Notes
Hospitals are listed alphabetically within each tier.
Measures beyond those shown in the tables were used to evaluate hospitals (see “About This List” at the bottom of the article).
The patient safety indicator (in this case, PSI 90) was developed by the Agency for Healthcare Research and Quality as a composite measure of potentially preventable adverse events and complications from inpatient procedures.
More Top Picks Chest Freezer
Cardiac surgeons at the University of Chicago Medical Center perform an innovative procedure known as totally endoscopic coronary artery bypass. Using an advanced robotic platform called the da Vinci Surgical System, they cut four or five fingertip-size slits in the chest, through which they guide tiny robotic arms and a camera to perform the bypass. All the while, the patient’s heart continues to beat, and no heart-lung bypass machine is required. The benefits of this minimally invasive surgery include faster recovery, lower risk of complications, and minimal scarring.
A Tube and a Balloon
For people over 75 or with certain medical conditions, undergoing open-heart surgery to have a valve replaced can be particularly dangerous. In these cases, surgeons at the University of Chicago Medical Center instead perform a procedure known as transcatheter aortic valve replacement. A long, thin tube is threaded through the arteries from the groin (or wrist) to the heart. Doctors send a balloon through the tube first to make room in the heart for the replacement valve. “In less than 30 seconds, we crush the old valve out of the way and implant a new valve, which immediately starts functioning,” says Sandeep Nathan, an interventional cardiologist at UChicago.
In preparation for the procedure, doctors map the pathway using ultrasound. They may find calcium deposits that need to be cleared. “There are a lot of twists and turns in these vessels, so all of those things must be navigated very carefully,” says Nathan.
Patients are typically ready to go home within a day or two. “For many, the benefit is instantly recognizable,” Nathan says. He recalls one patient who was surprised that she was able to breath easily again right away. UChicago’s oldest TAVR patient was a 103-year-old retired Chicago public school teacher. Says Nathan: “She lived four more very productive and enjoyable years, independently living in Hyde Park.” — Robert Loerzel
In recent years, robotic techniques have revolutionized lung cancer surgery, minimizing the need to cut open patients’ chests. That includes a new single-incision method embraced by Endeavor Health Evanston Hospital. “When you do incisions, you have to go between the ribs, and that’s where the nerves run,” explains Seth Krantz, a thoracic surgeon at Endeavor. “Even with small incisions, if you do four or five, you’re going to have a fair amount of nerve pain. If you do one, you have less.”
Do or Dye
Because invasive breast cancer can spread to underarm lymph nodes, doctors often remove them during mastectomies as a precaution. But this means that some patients are unnecessarily placed at increased risk of lymphedema, a painful swelling of the arms that can result from lymph node removal. “We should first know what those lymph nodes are doing,” says Chantal Reyna, a surgeon at Loyola University Medical Center in Maywood.
To figure that out, Loyola is using a new procedure called delayed sentinel lymph node biopsy. “If a patient is undergoing a mastectomy, we actually can put a dye in that will travel up to the lymph node,” Reyna says. That dye helps identify if cancer is present there. “Now we are doing lymph node surgery only on someone we know needs it,” she says. — Robert Loerzel
More Top Picks Best Slippers For Plantar Fasciitis
Prostate surgeons at Northwestern Memorial Hospital use cryoablation, which delivers extremely cold gas through a needle to freeze and destroy abnormal tissue, to zero in on cancerous cells and leave surrounding structures intact. Done in conjunction with minimally invasive laser surgery, “the procedure shows early indications of effective cancer therapy while allowing patients to have improvements in their urinary function with only mild effects on sexual function,” according to Northwestern.
The Bespoke Spinal Surgery
Think of the preparation that spinal surgeons Nader Dahdaleh and Christopher Ahuja go through at Northwestern Medicine Delnor Hospital in Geneva as akin to making a custom suit. But instead of tape measures, they use a high-tech scanner and artificial intelligence to tailor their surgeries to the patient.
It starts with a French-made EOSedge scanner. (Northwestern Medicine has two in its health system.) In addition to emitting lower levels of radiation than a traditional X-ray, this million-dollar machine — an eight-and-a-half-foot-tall, V-shaped contraption that Dahdaleh calls a “game changer” — generates a sharper image. This 3D scan delivers a composite picture of the patient’s spinal condition and allows for more precise measurements, improving the fit and function of the screws, rods, and other implanted devices.
The scan is then run through EOSedge’s AI-based software, which analyzes the spinal alignment to help the doctors pick an appropriate treatment. And if surgery is required, they can run simulations of different approaches to see which one leads to the best outcome. The software also measures bone density. “That’s key,” Dahdaleh says. “You don’t want to implant in patients who have poor bone quality, because they’re at risk of screws pulling out and hardware failure.”
All this tech-assisted planning means a lighter cognitive load on the doctors during the operation. “In any spine surgery, we’re making hundreds, if not a thousand, decisions on the fly,” Ahuja says. “Some of the procedures we do are six, seven, eight hours long. During that time, any human becomes fatigued. We have to be on our A-plus-game at all times. If we can reduce it from 1,200 decisions to 1,100, we’ll take the win.” — Mike Thomas
ABOUT THIS LIST: It was compiled by Castle Connolly (castleconnolly.com/top-hospitals), a trusted health care research company with over 30 years of experience that is dedicated to helping patients find top doctors and institutions. The Castle Connolly Top Hospitals list provides a data-driven resource to identify leading hospitals for various medical procedures, using medical insurance claims data, proprietary analysis, and physician nomination data to assess patient-outcome performance metrics such as mortality, complication rates, patient safety, and recovery and discharge rates. As part of Everyday Health Group, Castle Connolly contributes to a larger mission of driving better clinical and health outcomes through informed decision making and trusted content, reaching over 67 million health consumers and 890,000 U.S. practicing physicians.