None of us wants to think about this, but getting good medical care isn’t a sure thing.  While the vast majority of providers meet minimum requirements or better, many Americans are injured or killed by the medical care they receive.

Nearly two decades agohe National Academy of Sciences’ Institute of Medicine issued a national report, “To Err Is Human”, estimating that as many as 100,000 American hospital patients died in one year due to medical mistakes.  Subsequent studies have established a range that is even higher, from a low of 250,000 to as many as 440,000 hospital patient deaths annually.

No matter what the number, they are staggering.  And experts now consider deaths due to medical mistakes as the third leading cause of death in America, behind heart disease and cancer.

The Institute of Medicine’s 1999 report called for sweeping changes to substantially reduce the number of medical errors.  Improving patient safety is where policy makers must place their focus.

Positive medical care outcomes depend on carefully-coordinated care, communication, and policies designed to protect patients from harm.  Not all hospitals are alike.  Choosing the right hospital can be even more important than picking the right doctor.

New York State offers some information in this area.  The state Health Department has a program, hospital profiles (https://profiles.health.ny.gov/hospital/), which provides some useful information on the frequency of medical procedures that are performed at each hospitals.  It also offers doctor profiles (https://www.nydoctorprofile.com/), which allows patients access to background information on physicians.

But these profiles are often incomplete and do not rank providers by the quality of care.

In light of that vacuum of medical provider quality performance data, outside private groups have developed their own measures.  US News & World Reports magazine issues an annual “Best Hospitals in the U.S.”  Healthgrades.com also issues quality information on doctors and hospitals.

Perhaps the most comprehensive is the annual hospital ranking issued by The Leapfrog Group (http://www.leapfroggroup.org/).  Leapfrog was created over 15 years ago by large businesses that were frustrated by the lack of quality health data.  The businesses usually negotiated coverage for their employees, yet lacked the data to comparison shop.

Leapfrog’s Hospital Survey is considered by many to be the “gold standard” for comparing hospitals on standards of safety, quality, and efficiency.  Leapfrog collects voluntarily-provided surveys from nearly 2,000 hospitals and cross checks it with other publicly-released data and medical experts to issue annual rankings.  The annual ranking shows that hospitals across the country show a lot of variation when it comes to patient safety.

Leapfrog then ranks the states based on the number of hospitals that have achieved an “A” ranking.  This year, the state of Maine topped the list with nearly 70 percent of its hospitals earning an “A.”  Rounding out the top five this year were Hawaii, Oregon, Wisconsin and Idaho.

New York State ranked poorly, as it usually does, this year ranking 48^th in the nation, with only 6 percent of its hospitals getting an “A” ranking.

That means that it’s critically important that patients choose a hospital with a good track record on keeping its patients safe from harm.  In addition to researching the sources mentioned earlier, here are some other ways patients can be vigilant right now:

Ask questions. Gain as much insight as you can from your health-care provider.  Ask about the benefits, side effects and disadvantages of a recommended medication or procedure.

Seek a second opinion. If the situation warrants or if uncertainties exist, get a second opinion from another doctor:  A good doctor will welcome confirmation of his/her diagnosis and resist any efforts to discourage the patient from learning more.

Bring along an advocate. Sometimes it’s hard to process all the information by yourself.  Bring a family member or a friend to your appointment — someone who can take notes and help you understand the information and ask questions.

Hopefully, you won’t need to use this information any time soon.  In the meantime, we should all be pushing for better healthcare oversight, more transparency so that consumers have data to make medical care choices and ultimately better outcomes, a healthcare delivery system where medical errors are rare.