O.C. Hospital Among 23 in State With Elite Rank : Health care: Kaiser Anaheim facility among those rated by an agency of experts as nation’s top 5%.

Twenty-three California hospitals are ranked among the top 5% of all U.S. hospitals in overall administrative quality, the national agency that sets standards for health care institutions reported Thursday.

A special commendation was given to just 273 of the 5,300 institutions surveyed by the Joint Commission on Accreditation of Health Care Organizations, which has been reviewing hospitals for 40 years.

The commission reviews hospitals every three years and the list issued Thursday is the first formal roster of a new ranking called “accreditation with commendation.”

Among the California hospitals with the highest ranking are nine Kaiser facilities, in Anaheim, Bellflower, Panorama City, San Diego, San Francisco, Santa Rosa, Vallejo, Walnut Creek and Woodland Hills.

Ordinary accreditation “means they are trying to operate the hospital in a way that I can feel reasonably safe going there and increases the likelihood that I will be treated well there,” said Dr. Paul Schyve, the commission’s senior vice president. The special commendation ranking means that the “hospital has been particularly dedicated in trying to do all things well, not just to meet the standards at an average level.”

Dr. Kenneth E. Bell, chief of staff at Kaiser Permanente Medical Center in Anaheim, the only Orange County hospital to make the joint commission’s top achievement list, called his hospital “the best-kept secret in Orange County.”

Bell said the 200-bed hospital is relatively unknown, although it is the only acute care hospital serving the county’s 190,000 Kaiser Permanente members.

“Until now, we haven’t had much of a marketing presence,” Bell said. “But we will in the future.”

The Anaheim hospital achieved the commendation because of its overall quality, but it has particular strengths in obstetrics, anesthesia, internal medicine and surgery, he said.

“We are a teaching hospital affiliated with UCI (College of Medicine) and have our own residency in family medicine,” Bell noted.

The commission survey includes more than 2,000 separate standards, including such issues as infection control, record-keeping for patients, use of pharmaceuticals, training of physicians, and the safety and security of buildings. A directive to improve performance in any of the areas means that the hospital has a “Type 1” defect and cannot receive the commendation ranking.

The ranking, in effect, gives a gold star to a hospital’s overall performance but is not intended as a guide to patients for specific treatments or procedures.

Most surveys of hospital quality measure the outcomes of specific medical procedures, such as the percentage of patients who survive heart transplants, bypass operations and the like. The Joint Commission survey, in contrast, focuses primarily on administrative procedures and specifically excludes such medical outcomes.

“A small local hospital may be excellent but often it does not have specialty services,” said Schyve. “Clearly, if I have to have a heart transplant I will go to the university hospital because a small hospital will not have that kind of service,” he said.

Some prestigious university hospital centers are located in old buildings needing safety improvements, a problem that could produce a Type 1 defect blocking the top rating, Schyve said.

About 80% of all U.S. hospitals are accredited. The special commendation category was created in 1991 and some hospitals that have received the accolade have publicized their own awards since then. But the commission waited until a full three-year cycle had been completed and all hospitals reviewed to issue its first complete roster of the highest-ranked institutions.

“We’re really pleased for the 23 California hospitals that did receive the commendation,” said Dorel Harms, vice president for professional services at the California Assn. of Hospitals and Health Systems in Sacramento.

“But we’re concerned that no one jump to any conclusions because this is such a dynamic process,” she said. “The process of review at hospitals has changed tremendously in recent years. . . . Over the next three years, we expect that probably more hospitals will receive the commendation ranking.”

In Southern California, the response was more skeptical. “Inevitably report cards are going to become a fact of life for hospitals,” said David Langness, vice president of communications for the Hospital Council of Southern California in Los Angeles. “But we still haven’t found one that is completely objective and, frankly, I don’t know if we ever will.”

California hospitals with the commendation ranking, in addition to the Kaiser institutions, are: Enloe Hospital in Chico, Atascadero State Hospital, Scripps Memorial in Chula Vista, Sutter Davis Memorial in Davis, Vencor Hospital-Sacramento in Folsom, CPC Rancho Lindo in Fontana, Cedar Vista in Fresno; Green Hospital of Scripps in La Jolla, Community Hospital of Monterey Peninsula, Naval Medical Center in Oakland, Sutter Memorial in Sacramento, David Grant USAF Medical Center at Travis Air Force Base, West Hills Medical Center and Whittier Hospital Medical Center.

Times staff writer Leslie Berkman contributed to this report.