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Hospitals looking out for No. 1 in survey

Hospitals looking outfor No. 1 in survey

Hospital administrators like to say privately that the US News & World Report hospital rankings are based too much on reputation to be taken seriously. But that won't stop Johns Hopkins Hospital officials from greeting staff with gifts tomorrow to celebrate being rated number 1 for the 14th straight year.

Around here, celebration is likely to be more muted. Massachusetts General Hospital ranked third and Brigham & Women's ranked 12th, the only New England hospitals to make the US News honor roll, based on quality in 17 specialties as well as reputation. But Brigham & Women's has finished as high as eighth in the past, while Mass General has remained in third place for years.

Meanwhile, Boston Children's Hospital lost out to Children's in Philadelphia for top pediatric honors, the second straight defeat after a 12-year run on top. Mass General was the only New England hospital to lead a specialty (both kidney disease and psychiatry), though several finished near the top in certain fields, including Dana-Farber Cancer Institute and Mass Eye & Ear Infirmary.

Mass General spokeswoman Donita Boddie noted a hard truth of the rankings game: they're just a nice honor ''until you slip."


Controling crowds in the UMass ER

It wasn't supposed to be this way. When the emergency room opened a quarter of a century ago at UMass Memorial Medical Center in Worcester, it was designed to handle 35,000 patient visits a year. These days, there are more like 75,000 visits. It's a reflection of consolidation in the hospital business, as well as the emergence of UMass as a major trauma center.

The solution: Construction of a new emergency department, cornerstone of a $125 million expansion at the hospital. Today's ER has 46 treatment bays (58 if you include spaces carved out of hallways), while the new facility is expected to have 75, said Wendy Warring, executive vice president of UMass Memorial Health Care.

''I would tell you we have done yeoman's work maintaining the quality of patient care" in the current facility, Warring said, ''but patients do experience -- as they do elsewhere -- extended emergency room waits. And they are sometimes cared for in very crowded conditions, which is probably uncomfortable for them and certainly uncomfortable for the staff who cares for them."

The new emergency department, set for completion at the end of next year, will be able to handle 90,000 visits a year.


Brockton switches its allegiance to Tufts

Unable to resolve a dispute with its long-time affiliate, Boston Medical Center, Brockton Hospital is switching its affiliation to Tufts-New England Medical Center.

Brockton Hospital and other community hospitals for years have sought partnerships with Boston teaching hospitals. In these agreements, the teaching hospital usually sends specialists and residents to the smaller hospital while the community hospital refers patients with complex problems to its academic partner. Brockton Hospital also needs sponsorship from a teaching hospital to offer emergency angioplasty for cardiac patients.

But in this case, the two hospitals disagreed about how to expand cardiac services in Brockton, and how much complex cardiac care would be provided by Boston Medical Center doctors and how much would be done by doctors recruited to Brockton.

As a result, they are ending a 30-year partnership in July 2005. Boston Medical Center will no longer rotate a large number of residents to Brockton Hospital and could stand to lose 100 to 150 patient referrals a year. Instead, Tufts-NEMC will send about 80 residents a year to the community hospital and has agreed to help recruit new cardiologists to Brockton.


Gene sequencing coming to the masses

The National Human Genome Research Institute awarded Harvard $10 million over the next five years to develop new technologies that will drastically lower the cost of sequencing genes.

Now, it costs about $20 million to sequence one person's DNA; the goal is to get it to about $1,000, which would open up tremendous possibilities for personalized medicine. Rather than taking a one-size-fits-all approach to treating a disease, doctors could tailor care to each patient.

George M. Church, the team leader, said his group plans to scale down the cost of genome sequencing by using less expensive equipment, like basic microscopes, and smaller amounts of chemicals.

Church likened his team's mission to the creation of the World Wide Web -- when the equipment was already available and only the procedure was missing.

On the other side of Cambridge, the Broad Institute last week received $75 million from the National Institute of Allergy and Infectious Diseases to establish a new center to sequence the genomes of organisms that can cause disease or be used for bioterrorism.