The following terms appear in the rankings tables. More detail as well as descriptions of other measures that were included in scoring but do not appear in the rankings tables are available in a full-length methodology report at health.usnews.com/pediatrics.
Terms used in more than one specialty
U.S. News Score
A summary of the overall quality of inpatient care. A score of 100 is assigned to the top-ranked hospital.
Reputation (%)
The percentage of surveyed pediatricians and pediatric specialists responding to U.S. News surveys in 2006, 2007, and 2008 for General Pediatrics, and in 2008 for all other specialties who listed the hospital as among the best for the most serious or difficult conditions in their specialty. It counts for 50 percent of the U.S. News Score in General Pediatrics, Heart and Heart Surgery, Neurology and Neurosurgery, and Respiratory Disorders. It counts for 60 percent of the U.S. News Score in Cancer, Digestive disorders, and Neonatal Care.
Nurse staffing
A ratio that reflects the balance of nurses to pediatric inpatients. Higher is better. Nurses must be on-staff RNs. The number of nurses is expressed in "full-time equivalents"—two half-time nurses are equivalent to one full-time nurse, for example. The number of patients is the average daily census of inpatients. In Neonatal Care, the number of nurses represents those dedicated exclusively to NICU care.
Nurse Magnet hospital
"Yes" means that as of March 1, 2008, the hospital met standards of nursing excellence set by the American Nurses Credentialing Center, an arm of the American Nursing Association. The most current list of Nurse Magnet hospitals is available at nursingworld.org.
Advanced technologies
Indicates the number of advanced technologies available in a specialty onsite or through a formal arrangement with another community facility. The maximum number varies from 6 to 13, depending on specialty, drawn from a universe of 18 services. Examples include positron emission tomography/computed tomography (PET/CT combined), intensity-modulated radiation therapy (IMRT), robotic surgery, and molecular diagnostic/virology laboratory.
Patient & family services
Indicates the number of services offered to address patient and family needs. The maximum number is nine. Examples: certified child-life specialists, interpretive services, and sleep rooms for parents and siblings.
Clinical support services
Indicates the number of medical and/or surgical services available to support the care of patients in this specialty onsite or through a formal arrangement with another community facility. The maximum number varies from 4 to 7, depending on specialty, drawn from a universe of 10 services. Examples include neonatal intensive care unit (NICU), pediatric intensive care unit (PICU), surgical intensive care unit (SICU), reverse isolation/infection control facilities, and pediatric anesthesia program.
Terms used in individual specialties
General Pediatrics
Readmission rate
Represents the rate at which patients return to the hospital within 30 days of discharge following an inpatient stay for a surgical procedure. From 1 (best) to 3 (worst).
Daily inpatient volume
The average number of inpatients per day in the last calendar or fiscal year, depending on reporting format. Newborns are excluded.
Cancer
Volume
Represents the number of inpatients who were treated for acute lymphocytic leukemia, brain tumors, and solid tumors in the latest 12-month reporting period.
Palliative care
Indicates an organized, staffed program directed at children who are terminally ill or are living with a condition, such as chronic pain, that limits their quality of life. The intent is to minimize pain and discomfort, support children and their families emotionally and spiritually, and help with financial guidance and needed social services. To receive credit, all team members in the program must have specific training in pediatric palliative care.
Digestive disorders
Volume
Represents the number of inpatients treated for specific digestive disorders by specialized interdisciplinary medical teams in the latest 12-month reporting period.
Programs
Represents how many of seven specialized interdisciplinary treatment programs are offered. Examples: intestinal rehabilitation program, cystic fibrosis treatment program, total parenteral nutrition support program, and liver transplant.
Heart Surgery
Surgical mortality
Represents death rate following heart surgery considered moderate to difficult (categories 3-6 in the Risk Adjustment for Congenital Heart Surgery coding system, or RACHS-1) in the latest 12-month reporting period. From 1 (best) to 3 (worst).
Surgical volume
Represents the number of patients who received heart surgery considered moderate to difficult (categories 3-6 in the Risk Adjustment for Congenital Heart Surgery coding system, or RACHS-1) in the latest 12-month reporting period.
Catheter procedure volume
Represents the number of patients who had catheter-based procedures for heart disorders in the latest 12-month reporting period. Examples of such procedures include balloon angioplasty, stent implantation, and transcatheter arrhythmia ablation.
Cardiovascular services
Indicates how many of 11 specialized technologies and services are offered by hospitals to support diagnosis and treatment of heart disorders. Examples: dedicated cardiac surgery operating room(s), inpatient cardiology consultation services, cardiac diagnostic catheterization laboratory, ventricular assist program, and echocardiography laboratory. The maximum number of services is 11.
Neonatal
Volume
Represents the number of patients who had various conditions or treatments in the latest 12-month reporting period. Examples: extracorporeal membrane oxygenation (ECMO), repair of patent ductus arteriosus, treatment for retinopathy of prematurity.
NICU nurse staffing
A ratio that reflects the balance of nurses to pediatric inpatients. Higher is better. Nurses must be on-staff RNs dedicated exclusively to NICU care. The number of nurses is expressed in "full-time equivalents"—two half-time nurses are equivalent to one full-time nurse, for example. The number of patients is the average daily census of inpatients.
Neurology & Neurosurgery
Mortality
Represents death rate for inpatients who were diagnosed with seizures or had surgery to remove a brain tumor in the latest 12-month reporting period. From 1 (best) to 3 (worst).
Volume
Represents the number of all neurology inpatients and the number of inpatients who had specific procedures such as surgery for epilepsy, removal of a brain tumor, or treatment for head trauma in the latest 12-month reporting period.
Respiratory Disorders
Cystic fibrosis outcomes
Represents success at improving the overall health of cystic fibrosis patients. Includes a composite of the median body mass index (BMI) and forced expiratory volume (FEV1) for pediatric cystic fibrosis patients treated at the hospital in the last year. From 6 (best) to 1 (worst).
Cystic fibrosis volume
Represents the number of patients treated for cystic fibrosis by the respiratory program at the hospital in the latest 12-month reporting period.
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