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Improving the standard of care in hospital settings

President of the Lown Institute, Dr. Vikas Saini (MD'80) created the Lown Hospital Index, a way to quantitatively rank the most socially responsible hospitals in the U.S.

ʴDzٱ:December 3, 2024

:Dayna Park

Vikas Saini portrait

The , created by Dr. Vikas Saini (MD'80),is the first ranking system to identify measurable standards for social responsibility in hospitals. The rankings consider the full range of what hospitals do as care providers, employers, and partners, such as pay equity and racial inclusivity, and set benchmarks for exceptional patient care and commitment to community betterment.

Launched in 2020 during the surge of the pandemic, the goal of Dr. Saini’s Index is to enhance patient experience through improved outcomes, value, and equity in care by ensuring health facilities are held accountable for their performance. The Index acts as a measurement tool that can identify success rates in patient care and as a way to further understand the gap between a hospital’s current working systems and the contemporary needs of patient care.

Asking the important questions

Dr. Saini recognizes that patient needs are not uniform from one region to another. “By comparing traditional metrics that have been used across cultures and regions to measure the standard of care over centuries, we can better understand how to make a difference in patients’ health and well-being,” he explains.

To build more equitable, patient-centred health systems, we must first learn what factors are contributing to existing injustices and inequalities.Dr. Saini draws on his experience in the United States, where privatization plays a big factor in this imbalance. “The polarization between private and public health care is wide,” says Dr. Saini, “and the demographics that it impacts most include marginalized and rural populations.”

Application of the Index

The Hospital Index has started to have positive impact In Ohio. Many community organizations for several years had been calling upon the Cleveland Clinic to support community investment and funding to remove all lead paint from all the houses in the neighborhoods around the hospital. As a result of publicity brought about by the Index, the Cleveland Clinic finally announced $50 million to support the initiative. “We're prompting people to make a change, and to actually see these changes happen is very gratifying,” reflects Dr. Saini.

In the context of Atlantic Canada, Dr. Saini would like to see if the Hospital Index can provide insights into the state of our health-care system. Dr. Saini admits there is no easy answer or quick solution to the access-to-care challenges and physician and nursing shortages currently being faced, how­ever, he identifies one truth he has come to learn. “When it comes to social responsibility, the highest performing health-care systems have high levels of community engagement,” he says.

“The role of the Hospital Index is to ask key questions and generate conversation that can lead to change; it's about the journey of getting health care to encompass quality, value, and equity for our patients.”

Fond memories

Before attending medical school, Dr. Saini had to decide between Yale and Dalhousie, which was not such a difficult choice in the end. Growing up in Fredericton, N.B., Dr. Saini enjoyed the tightly knit community that ϳԹoffered, which, when combined with the superb clinical traditions in Halifax, made the choice an easy one.

Dr. Saini enjoyed the exceptional clinical education ϳԹoffered and would go on to train in internal medicine at Johns Hopkins, and then to specialize in cardiology at Harvard. After co-founding an anesthesia device company that developed a consciousness monitor, he went on to practice cardiology in the small community of Cape Cod for nearly 15 years. He remembers his many classmates of the Class of ‘80 with warmth and fondness and recalls meeting with them frequently in a student-initiated seminar series to discuss the social aspects of medicine, social epidemiology, and global intersections of health care.