By Avery Comarow, US News Writer

Posted July 15th 2010

It’s no secret that all hospitals are not equal. The special quality shared by the 152 that made it into the new 2010-11 Best Hospitals rankings (out of nearly 5,000 that were considered), and even more so by the 14 in this year’s Honor Roll, is their ability to take on and meet the most difficult challenges. Their operating rooms showcase delicate, demanding procedures—excising a cancerous portion of a pancreas without destroying the rest of the fragile organ, say, or restoring function to an arthritis-ravaged hand through a creative blend of fusing joints and splicing tendons. They are referral centers for ill patients with multiple risks—advanced age plus heart failure plus diabetes, perhaps.

Patients at these centers are not free from hospital-based infections or immune from getting the wrong drugs or becoming victims of other medical errors. No matter how skilled or deep their expertise, even “best hospitals” don’t do everything right. But when the stakes are high, calling for unusual capabilities, they are hospitals that can save lives that might otherwise be lost or preserve quality of life that might otherwise be sacrificed. That is why U.S. News has published the Best Hospitals rankings for 21 years: to help guide patients who need high-stakes care because of the complexity or difficulty of their condition or procedure. For 2010-11 we analyzed 4,852 hospitals, virtually every one in the United States, in 16 specialties from cancer and heart disease to respiratory disorders and urology. Only 152 centers appear in even one of the 16 specialty rankings. Fourteen ultra-elite Honor Roll hospitals had very high scores in six or more specialties.

In 12 of the 16 specialties, the quality of hospital care can determine life or death. Therefore the largest part of each hospital’s score in those 12 specialties came from death rates and other hard data on patient safety, volume, and various care-related factors such as nursing and patient services. The rest of the score was derived from a reputational survey of specialists. The 50 highest scorers were ranked. Scores and complete data for another 1,740 unranked hospitals are also available. In the four other specialties—ophthalmology, psychiatry, rehabilitation, and rheumatology—hospitals were ranked on reputation alone. The number of deaths in these specialties is so low that mortality data and certain other categories of data are not relevant factors.

A detailed description of the analysis in the 12 specialties is available. In brief, death rate, care-related factors, and patient safety added up to slightly more than two-thirds of each hospital’s score. The reputation portion of the score used responses from nearly 10,000 physicians, who were surveyed in 2008, 2009, and 2010 and asked to name five hospitals they consider among the best in their specialty for difficult cases, ignoring cost or location.

The Honor Roll requirements were so stiff that 99.7 percent of all centers in the nation were excluded. A hospital had to be ranked in at least six specialties, but ranking alone was insufficient for inclusion. It also had to have an extremely high score (in statisticians’ terms, at least 3 standard deviations above the mean). That earned 1 point per specialty. Reaching the top of the Honor Roll called for even higher scores (4 or more standard deviations above the mean), earning 2 points, in far more specialties. The highest-ranked hospitals on the Honor Roll, which is ordered by points, had high scores in 15 of the 16 specialty rankings. Johns Hopkins stands at No. 1—as it has for the last 20 years.

NEON providers are committed to a service delivery model that addresses accessible personalized care. Patients have access to a primary care physician, who coordinates all of their health care needs.

The provider staff currently includes 35 physicians, 10 dentists and a staff of Certified Nurse-Midwives and other support personnel. In addition to clinical services, patients have access to social work, health education, family planning and nutrition counseling, all of which provide a multi-disciplinary approach to improved health outcomes. Since its inception, NEON has maintained a history of collaboration with its community partners to assure the provision of quality health care services to residents of Northeast Ohio.

Ancillary services such as laboratory, x-ray, nutrition and pharmacy services are also available, meeting a wide array of primary care needs. NEON accepts a number of payment arrangements for services including Medicare, Medicaid, CareSource, Anthem, United Health Care Plan, Medical Mutual of Ohio, CIGNA and other commercial insurance plans. Services are also available on a sliding fee scale, incorporating a patient’s family size and income.

Comprehensive Services

• Primary Care Services for Adults and Children
  • Adult Medicine
  • Pediatrics
  • Family Medicine
• Perinatal Clinical Care
• Gynecology & Family Planning
• HIV / STD Testing
• Mammography
• Ultrasound Services
• Laboratory & X-Ray
• Dental
• Optometry
• Pharmacy
• Behavioral Health
• Nutrition
• Health Education
• Social Work
• Flex Sigmoidoscopy
• Dermatology
• Referral Services

Programs & Services

• Comprehensive Perinatal Care Program
• CFHS Perinatal, Pediatric and Adolescent Outreach Program
• MomsFirst
• BPHC Diabetes & Asthma Collaboratives
• Shaw High School Wellness Center
• Job Corps Wellness Center
• Nursing Home Services
• Senior Plus Program
• Substance Abuse Initiative
• BEST Program
• Cuyahoga County BCCP
• Women, Infants and Child
• Women Program
• Women of Wellness (WOW) Program

Within the next ten years, the US population will grow significantly older and more diverse. The minority older population will triple by 2030, when one quarter of the elderly population will belong to a minority racial or ethnic group (US Census Bureau, January 2000). Different racial and ethnic groups have diverse beliefs and attitudes about health and medicines, which may affect adherence to therapy.A failure to appreciate these differences may contribute to misunderstanding or miscommunication about health care.

No one list can define the values that older adults may place on medications, or their beliefs about how health and healing take place. Each person must be considered individually. Listening and asking nonjudgmental questions begins the process of understanding people’s diverse beliefs and practices about health and healing and how to integrate them into interventions to improve medication adherence.

NEON’S Adult Medicine program offer a comprehensive medical service to address the need of African American Adults.

The pediatric patient population in the United States is continuously becoming more culturally diverse. It is estimated that by the year 2020, approximately 40% of school-age Americans will be minority group children.*

The American Academy of Pediatrics (AAP) recognizes that the cultural diversity of the population has implications for the provision of pediatric health services. The Academy recognizes the importance of culturally effective pediatric health care, which is defined as: “the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of cultural distinctions. Such understanding should take into account the beliefs, values, actions, customs, and unique health care needs of distinct population groups. Providers will thus enhance interpersonal and communication skills, thereby strengthening the physician-patient relationship and maximizing the health status of patients.”**

Dental Hygiene is an ongoing health deficiency in the African American Community.  The Office of Minority Health studies reveal that children aged 2 to 4 years, 26% of African Americans have experienced dental cavities in their primary teeth, compared to 20% for Whites, in 2004. African American children are 40% less likely to have preventive dental sealants than do their White classmates. The percentage of people of all ages who had untreated cavities was substantially higher for African Americans than for Whites.

Among adults aged 35 to 44 years, 40% of African Americans as compared to 23% of Whites have tooth decay. African Americans are more likely than Whites to have teeth extracted. Higher levels of gingivitis and periodontal loss of attachment were also seen in African Americans as compared to Whites. A greater percentage of African Americans 18 years and older have missing teeth compared to Whites. African American males have the highest incidence rate of oral cavity and pharyngeal cancers in the United States compared with women and other racial/ethnic groups. In 2004, 30% of African Americans had annual dental visits, as compared to 50% of the Caucasian population.

Fibroids can occur in many locations throughout the uterus. Some may occur within the wall of the uterus, while others can grow within the uterine cavity (called the endometrium). Pedunculated fibroids are attached to the outside of the uterus by a thick stalk, similar to the root of a plant. Some women have only one, small fibroid, while others have dozens of them. Even though most are small (less than golf ball sized) others can grow to the size of a watermelon! It is the combination of size, number, and location that can produce symptoms. It is impossible to predict who will get fibroids. African-American women get them more often than Caucasian women, and some researchers estimate that up to 50% of African-American women will develop fibroids. In some cases a small or medium-sized fibroid will stay the same size, or even become smaller, but in other cases it may slowly grow and develop symptoms over time. Many women have fibroids and never know it, but other women may develop significant symptoms that bring them to their physician’s office.

African Americans who eventually go blind usually go blind from glaucoma. It is the leading cause of blindness with the African American population. It is seven times more common in African Americans than in Caucasians. Caucasians in the age group of 45 to 65 have 17 times less of a chance of getting glaucoma than African Americans in the same age group. African Americans usually experience the most common form of glaucoma known as open angle glaucoma. Over 16% of African Americans don’t even know what glaucoma even is.

Less than half of the adult population have their eyes examined bi-annually with a dilated eye exam.  This is the most effective way to detect glaucoma and many people are not comfortable with the technique. Almost 10% of the Caucasian population in the United States are not familiar with what glaucoma is.

Pregnancy is an exciting time in a woman’s life. It can also be a time of great anxiety and fear of the “unknown” as a new life is growing and developing inside the womb. To help ensure that things go as planned, it is essential that you receive proper prenatal care. Prenatal care is important for all women because it can help to identify conditions in the woman and/or fetus that may jeopardize the pregnancy.

Prenatal care is especially important for the African American woman. We have the highest incidence of pre-term labor, low birth weight babies and other pregnancy-related complications. Also, certain diseases and illnesses that are frequent in our community (diabetes, hypertension, sickle cell) can cause significant problems in pregnancy. For this reason, early and frequent prenatal visits are essential to help ensure a healthy pregnancy and ultimately, a healthy baby.

NEON’S origins lay within the turbulent civil rights era of the 1960’s! Hough-Norwood was the firstborn at 1465 East 55^th in 1967.President Lyndon Johnson established the Council For Economic Opportunities in Greater Cleveland to administer and coordinate his war on poverty in the city. Under the leadership of Ralph W. Finley, The Cleveland CEO focused on providing increased opportunity and services for the area’s poor. Hough-Norwood was one of the prominent programs in its efforts to provide health service for the needy. The Academy of Medicine of Cleveland also played a role in the creation of Hough-Norwood and regional health planning after membership began to accept Medicare and Medicaid.

Hough-Norwood offered primary care to any resident of the Hough-Norwood or Goodrich area with incomes below the $4,200 poverty line for a household of four. It trained neighborhood residents for ‘outreach’ and health action work. The clinic made transportation and child care available to its active role of patients. Hough-Norwood serviced a diverse community of African Americans, Slovenian, Spanish and Croatian constituents. By 1971 Hough-Norwood was servicing over 1500 persons on a weekly basis. In 1972 the center opened the satellite facility at 8300 Hough Avenue and in 1980 the facility at 12108 Superior opened its doors and welcomed the community.

Today operating under the regional auspices of NorthEast Ohio Neightborhood Health Services (NEON) there are six primary care facilities on the east side of Cleveland. Offering quality affordable services in Pediatrics, Dental, Vision, OB/GYN, Podiatry and many more NEON services over seventy thousand patients from lower to middle income brackets weekly. CEO Willie F. Austin has been with this institution practically from its inception.

ANY AND ALL ARE WELCOME!

Americans spend a great deal of time on their feet. As the Nation becomes more active across all age groups, the need for foot care will become increasingly important to maintaining a healthy lifestyle.

The human foot is a complex structure. It contains 26 bones—plus muscles, nerves, ligaments, and blood vessels—and is designed for balance and mobility. The 52 bones in the feet make up about one-fourth of all the bones in the human body. Podiatrists, also known as doctors of podiatric medicine (DPMs), diagnose and treat disorders, diseases, and injuries of the foot and lower leg.

Podiatrists treat corns, calluses, ingrown toenails, bunions, heel spurs, and arch problems; ankle and foot injuries, deformities, and infections; and foot complaints associated with diseases such as diabetes. 10.8% of all African Americans have diabetes! To treat these problems, podiatrists prescribe drugs, order physical therapy, set fractures, and perform surgery. They also fit corrective inserts called orthotics, design plaster casts and strappings to correct deformities, and design custom-made shoes. Podiatrists may use a force plate or scanner to help design the orthotics: patients walk across a plate connected to a computer that “reads” their feet, picking up pressure points and weight distribution. From the computer readout, podiatrists order the correct design or recommend another kind of treatment.