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To choose your hospital or your private clinic

Take account of already made remarks in the web page on physician choice, concerning financial solidity of the hospital and its respectability.

Above all, be advised by your doctor, on condition that he will deal with you and care you in this establishment.

Read the hospital annual report. If you do not find, in this report of a large public hospital, chapters on quality management and statistics on incidents to patients, especially if one boast on medical publications, posters and conferences financed by pharmaceutical and medical equipment industry, be wary.To be concerned with a problem, it is already to solve partially it. Medical practices improvement always passes by knowledge of incidents and deaths numbers, and by search for their causes. Today, any center of care must set up a follow-up legibility of good practices.

Avoid beeing treated in a teaching hospital where there are more doctors in training, (interns, registrars, residents, senior residents) than trained and experienced specialists (doctor head of service, doctors head, doctors associated head, associated doctors, consultants). Doctors in training supervision is undoubtedly defective there, especially during night and public holidays. It is in particular the case, if there is not a proportion of several true supervising trained and certified physicians for one physician in training. That 24 hours a day, 7 days a week, it is obvious. You point out that, in Switzerland in particular, public hospitals have almost all a mission of formation, and it is thus there, that future surgeons FMH, inter alia doctors specialists, make their first weapons on you and other patients. Supervision must thus be there very rigorous 24h on 24, 7 days a week.

Avoid beeing treated or looked after in a hospital where not all the nurses are excellent.

If the hospital appears dirty to you, or that personnel do not frequently wash their hands, change your hospital quickly. Probably this hospital does not have an infection consultant.You are much more likely to catch an infection there called hospital or nosocomial infection. According to infectious diseases control in the USA (CDC of Atlanta), nosocomial infections affect each year, in the USA, roughly 2 millions acute care patients, that at a direct cost of approximately 3.5 billions dollars. For chronic patients hospitalized in hospitals and homes, it is still worse. The CDC estimates that more than 1.5 million nosocomial infections cases occur there every year, that is to say, on average, one infection by chronic patient and year (CDC, 1999). The epidemiologic studies evaluated that a third of nosocomial infections could be prevented, thanks to infection well-organized checking routines. However, only 6 to 9 % of these infections, currently, are really avoided.

The Mortality and Morbidity Conferences (M&M) were introduced early in the twentieth century (1917) into anglo-saxon hospitals. It is about a standardized system of cases report which good hospitals physicians practise, to study reasons and responsibilities concerning unfavourable outcomes of care. M&M Conferences review case-by-case, which stresses learning what could have been made differently in a given case, rather than to punish individuals, and who insist on the value of knowledge, competences, and vigilance to anticipate problems. You do not hospitalize a patient in a public hospital, where the quality management does not include at least M&M Conferences.