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Hospital Checklist

When you are ready to choose between two or more hospitals for your care, the following checklist can help you keep track of what the differences are among those hospitals. You can print out a copy of the checklist for each hospital you are considering, then compare them side by side.

Hospital name:

Does your doctor practice at this hospital?

Primary care physician

Treating specialist

Notes:



Does your doctor recommend this hospital for you? What is the reason?

Primary care physician

Reason:

Treating specialist

Reason:



Would care at this hospital be covered by your insurance, managed care plan, or Medi-Cal?

Full coverage

Lower-tier coverage



How does overall care at this hospital rate for your condition or procedure? (Each measure not available for all conditions/procedures.)

Mortality Rate

Poor Below Average Average Above Average Superior Not Rated

Quality of Care

Poor Below Average Average Above Average Superior Not Rated

Timeliness of Care

Poor Below Average Average Above Average Superior Not Rated

Patient Safety

Poor Below Average Average Above Average Superior Not Rated

Preventive Care

Poor Below Average Average Above Average Superior Not Rated

PATIENT EXPERIENCE

Overall Patient Experience

Poor Below Average Average Above Average Superior Not Rated

Medical Patient Experience

Poor Below Average Average Above Average Superior Not Rated

Surgical Patient Experience

Poor Below Average Average Above Average Superior Not Rated

Maternity Patient Experience

Poor Below Average Average Above Average Superior Not Rated

Notes:

Do the hospital's rules and services meet my needs?

Location and Environment (location, rooms, visiting hours and overnight guests)

Notes:

Restrictions on Care (religious or ethical restrictions, women's health, end of life care)

Notes:

Language and Diet

Notes:

Support Services

Notes:

Hospital Tour (area of hospital where you will receive treatment, room types, cafeteria, etc.)

Notes:

Final Decision. Once you have made up your mind about the hospital at which you would prefer to receive your care, let your doctors know. If you choose the same hospital your doctors have indicated is their preference, you need do nothing more. But, if it turns out that the hospital you prefer is not the same as the one your doctors are recommending, you should discuss the final decision with your doctors.

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