CAMBRIDGE, Mass.—“Where do you go for great health care in Las Vegas?” Answer: “The airport.”
That local joke set Las Vegas Sun reporters Marshall Allen and Alex Richards on a two-year quest to figure out what was wrong with medical treatment in Las Vegas—and why. The result, after a digital dig into 2.9 million inpatient hospital records and more than 250 interviews, was a five-part series that earned them one of the most prestigious investigative prizes in journalism.
Using an impressive armory of multimedia tools, “Do No Harm: Hospital Care in Las Vegas” combined compelling patient stories and medical statistics to tell the Sun’s readers about one of health care’s most insidious problems: preventable life-threatening infections or injuries acquired while undergoing hospital treatment. A landmark 1999 Institute of Medicine study calling for a stronger patient protection strategy estimated that there may be as many as 98,000 deaths in U.S. hospitals annually related to medical errors.
“Everyone in health care knows about this except the patient,” Allen said yesterday at a Harvard Kennedy School symposium featuring eleven journalists who worked on the six entries selected as finalists for the 2011 Goldsmith Prize for Investigative Reporting. “I write from the point of view of the patient” and try to be a “representative of everyday [people] as they encounter the healthcare system,” he said.
The Sun’s impressive hospital series won the $25,000 top Goldsmith prize over blockbuster exposes involving all levels of government that were produced by reporters at several well-known American newspapers, NPR, and ProPublica.
“You have to have a lot of humility to work at the Sun,” said Allen, thirty-eight, a former youth minister turned reporter who came to the paper five years ago. “You never see a front-page story on a newsstand, and a lot of people in Las Vegas don’t know we exist.” But, he added, that “allows us to be more nimble and flexible…. We’re not the paper of record, and there’s a lot of freedom in that.”
In fact, the sixty-year-old Sun has an unusual distribution model. In 2005, it amended a joint operating agreement with its rival, the Las Vegas Review-Journal (which is the newspaper of record in town), and is now published as a daily eight-page insert inside the Review-Journal. The Sun remains independent in content and news staff, and the place where it really shines is its own website, LasVegasSun.com, where it has adopted all the bells and whistles of the digital age to bring analytical enterprise stories to life. The paper drew national attention in 2009 when it won the Pulitzer Prize for Public Service for its investigation of construction deaths on the Las Vegas Strip and the failures of government, management, and labor unions to protect workers.
“It’s the most integrated print [and] web operation at any newspaper in the country. There may be others like you, but I don’t know of one,” said Alex Jones, director of Harvard’s Joan Shorenstein Center on the Press, Politics and Public Policy, which administers the Goldsmith Prize. Jones calls the Sun’s approach “the future of news.” As he noted yesterday, the paper is currently losing money, but enjoys the generous support of publisher Brian Greenspun, who joined reporters Allen and Richards on their trip to Cambridge for the Goldsmith award ceremony Monday night.
Jones called the Sun’s prize-winning hospital series an example of “dogged reporting and sophisticated analysis” that accomplished what state government regulators had failed to do: create a transparent public platform to provide consu to mers with access quality-of-care information that would help make local hospitals more accountable.
When Allen was first asked to cover health care in the notorious American gambling town, his first reaction was “I can’t imagine anything more boring,” he recalled in an interview here yesterday. But, he added, “I could not have been more wrong.” When he dove in, Allen found fertile ground in a beat with rich story possibilities that resulted in several prize-winning series and the Association of Health Care Journalists’ top prize for beat reporting in 2009.
In the “Do No Harm” series, Allen and digital reporting wizard Richards, twenty-nine, made a public records request to Nevada officials that yielded a database with 2.9 million inpatient hospital billing records reported to the state from 1999 to 2009. “We decided we could impose transparency on them,” said Allen, by opening up the state data to the general public.
But “it was like wrestling with a python,” he said, as the reporters asked themselves, “How do we make this meaningful to the public?” They decided to focus on roughly 560,000 records from 2008 and 2009, and compared records of patients’ conditions at the time of admission to their conditions at discharge. By tracking hospital billing codes at thirteen hospitals in the Las Vegas area, they found 969 cases in which patients sustained potentially preventable cases of infection or injury, including surgical mishaps, while receiving hospital care, Richards said. Allen also interviewed about 250 doctors, nurses, hospital administrators, and patients for the investigative project.
The resulting five-part series, which appeared over a six-month period in 2010, exploited the Sun’s online talents, as the reporting duo worked with colleagues to provide multimedia ways to tell the story, including patient profiles, videos, photographs, source materials, a readers’ forum, and interactive tools that readers could use to mine the data for themselves. Nevada is one of forty states with similar hospital data, said Richards.
“The outrageousness of our health care system was most evident in patient stories,” said Allen, who once did missionary work in Nairobi. He recalled one case in which a patient got a hospital infection “that nearly killed her. But she’s still on the hook for medical bills to treat MRSA (a bacterial infection resistant to some antibiotics) that she acquired in the hospital. Here’s a little old lady on a fixed income being hounded by bill collectors because she can’t afford to pay for what happened to her in the hospital. That’s just unjust.”
Allen noted that the Sun was “a little oasis of great ideas” for journalism and an “incubator for reporters” that empowered them to do good enterprise work. Ironically, Allen recently left the Sun for a new job in New York City, starting Wednesday, as a national health reporter for the non-profit investigative outlet ProPublica. His colleague Richards left the Sun last summer for The Chronicle of Higher Education in Washington, D.C., after doing the digital analysis for the series.
The prestigious Goldsmith investigative reporting prize, funded by a grant from the Greenfield Foundation, honors journalism that “best promotes more effective and ethical conduct of government, the making of public policy or the practice of politics.” The Goldsmith winner, selected from among six previously announced finalists, was kept secret until Monday evening’s announcement. The Goldsmith finalists are often strong contenders for the Pulitzer Prizes, which will be announced at Columbia University on April 18.
Other Goldsmith finalists, who received $10,000 prizes, included Los Angeles Times reporters for a series exposing widespread city hall corruption in tiny Bell, California; National Public Radio for a series on the power of the bail bond industry across America; ProPublica, NPR’s Planet Money, and Chicago Public Radio for a collaborative project on “The Wall Street Money Machine;” the San Jose Mercury News for the first comprehensive analysis of the influence of outside industries and lobbyists on California state lawmaking; and The Washington Post for a two-year investigation into the massive expansion of government intelligence work after 9/11 in its “Top Secret America” series.
Frank Rich, the New York Times columnist who has just announced his departure to New York Magazine, received the Goldsmith Career Award for Excellence in Journalism. In a talk at Harvard Monday night, Rich was upbeat about the future of journalism, despite the current climate of uncertainty. “The news business will eventually flourish,” he said, noting that the history of modern communication, in which radio survived television, shows that “most apocalyptic predictions of doom don’t come true.” Rich said the future of journalism, regardless of platform, rests upon “on-the-ground reporting….How else can we know what is really happening?”
Editor’s Note: Russell, a former Shorenstein Center fellow, judged the 2007 Goldsmith Prize for Investigative Reporting.
Correction: The text of this article was changed to reflect the fact that the Sun amended an existing joint operating agreement with the Las Vegas Review-Journal in 2005; it did not strike a new agreement at that time.
Cristine Russell is a CJR contributing editor and the immediate past-president of the Council for the Advancement of Science Writing and a senior fellow at Harvard’s Belfer Center for Science and International Affairs. She is a former Shorenstein Center fellow and Washington Post reporter.