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The Liberty Bell is an iconic symbol of  American independence, located in Philadelphia,  Pennsylvania. In its early years, the Liberty Bell was used to summon lawmakers to legislative sessions and to alert citizens to public meetings and proclamations.


Formerly placed in the steeple of the Pennsylvania State House (now renamed Independence Hall), the bell was commissioned from the London firm of Lester and Pack (today the Whitechapel Bell Foundry) in 1752, and was cast with the lettering (part of Leviticus 25:10) "Proclaim LIBERTY throughout all the land unto all the inhabitants thereof."  It originally cracked when first rung after arrival in Philadelphia, and was twice recast by local workmen John Pass and John Stow, whose last names appear on the bell.



5 Liberty Bells Grading


The 5 Liberty Bells citizen-oriented hospital grading provides a grade for the hospital’s overall performance. The overall 5 Liberty Bells grade is made up of the following categories:


◊ How safe is your hospital?

◊  Public reporting: accountability and transparency      

◊ Quality of medical care delivered at the hospital

◊  Access to quality care at the hospital   

◊ Cost and value of care

◊ Community benefit

◊  Patient’s experience of their  hospitalization


Sample Hospital: Abington Memorial Hospital Profile 


Overview of the 5 Liberty Bells grading approach. For each category click on the title to learn more about the category and the specific grading.  


How safe is your hospital? 

The 5 Liberty Bells grade for How Safe is Your Hospital?  is motivated by the belief that all healthcare institutions must be top performers when it comes to patient safety. There is growing evidence that hospitals that commit to achieving excellent patient safety outcomes have been able to eliminate them.  

Hospitals are graded based on how close they are to an aspirational goal of excellent medical care. How well is the hospital performing when it comes to eliminating life-threatening infections. We compare the hospital’s performance to the best hospitals in each category of patient safety and related outcomes. Each category includes actionable information and tools to get to ZERO errors by 2021. 



Quality of medical care delivered at the hospital    

The  5 Liberty Bells grade for quality medical care is motivated by the belief that for most medical conditions the knowledge and tools to achieve universally excellent results exist and available to all hospitals. Additionally, since many medical events occur without warning, regardless of where we may be, all hospitals need to provide excellent care. We rate the quality of medical care provided by the hospital. We include information and tools to make the user an effective part of the treatment team to achieve excellent outcomes.  

The 5 Liberty Bells grade for quality medical care measures the hospital's performance as compared to the outcomes achieved by the best hospital in each category. The information includes many aspects of the process of care, the outcome of care and complications that are the result of hospitalization.

We also document whether specialty programs meet and follow guidelines established by specialty societies or other appropriate bodies (e.g., whether a cancer treatment center has been approved by the American College of Surgeons, the Association of Community Cancer Centers, or the National Cancer Institute).  



Public reporting: accountability and transparency 

The 5 Liberty Bells grade for public reporting: accountability and transparency reflect how well the hospital complies with legal requirements to make public performance information and related data. We are particularly focused on requirements for nonprofit healthcare originations.

In addition, we include in our grade how well the hospital provides information about the quality of care that it delivers the ease of using its website, and information available to the public about the process of care and other important variables. Our grade includes the following aspects of the hospital's transparency.  


Cost and value of care 

The 5 Liberty Bells grade for cost and value of medical care provides information about the cost and value of medical services provided by the hospital. The value of medical services is derived from the cost of a particular medical service and the hospital’s reported outcomes. Efforts are made to provide meaningful personalized, insurance-based, information that includes co-pays and other charges. The value information will compare hospitals and other facilities and strategies to get the best value.    The cost and value of the following procedures will be provided:  MRI, colonoscopy, surgery.


Access to quality care at the hospital

The 5 Liberty Bells grade for access to quality medical care is derived from availability and ease of accessing medical care at the hospital.

The overall grade includes the experience of patients attempting to receive services at the hospital. What is the insurance requirement? How well are the needed medical services coordinated?  What are the waiting times to see healthcare providers?  These results are compared to best practices in a particular category. 

As more “hospital” network emerges, we will include ease of coordination of care. For example, whether the facility's affiliation with a provider network would make it more likely that a consumer would be referred to health professionals or other organizations in that network. The access goes beyond medical services and must include the availability of translation or interpretation services for non-English speakers and people with communication disabilities. 



Community benefit

The 5 Liberty Bells grade for community benefit grades the hospital on how well it meets its mission and vision and complies with the governance and community benefit requirements. In addition, it provides information and for citizens to “hold hospitals accountable” for taxes that are utilized for medical services and their tax-exempt status?

Is the hospital a “good neighbor” in their communities? How do they determine the community benefits activities that justify their tax-exempt status? 


Patient’s experience of their  hospitalization

Patient’s experience of their hospitalization and the hospital ‘s 5 Liberty Bells grades the hospital-based on what patients who used the hospital say about their experience. This information is collected nationally and is available on Medicare Compare. It includes responses by recently-discharged patients about their hospital experience. For example, how well their hospital’s doctors and nurses communicate with patients, and how well they manage their patients’ pain.


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