If Indian Restaurants Can Be Transparent, Why Not Hospitals?


IMG_4166I was happy to see that one of my local Indian restaurants not only has very good Yelp reviews… they also have a top score (a perfect score!) from the health inspector.

This is proudly displayed (as it should be) near the register. Click on the image for a larger view.

Why don't we see similar summaries and information posted in hospital lobbies? What were the most recent deficiencies from the latest accreditation visit from the Joint Commission or another body? The more I think about it, why don't airlines post similar information about maintenance and other public safety issues?

I know hospitals are complicated… but there are pressing public safety concerns (see the data). Bad kitchen practices and improper food handling can lead to food poisoning and other serious problems. I know there are attempts at online scorecards, like CMS Hospital Compare, but the data is often very incomplete (unlike a health inspector's website for restaurant inspections). Bad hospital practices can lead to harm and death. Do any hospitals have to post scores similar to what's required in the window of New York restaurants? Why isn't the public demanding more transparency?

Of course, I don't see San Antonio restaurants with bad safety scores posting that in the window as a warning. The news regularly highlights problems… but not really with healthcare. There's not a weekly feature on hospitals with poor quality track records and hardly anybody ever gets shut down.

I guess the public also assumes a certain level of hospital infections and errors are normal or inevitable? Do we accept that a certain number of restaurant customers are just bound to get e. coli?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Hospitals are constantly rated and reviewed by private and government compliance groups. That information is typically shared in professional journals. There are multiple listservs that rate hosptials by speicalty care and a number of comprehensive databases of hospital inspections are maintained by the government and private companies. You may want to visit http://www.hospitalinspections.org, a venture led by the Association of Healthcare Journalists that launched in 2011. As with most industries I strongly suggest sourcing information from at least two or three leaders and, of course, your personal network. Hope that helps.

    • Thanks, Doug. There’s information available… but my point is that hospitals don’t make it easy to find and they generally aren’t displaying it at the lobby or the registration desk. Or, the hospitals are hanging dubious “best hospital” banners that aren’t really based on good data.

  2. Hi Mark

    There are simple reasons why this information rarely is easy to find.

    1. Providing it would cost some organizations money, and some people their jobs, so bad news like bad inspection reports are not easy to get or even find. Until there is a legally defined requirement to display the information, and defined inspection requirements to go with them, they just won’t get posted very publicly. Lets be honest every restaurant inspection should be posted on their front door, but how many do you actually see?

    2. Whether you like the rating of a hospital or not, you often do not get a choice when you really need one. Whether and ambulance takes you to the nearest one, whether you have to go to the one you can afford, or whether you have to go to the one your insurer provides you. We do not always have a choice.

    3. Capacity those few places that have great standings just cannot handle the volume in the end, and there is no way most of them could grow fast enough to handle it, while keeping their systems up, it just to much growth and change to deal with. Toyota found that out recently, and it is why Honda avoids aggressive growth in the auto industry.

    4. A shortage of inspectors. The truth is both restaurants and hospitals get inspected far less often than they actually should, simply because there are far to few inspectors in most areas. For hospital there is in fact no real set of inspectors at all. Any reports other than official ones are too subjective.

    We may not like the lack of transparency, but fixing it will actually require action by some level of government.

    • Thanks for the comment, Robert. Great points. Some cities, like New York, do require the posting of the summary letter grade in the window facing the street. I guess if a restaurant has a C grade, it’s easy enough to find the detailed info online.

      The “lack of capacity at the ‘good’ hospitals” problem can only be solved by working to improve the quality and safety of every hospital. Everybody deserves the best care and we need to keep working toward that…

  3. Hi Mark,

    I really liked this post. At the hospital I am currently interning at, we are actually implementing this kind of transparency. Our Continuous Improvement team has gone around to the many different departments and helped them set up these metrics. Often times, the metrics used are simple ones that show how the staff is making sure that the patients are getting the best treatment and that the staff cares.

    One example I saw was that a department showed the number of days between a fall. I liked that because it showed the the staff was focused and making sure the patients were safe. It also shows the teams goal for how many days they wanted, as well as a graph showing the trends.

    Just simple examples like that I believe will help add value to the customer.


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