing hospitals to learn organizational-level best practices.

Original languageEnglish (US)
Pages (from-to)290-310
Number of pages21
JournalMedical Care Research and Review
Issue number3
Publication statusPublished - Jun 2011
Externally publishedYes



  • composite measures
  • high-performing hospital
  • performance measures
  • quality

ASJC Scopus subject areas

  • Health Policy

Cite this

Shwartz, M., Cohen, A. B., Restuccia, J. D., Ren, Z. J., Labonte, A., Theokary, C., ... Horwitt, J. (2011). How well can we identify the high-performing hospital? Medical Care Research and Review, 68(3), 290-310.