If you've got a serious medical problem, the takeaway from US News & World Report's rankings of hospitals is obvious: For cancer, the University of Texas MD Anderson Cancer Center in Houston is the most likely to offer you effective treatment; for heart trouble, the Cleveland Clinic is number one.
But what if you're a nurse or allied healthcare worker, or you're considering a career in healthcare? What's different about working at a top hospital? And what distinguishes the healthcare professionals who are hired by the best hospitals?
Creating a Talent Pipeline
High-ranking hospitals and their staffs distinguish themselves by the goals they set. "We have a high expectation of individuals we're hiring, and our hires have a high expectation of us," says Joseph Cabral, director of career services at NewYork-Presbyterian Hospital in New York City.
But the best hospitals do more than just hope for the best; they set recruiting and training resources to the task. At Children's Memorial Hospital in Chicago, "we have a nurse internship program that gives new grads better support," says Armando Morales, a nursing recruiter.
While some hospitals pride themselves on hiring many top-of-their-class graduates, other institutions say academic performance doesn't predict professional accomplishment. "You can take any nurse and make them successful by giving them the right tools," says Sharon Dickinson, a clinical nurse specialist in the surgical intensive care unit at the University of Michigan Medical Center in Ann Arbor.
Special Challenges and Rewards
Top hospitals treat lots of acutely ill patients, who flock there for life-saving care. This poses intellectual and emotional challenges for the healthcare staff.
"We get the most unusual cases, the sickest patients, those with multiple conditions," says Jan Mulcrone, director of human resources at the 12,000-employee University of Michigan Health System.
Dickinson says Michigan's nurses thrive in the environment of a teaching hospital.
"The MDs here are top researchers on the cutting edge of new technologies and treatments," says Dickinson. "That really prompts us to stay on our toes, to read the literature, to ask what we can do to take better care of our patients."
And although top hospitals are very attractive to candidates, these institutions and their employees still must cope with understaffing. "We're better off than most hospitals, though we are experiencing a nursing shortage," says Mulcrone.
Taking Care of Their Own
In many cases, the hospitals with the best reputations try to keep their workers happy by giving them opportunities for advancement.
"A lot of folks who enter in medical tech positions can pursue their bachelor's degree with help from the hospital," says Catherine Broom, a clinical nurse specialist at the University of Washington Medical Center in Seattle.
Top hospitals also create opportunities for advancement within their organizations. Nurses may work toward a promotion to clinical manager; medical technologists may seek a role as a laboratory supervisor.
And there's a payoff for the institutions: Employees of top hospitals tend to stay put. "Good relationships help to curb turnover," says Cabral of NewYork-Presbyterian. "Our annual turnover rate is 8 percent to 10 percent, while the New York City average is 17 percent."
Culture and Physician-Staff Relationships
Some high-ranking hospitals are improving their cultures and the quality of care by including a wide range of workers in major decisions. "Staff from various disciplines contribute to everything from the physical design of units to how patients are cared for," says Broom.
But top hospitals are far from immune to daily intramural battles. "Physician-nurse relationships are still a huge problem in nursing," Dickinson says.