U.S. News and World Report today released its fifth annual rankings of Best Children's Hospitals for such pediatric specialties as cancer, cardiology, neurology and orthopedics. "Honor Roll" hospitals that excelled in four or more specialties are:
1. Children's Hospital Boston
1. Children's Hospital of Philadelphia
3. Cincinnati Children's Hospital Medical Center
4. Texas Children's Hospital, Houston
5. Children's Hospital Colorado, Denver
5. Johns Hopkins Children's Center, Baltimore
7. Seattle Children's Hospital
8. Children's Hospital Los Angeles
8. Children's Hospital of Pittsburgh of UPMC
8. New York-Presbyterian Morgan Stanley-Komansky Children's Hospital, N.Y.
8. St. Louis Children's Hospital-Washington University
A place on the list, which is determined by the responses of 1,500 physicians to where they would send the sickest kids, is a badge of honor for hospitals.
"The list is a huge deal, even though we all know it's somewhat of a popularity contest," said Dr. Marie Savard, a Philadelphia internist and ABC News medical contributor. "We all understand that great hospitals don't always get on that list for various reasons. Bigger hospitals with more aggressive PR departments have a better shot at landing a top spot. But just because your hospital's not on the list, don't assume it doesn't meet the criteria."
Savard, who is also a patients' rights advocate, said hospitals that tailor treatments to the specific needs of each patient and coordinate care with teams of experts from admission to beyond discharge get top scores.
"Is the hospital addressing the very individual needs of patients? That's the critical focus, because everything falls out from that," Savard said.
For children, those individual needs can extend beyond medical ones.
"They can be cultural, like language. And how friendly is the hospital? Is the family able to stay? And are families and friends involved in the treatments? These things are very important for patient satisfaction," Savard said.
Kids often travel to bigger hospitals for more specialized care. But at the end of the treatment, they go home or to smaller hospitals in their hometowns. How well does a hospital handle this move?
"A lot of mistakes and readmissions happen because hospitals didn't plan for the transition back to the home or community hospitals," Savard said, emphasizing the importance of discharge planners who coordinate care outside the hospital doors. "It's important to make sure somebody's communicating to outside doctors. Kids can come in from all over and get transferred back to their small town after treatment. We need seamless care."
The types of procedures offered and safety records also influence hospitals' rankings, as well as the quality of doctors they attract.
"Do the hospitals offer the state-of-the-art procedures that we know are the best?" Savard asked, adding that the hospital's average length of stay, infection rate and death rate all reflect the quality of care. "Fabulous physicians are going to want to practice in centers where there's a team of experts, and they work with colleagues who are equally well-trained."
And at a time when everyone has money on the mind, value matters too.
"Everybody is looking at value, especially in this day of health care reform and limited dollars," Savard said. "Is the hospital using money wisely?" In other words, "Are we getting the biggest bang for our buck?"
Ultimately, the rankings come down to where people would want to bring their kids. But the rankings by U.S. News and World Report and other online hospital raters influence parents' decisions. But parents can use the criteria to evaluate hospitals that aren't on the list.
"As consumers, we need to do a little bit of homework and ask these questions," Savard said. "And parents can trust their family doctors to help navigate them through these questions."