September 28th, 2010
06:00 AM ET

Empowered Patient: How to choose the right hospital

Chuck Toeniskoetter says he's alive today because of a nurse and a paramedic who made sure he went  to the right hospital when he suffered a stroke on a California mountaintop.   The lesson Toeniskoetter learned can make everyone a more empowered patient.

Toeniskoetter had just finished a morning of skiing on Bear Valley Mountain when he suffered a massive stroke.  The helicopter pilot wanted to take him to the closest hospital, so not to waste precious minutes.  The nurse and paramedic fought to take the patient to a hospital 15 minutes further away – Sutter Roseville Medical Center in Roseville, California – where he was much more likely to receive a drug that could reverse the effects of the stroke.

"They stood on the runners of the helicopter and were relentless with the pilot," Toeniskoetter remembers. "They saved my life."

Toeniskoetter was paralyzed on one side but had a full recovery.  His story will be told in the Empowered Patient special on CNN Saturday and Sunday at 7pm ET.

At Sutter Roseville Medical Center in Roseville, California, Toeniskoetter received tissue plasminogen activator (TPA), a drug that dissolved the clot in his brain.

Kathy Snider was the nurse who made sure Toeniskoetter got to the right hospital.

“He needed to go to a hospital where there were specialists standing by,” Snider remembers of the event some ten years ago. “Small hospitals don’t offer that.” She remembers she had to argue hard with the pilot to get him to take Toeniskoetter to the Roseville hospital. “We kind of got in each other’s faces,” she says.

Studies are now finding that not all hospitals are created equal for every medical emergency. Whether it's a stroke, a high-risk birth, or a heart attack, the research says it's worth doing whatever it takes to get to the right place.

"A lot of people think hospitals are all the same," said Dr. Samantha Collier, chief medical officer at HealthGrades, which ranks hospitals. "They're not."

Of course, not everyone is lucky enough to have someone like Kathy Snider by their sides when disaster strikes. But when it’s not an emergency,  you can do you own research. U.S .News & World Report has a listing of 5,000 hospitals across the country.  You can put in your zip code and the procedure you need to have, and the site will tell you the best-ranked hospitals in your area.  HealthGrades and Leapfrog will tell you success rates for various procedures at hospitals near you, and will give safety data for the hospitals as well.

soundoff (50 Responses)
  1. Donna Thompson

    I am on this page that you mentioned this morning and I cant find the spot or link to choose the right hospital. Can you please direct me? Thank you.

    September 28, 2010 at 08:07 | Report abuse | Reply
    • Rick


      September 28, 2010 at 09:51 | Report abuse |
    • David H. Hunt

      Where are the hospital located, can't find the chart. please notify me

      September 28, 2010 at 13:05 | Report abuse |
    • Wronged1

      I entered Centennial Medical Center in Ashland City, TN in October 2010 with stomach pain to the ER at 3 am in October 2010. I was diagnosed with pancreatitis and sent for bloodwork, CAT scans and other unexplained tests that were never shown to me. An IV was inserted in the inside crook of my elbow which was always causing pain and leaking and coming out as I slept. The nurses were brutal saying I was "ripping out" the IV and causing the alarm to go off, when in fact I was perfectly still and the alarm still went off.

      When I asked for the alarm sound to be turned down, the nurse refused and came less and less to either reset the IV or tone the sound down. The nurses were confrontational and very rude. One even asked me if I "hated nurses".... geeze... please move the IV to a better location, NO!!!! said the Nurse. I asked for her name and her supervisor and she never gave me one. I complained to Administration and nothing was done.

      I was consistently tormented by this nurse who woke me up often and wondered why I was delerious... um… try being very sick, going without 48 hours sleep, food and you would be too.

      A port valve was inserted into my right arm and the other IV finally removed after a few days.

      Later that day (after I complained of the horrible nurse with the bad attitude) I was given strong doses of Dilotted and other medications to control the pain. Later my Dr., came in and said they needed to transfer me to Centennial Medical Center in downtown Nashville, TN where they will "better be able to assist in my condition". I was told I had pancreatitis and internal bleeding and will be admitted to the ICU.

      I arrived at Centennial Medical Center in Nashville, TN by ambulance and entered a room in the ICU.

      The room smelled of rotten bodies and old feces. The stench was almost unbearable. Later I would find out why....

      Dose upon dose of Dilotted and other meds were given to me without explanation. I was put into a bed so high off the ground I had to climb out with the excrutiating stomach pain. The nurses again, except for one, had very nasty "better than thou" attitudes. I had to literally beg for pain relief, saline, remind them when the IV’s ran out, and give NPO (no food or water by mouth for days). "When I'm good and ready" I heard often when I pressed the button for help.

      After so many pain meds I felt I was beginning to become a bit confused and out of sorts. I had to go to the bathroom one time and didn't make it and wet the bed which infuriated the nurse. I was so dizzy from the meds I couldn't walk. I was then told to call when I wanted out... when i pressed the button 30 minutes or more would go by (IN ICU mind u) without any help. After a few episodes of this treatment i wanted to go home and asked to be released and moved to a different hospital.

      I then got out of bed and began to put my clothes on expecting them to call my dad to come pick me up to put me in a different hospital or arrange for an ambulance to…

      Yeah right... they literally came running and screaming at me, jerking the clothes out of my hands and slamming me onto the bed and strapping my legs spread eagle (note: they didn't allow me to wear underwear because I would just mess them up, so my private parts were for all to see) and I'm a female. They then strapped my hands so hard to the bed rails I couldn't even move. I had to bruise my wrists just to even attempt to press the nurse button.

      I was never offered TV to watch, never given a sponge bath of any sort after days and forced to lie in my feces and urine for up to 3 hours at a time.

      When asked why I was being treated like this, the nurses said “tough, if you’d do what we say, you wouldn’t be like this”. The restraints stayed this way for 2 days. The bruises on my ankles and wrists are so bruised they are deep purple.

      I cried for any help going down the hall and they ignored me. I asked for the police, they denied me. I asked to speak to my family, they wouldn’t call. I wanted to see my doctor, he never came.

      Confused. That’s what they said I was. Confused. Did this warrant being strapped to a bed like an animal and treated so cruely?

      Finally after a few days, my family arrived and the “nursing staff” said I could go. I was so excited when they took the restraints off I immediately sat up… my kidneys hurt so bad and my skin was bright yellow.

      This was interpreted as aggressive behavior (!!!!!) that 4 orderlies pulled my pants off in front of my family and shoved an orange catheter up my urine track leaving me naked and exposed again and HARD restraints put on…. Another 2 days like this.

      It was just aweful. It was like being in hell, in jail and what did I do to deserve this… act confused?… oh… I called the bed a couch, I guess that was confused… I missed a few questions on who the 6th president was, and got the day wrong once…. Geeze….

      Back to laying in my muck and feces…. It got worse and the “teeny bopper” nurse was NEVER around to do anything. No bath, no shower, no rinse, and I couldn’t cover my privates because I was strapped to the bed. I was so cold and wet from urine, I layed their half naked all night in misery.

      After a few days I assume the Dr. decided he needed to come see me and saw my condition and they took the shackles off. I was moved upstairs out of ICU and spent 2 days being finally treated like a human. Funny after a ½ day the yellow faded from my skin and the kidney pain went away.

      BTW… dismissed from the hospital anemic and with pancreatitis and a few scripts. Anemic huh… never checked on the internal bleeding?

      This hospital is HELL ON EARTH!!!!!

      They also violated my HIPAA rights by giving out some “access” code to somebody who called in, when I explicitely put that I did not want ANYBODY outside to know the number.

      Beware this hospital. BTW… my mother, who is in her 80’s caught MRSA (pronounced Mercer) in this hospital and about died last year. Their excuse? They caught it from the nursing home.

      October 17, 2010 at 08:55 | Report abuse |
    • Monica Perez

      Another excellent website is http://www.HealthGrades.com for hospitals, doctors and dentists. Hope this helps.

      June 9, 2012 at 19:22 | Report abuse |
  2. Tom Shute

    Opps! Found one.

    September 28, 2010 at 08:41 | Report abuse | Reply
  3. Bonnie

    The link for choosing hospitals in my area is not visible on your webpage. Your show indicated that it was on the bottom right side, but there is no link showing. Please advise me on how to find this link.

    September 28, 2010 at 09:07 | Report abuse | Reply
  4. Peter

    Where are the links to the hospital information?

    September 28, 2010 at 09:33 | Report abuse | Reply
    • Simon


      September 28, 2010 at 09:41 | Report abuse |
  5. Simon

    Here is the link CNN mentioned this morning ( http://health.usnews.com/best-hospitals/rankings ) to choose the right hospital. You can also click on the bold blue word ( U.S. News & World Report ) in the last paragraph of the article. Hope this helps.

    September 28, 2010 at 09:38 | Report abuse | Reply
  6. Katrina, Houston TX

    Can't find...Find the right Hopsital, please advise.

    September 28, 2010 at 09:38 | Report abuse | Reply
  7. Simon

    Here is the link CNN mentioned this morning ( http://health.usnews.com/best-hospitals/rankings ) to choose the right hospital. You can also click on the bold blue word ( U.S. News & World Report ) in the last paragraph of the article. Hope this helps.

    September 28, 2010 at 09:39 | Report abuse | Reply
  8. Sly

    That was an excellent story. I have a related story about docmatcher com here in nyc. It was set up by a Brooklyn doctor to help patient find a specialist for themselves. She set it up after she a doctor couldn't find a specialist for an issue her husband was having.

    September 28, 2010 at 09:40 | Report abuse | Reply
    • standford

      I started from the begining and also the 1st 2 sites square measure donotfollow blogs… therefore i stop wasting my time to ascertain the remainder of the blogs.. Please update with new DOFOLLOW sites

      December 24, 2012 at 02:07 | Report abuse |
    • danielbird112

      You gave away a lot of data for gratis than any guru ever would!It may be a nice list indeed! I don’t shrewdness to thanks. Cheers!

      December 26, 2012 at 04:28 | Report abuse |
    • benjamin

      We area unit web selling professionals committed to achieving your business goals. we've got years of expertise. we have a tendency to work at intervals your budget and complete comes on time. we have a tendency to ne'er stop till you're happy

      January 1, 2013 at 02:57 | Report abuse |
  9. Patty

    I can't find any of the links you mentioned this morning on choosing the right hospital in my area.

    September 28, 2010 at 09:40 | Report abuse | Reply
    • reloareme

      I have been reading out a few of your posts and i must say clever stuff. I will definitely bookmark your website.

      G. Wells – "Security puts a premium on feebleness."

      January 18, 2011 at 17:44 | Report abuse |
  10. Joy Johncox

    I too am interested in thes links that were mentioned this am – If they are here I can't find them! – As a professional Registered Nurse (38 years experience) who for the last 9 years has specialized in Medicare denials and appeals – My comment is – From a patient and best treatment option this program was excellent and the advise is right on – Always go to the best hospital to treat your disease / injury. However your viewers need to know that Medicare / Caid and most Third Party Payors will deny miles (or sometimes the total claim amount) if you are not utilizing the "Closest" facility with the services needed. By that I mean – If you are at a 100 bed rural hospital which offers open heart surgery (that maybe just started these services last month) you will be denied transportation charges to a further / larger more experienced Heart Center – Same holds true for Oncology, Neurology, Neurosurgery etc. And the health standard of continuity of care is NOT respected by Medicare or other payors as a routine. Just felt your viewers needed to know. My Department has to appeal these denials all the time for the patients that we transport from the scene or transport from one hospital to another (we are an Air Ambulance service) It is very frustrating and time consuming for us, physicians who order these transports / transfers for the best treratment options for these patients – We usually have to go all the way to third level appeal with Medicare which is Administrative Law Judge Hearing (where we finally get to present our case orally to an HHS Judge). In the meantime, the poor patiemt / family is waiting to hear whether they will owe money for these emergency services.

    September 28, 2010 at 09:41 | Report abuse | Reply
    • Simon

      http://health.usnews.com/best-hospitals/rankings You can also click on the bold blue word ( U.S. News & World Report ) in the last paragraph of the article. Hope this helps.

      September 28, 2010 at 09:43 | Report abuse |
  11. AB

    I dont see the link either.

    September 28, 2010 at 09:41 | Report abuse | Reply
  12. richard veitch

    where is the best hospital in my area to have artroscopic knee surgery

    September 28, 2010 at 09:42 | Report abuse | Reply
  13. sly

    guys the links are the blue words in the article specially at the end of the article you can click those words.

    September 28, 2010 at 09:44 | Report abuse | Reply
  14. William Call

    what hospitals are close to my address. 8458 w marco polo road peoria,az 85382

    September 28, 2010 at 09:44 | Report abuse | Reply
  15. jim

    A good link to find hosptials with good patient safety and outcomes metrics is http://www.healthgrades.com. It rates hospitals base on patient safety indicators (PSI) taken from Medicare discharge criteria.

    September 28, 2010 at 09:47 | Report abuse | Reply
  16. John E. Knack

    After a knee replacement last year, I had a staph infection which too a full year to cure. I'm due to get the other knee replaced and would like to know how to find the safest hosp. in my area. I'm told you can get infected at all hospitals and I'm curious which ones have the highest frequency. I live north of Nashville Tn and would like to confine the search to within 25 miles. Thank you.

    September 28, 2010 at 09:48 | Report abuse | Reply
  17. Mary Snider

    I can't get the web page either.

    September 28, 2010 at 10:00 | Report abuse | Reply
  18. Beth Henry

    I wonder if someone could direct me asap to the site you mentioned this morning. We may have to go to an emergency room shortly and I would like to know this info. We are in Houston, Tx.? I can't find a link to the site they said was there this morning.

    September 28, 2010 at 10:08 | Report abuse | Reply
  19. Mary Snider

    Finnally got it, Thank You, very informative!!!!!!

    September 28, 2010 at 10:29 | Report abuse | Reply
  20. Carml.

    It is impossible to obtain accurate statistics on hospital acquired infections in the USA. Websites invariably post foreign numbers but US sites will only provide to medical personnel. Why so shy? This information should be available as it is crucial to know which hospitals might be safer.
    Any websites where stats are actually available?

    September 28, 2010 at 10:38 | Report abuse | Reply
  21. Beth Henry

    I posted a little while ago. Can someone please send me the link they mentioned this morning regarding hospitals? We need information on Houston hospitals/spine surgery.
    Beth Henry

    September 28, 2010 at 11:10 | Report abuse | Reply
  22. gary w

    thankyou for this info . I went to the site and found the best doctor for me so i called and made a plan to see the doctor . i am new to the area needed to a doctor .
    again thanks

    September 28, 2010 at 11:11 | Report abuse | Reply
  23. Pete Nagle

    Where is the link to find the right Hospital!!??

    September 28, 2010 at 11:23 | Report abuse | Reply
  24. Brooks F

    I, too, cannot find the Hospital link. Help us all out.

    September 28, 2010 at 12:26 | Report abuse | Reply
  25. Alice T

    Where is the link for a zip code to find the right hospital. HELP!


    September 28, 2010 at 12:48 | Report abuse | Reply
  26. Don

    Where is the hospital list? It must be the old bait and switch, just a device to get people to the website.

    September 28, 2010 at 12:51 | Report abuse | Reply
  27. Karen Wickman

    Thank you. This was a terrific report! Years ago while living in NY, my husband suffered from a viral cardiomyopathy that was misdiagnosed as the flu. He was sent home to 'rest'. I watched him getting worse, and saw his color turn ashen. I knew something was seriously wrong, and persisted in spite of him telling me he just needed sleep. My personal physician answered the emergency call, and luckily interned at a heart hospital. He knew the symptoms, and told me to get him into the nearest hospital within 15 minutes. It saved my husband’s life, who was in cardiac arrest with an irregular heart beat overworking at 160 beats per minute. Several weeks later, he was released from ICU to home therapy and thankfully recovered without too many issues after 9 months. From time to time, he goes into that irregular rhythm and requires cardioversion to reset to normal sinus rhythm. Finding a good hospital in case of emergency is priceless!

    September 28, 2010 at 12:52 | Report abuse | Reply
  28. Larry

    Don't Forget that the NURSE on the scene argued with the pilot and got the victim to the RIGHT HOSPITAL, not the CLOSEST.
    One of the tenets of being a nurse is to be an advocate FOR THE PATIENT/ CLIENT/VICTIM.

    September 28, 2010 at 13:12 | Report abuse | Reply
  29. KC

    The right doctor and the right hospital is crucial. I am permanently impaired due to a doctor who didn't know what he was looking at. He treated me for something he knew how to treat, which made me sicker, and then he blamed me for "not wanting to get well". Eventually, the president of the local support group told me that no one with our condition has EVER been given correct treatment at that medical center.

    September 28, 2010 at 13:33 | Report abuse | Reply
  30. je

    I think it is about time a nurse and a paramedic get some credit with the empowered patient. Usually people get on the bandwagon and start bashing nurses. Also, saying that they only do things for money. This guy is lucky that he had people who knew what they were doing instead of listening to the pilot. He most likely would have been dead or worse disabled.

    September 28, 2010 at 21:58 | Report abuse | Reply
  31. Joe Peterson, MD, CEO, Specialists On Call, Inc.

    This article is a perfect example of why tele-neurology has become so important to providing critical ED care, and telemedicine such an important tool. In the article, Nurse Snider talks about sending Mr. Toeniskoetter to a hospital, “…Where there were specialists standing by.” With emergency telemedicine consultations––combining technology and board certified, Joint Commission-accredited neurologists available 24/7, ready to respond within 15 minutes–– not only can any hospital can have specialists standing by, but every hospital should have specialists available immediately. This is especially important when time and the use of tPA is such a critical factor, as in the case of a stroke, and the additional 15 minutes could mean the difference between recovery and horrible permanent damage. Our neurologists have recommended, through emergency telemedicine consultations, using tPA for over 500 patients this year alone. Through the use of emergency telemedicine consultations, patients don’t need to be lucky and have Nurse Snider by their sides. Every hospital can and should have the specialists they need to treat their emergency.

    September 29, 2010 at 17:02 | Report abuse | Reply
  32. Prevention

    Normally I think this is OK–but depends on the doctor you get.
    Example: At a top rated hospital in Chicago–a 4th year medical student was misdiagnosed.Vomitting was bad–Visit to ER gave WRONG DIAGNOSIS –GI obstruction–See GI specialist on Monday-now this was on Saturday.
    Fortunately the patient had a close relative-trained at top hospitals–he took the patient to his hospital,did some test with an internist-Found MONO–with deteriorating Kidney/Liver function.He brought in 3 more specialists.All worked to stabilize the situation-took 5 days.
    WHAT IF the patient waited until Monday? 2 days could have created worse outcome.?

    October 2, 2010 at 18:05 | Report abuse | Reply
  33. Carie Appleseed

    No Protection Against Active Tuberculosis

    A profit driven health care industry can place more emphasis on making money rather than protecting against infectious diseases. Tuberculosis is a contagious disease and is often deadly. When people with active TB cough, sneeze, speak, sing or spit, they expel infectious aerosol droplets. 40,000 droplets are released in a sneeze. Just one single bacterium can cause a new infection. TB bacteria can live in your body without making you sick. One in ten latent infections will eventually progress to an active disease. TB kills more than half of its victims if left untreated.

    Kindred Hospital in Arlington, Texas did not follow CDC guidelines. NO self-closing device was on the TB patient's door. An anteroom was not available since the patient's bathroom door was a few feet from the main hallway. Employees and visitors in the "isolation room" wore surgical masks which are not effective in preventing inhalation of droplet nuclei. As a nurse, I received a fit testing, but was not given a respirator with a proper air filter. It's estimated that the US has 25,000 new cases of TB each year. If you think you were exposed to TB disease, you should call your doctor and local health department about getting a TB skin test. Although I just committed career suicide, I can sleep well at night.

    October 4, 2010 at 21:24 | Report abuse | Reply
  34. Stephan

    Your loved one's safety is always at risk once you leave them alone in the staff's hands. Some hospitals are very good and some are downright poor. My hospital gave my loved one a doctor who knowingly had a serious drug problem. They knew it and didn't tell us. I complained about his behavior and instead of taking care of the problem they had us intimidated by their attorney. My loved one died do to negligence. Suffocation. This hospital, Paradise Valley Hospital on Bell Road in Phoenix, Az continued to expose their patients to this doctor for 2 more years until he was busted by the Arizona Medical Board for drug use. Look up Dr Abraham Sayegh under Doctor Search. Paradise Valley Hospital should have put their patients safety as a priority, instead they kept everything hush hush. Always check your doctor thru your states medical board, it's real easy and only a click away on the internet.

    October 5, 2010 at 17:59 | Report abuse | Reply
  35. p raine

    I still cannot find the right local hospital in my area. I am interested in heart attacks hospitals. Where is the link to put in my zip code.

    December 24, 2010 at 11:50 | Report abuse | Reply
  36. raspberry ketone

    A cousin of mine, from the San Francisco area, found Dr. Ornish after having two heart attacks in his sixties. He is one of the oldest, if not the oldest patient, being in his nineties, of Dr. Ornish today!

    March 16, 2012 at 20:01 | Report abuse | Reply
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    March 17, 2012 at 07:13 | Report abuse | Reply
  38. Bee

    In reply to Tawny Nuesmeyer McGehee who questioned Elizabeth Cohen's credentials in connection with the article about medical errors: Elizabeth Cohen has a Master's in Public Health from Boston University, according to the information under "About Elizabeth Cohen" posted by CNN. She knows what she's talking about.

    June 16, 2012 at 16:32 | Report abuse | Reply
  39. johnsmith

    I disagree that a one-line comment is usually spam. i prefer to seem at photography blogs, and typically a good image deserves a compliment, however it does not ought to be a treatise.

    January 3, 2013 at 04:21 | Report abuse | Reply
  40. Frances Hector

    The resulting patient safety knowledge continually informs improvement efforts such as: applying lessons learned from business and industry, adopting innovative technologies, educating providers and consumers, enhancing error reporting systems, and developing new economic incentives.'..'"

    Most current post on our very own web page

    July 1, 2013 at 02:34 | Report abuse | Reply

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About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.