Smaller Rural Hospitals Provide Surgical Care That Is Just As Safe As Larger Urban Hospitals

A new study released in the July issue of the American Journal of Surgery compared the compliance of hospitals to the latest safety standards. It showed that smaller community hospitals were as responsive or even more responsive to new safety standards than their larger urban and tertiary care counterparts. It shows that you do not have to go to the big city to have a high quality, safe surgical experience. This is very important since currently 40% of Americans have their surgery in centers that are not large, urban, or tertiary care facilities.

In my years of experience I always knew this to be true, but it is nice to see it documented in a study. Most previous studies have bypassed the care given in the smaller and rural community hospitals. This has helped perpetuate the myth that for the best surgical care you must go to the large teaching hospital with cutting edge, expensive technology. If your surgery is that specialized that you need this type of care you will be referred there. But for more routine operations it was found that the smaller hospitals more quickly adopted new safety standards because there are fewer bureaucratic levels to cut through.

Specifically the study focused on how well hospitals implemented the expanded surgical time out procedure. The basic time out occurs before the patient is put under for surgery to verify that it is the correct patient, the correct surgery and the correct site. The expanded time out has a long checklist of additional safety items to check. Major surgeries such as hip and knee replacements, hysterectomies and colon resections were looked at for the study. It showed and overall compliance rate of 97% for the smaller hospitals with clinicians showing an extremely high standard of care.

So unless a patient needs a Cyberknife or DiVinci device for their care, they should feel comfortable going to their community hospital for surgery even if it is not listed in the U S News and World Report's Best Hospitals in America list.

More on this later.

Mark Brodeur