Sunday, November 22, 2009

Best Children's Hospitals

Best Children's Hospitals: Defining the Terms

Posted June 17, 2009

The following terms appear in the rankings tables. Additional details and descriptions of measures factored into the scoring but not displayed can be found in the complete methodology report.

[See America's Best Children's Hospitals and search for one near you.]

MORE THAN ONE SPECIALTY

U.S. News Score Summarizes overall quality of care. The top-ranked hospital in each specialty received a score of 100.
Reputation (%) Percentage of pediatric specialists responding to U.S. News surveys in 2008 and 2009 (Cancer, Digestive Disorders, Heart & Heart Surgery, Neonatal Care, Neurology & Neurosurgery, Respiratory Disorders) or 2009 (Diabetes & Endocrine Disorders, Kidney Disorders, Orthopedics, Urology) who recommended hospital for difficult cases.
Bloodstream infection index Relative rate of bloodstream infections in all pediatric intensive care units (neonatal ICU for Neonatal Care). Lower is better.
Infection prevention index Relative commitment to and performance in hand hygiene, flu vaccination, case reporting, and other activities that reduce infections. Higher is better.
Patient volume All patients in most recent 12 months with certain specialty-specific disorders or who received certain specialty-specific procedures. Higher is better.
Nurse staffing Relative balance of nurses and patients. Higher is better.
Nurse Magnet hospital Designation indicates hospital meets certain standards set by American Nurses Credentialing Center.
Patient and family services (of 8) Number of services related to overall quality of stay are offered from the following 8: certified child life specialists, family support specialists, pediatric psychologists, interpreter services, family resource center, sleep rooms for parents/siblings, school intervention program, Ronald McDonald House or other residential facility for parents.
NA Not applicable to this hospital.
NR Data not reported by hospital to U.S. News.

INDIVIDUAL SPECIALTIES

Cancer

FACT accreditation Meets standards set by Foundation for the Accreditation of Cellular Therapy for transplanting bone marrow and tissue.
Palliative care (of 2) Indicates hospital has formal program to help families of children with chronic or life-limiting conditions; additional credit if program is specifically available to cancer patients.
Participation in cancer research (of 5) Whether hospital belongs to one or more research networks plus additional credit for participating in early clinical trials.

Diabetes & Endocrine Disorders

Diabetes management index How well hospital prevents serious problems in children with type 1 diabetes. Higher is better.
Specialized clinics and programs (of 4) For lipid disorders, hypertension, comprehensive weight management, and Turner syndrome.

Digestive Disorders

Liver-transplant survival index Reflects three-year patient survival. Higher is better.
Transplant volume index Relative number of intestinal and liver transplants. Higher is better.

Heart & Heart Surgery

Surgical mortality index Relative death rate in complex heart procedures. Lower is better.
Surgical volume All patients who had specified complex heart surgery in latest 12 months. Higher is better.
Catheter procedure volume All patients treated through a catheter for specified disorders in latest 12 months. Higher is better.

Kidney Disorders

Kidney-transplant survival index Reflects three-year survival of both patients who received a kidney transplant and of the transplanted organs themselves. Higher is better.
Dialysis volume All patients who regularly received dialysis in most recent 24 months. Higher is better.

Neonatal Care

Neonatal ICU nurse staffing Relative balance of nurses and patients in neonatal intensive care unit (NICU). Higher is better.
Specialized clinics and programs (of 5) Craniofacial team, extracorporeal membrane oxygenation (ECMO) team, NICU-dedicated percutaneous intravenous central catheter team, spina bifida team, comprehensive retinopathy of prematurity program.
CDC infection-control reporting (of 4) Whether hospital participates in the National Healthcare Safety Network program and complies with specific standards for monitoring and reporting in order to reduce hospital-acquired infections.

Neurology & Neurosurgery

Surgical mortality index Relative death rate in most recent 12 months of patients having a first surgery for specified neurological disorders. Quality of initial surgery is key in this specialty. Lower is better.
Surgical infection prevention Whether hospital monitors compliance with specific surgical guidelines and tracks surgical-site infections in specified ways. Higher is better.
New-patient volume Reflects number of new patients in most recent 12 months who had specified disorders; quality of initial treatment is especially important in this specialty. Higher is better.
Specialized clinics and programs (of 9) Movement disorder clinic, neurofibromatosis clinic, neuromuscular clinic, tuberous sclerosis clinic, brain tumor program, cerebrovascular accident (stroke) program, craniofacial surgical program, neuro-oncology program, and spina bifida program.

Orthopedics

New-patient surgical volume Relative number of new patients in most recent 12 months who had specified procedures; quality of initial surgery is especially important in this specialty. Higher is better.
Specialized clinics and programs (of 7) For brachial plexus injuries, muscular dystrophy, neurofibromatosis, pain, skeletal dysplasia, spasticity, spina bifida.

Respiratory Disorders

Cystic fibrosis outcomes Reflects most recent health status of cystic fibrosis patients. Higher is better.
Respiratory procedure volume Number of specified diagnostic procedures and treatments in most recent 12 months. Higher is better.
Specialized clinics and programs (of 7) Multidisciplinary asthma center, noninvasive ventilation-support program, pulmonary hypertension program, congenital central hypoventilation team, multidisciplinary neuromuscular disease team, multidisciplinary ventilator/tracheotomy-dependent team, sickle cell anemia pulmonary support team.

Urology

Surgical volume Relative number of specified urological procedures in most recent 12 months. Higher is better.
Specialized clinics and programs (of 4) For kidney and urinary-tract stones, prenatal urinary disorders, spina bifida, voiding difficulties.

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