Our Methodology: Inside the 2012-13 Best Children's Hospitals Rankings

Grouping free standing Children's Hospitals with departments contained within full service general hospitals is inappropriate. Like many things the critical determing factor of quality reflects the weakest link in the chain-not the strongest (e.g take for example colleges- The top of the class at a large state University is probably competetive with a prestigous ivy league institution but the greater and true differences are realized in the middle and bottom of the class). So it goes with large hospitals. Free standing Children's hospitals are completely dedicated to the well being of children and their staffs are similarly oriented. Most people working at a free standing Children's hospital get paid LESS than at a large adult facility. As a result those working at Children's hospitals are there out of shared dedication and commitment to children. The differences are at the perimeters- e.g. when a child is brought down for an X-ray late at night - how likely are they to encounter someone who is patient with children? who is cognizant not to keep them lying on a stretcher in the hallway for a long time? who is aware and dedicated to different imaging protocols for children? This MIGHT happen in a large free standing hospital but it is more likely/more certain in a free standing Children's hospital. Organizations like NACHRI recognize this and do not allow membership for non-free standing childrens hospitals. Large full service hospitals like Mayo, Cleveland C, Johns Hopkins are outstanding overall facilites with lots of research and big names. While I am sure that they exert some pressure on USNWR to be considered on same playing field those of us that work in free standing facility (and get or see treatment in large full service hospital) are aware of the subtle, frequent and yet very profound differences exist between them and free standing Children's facilities. You should sub-stratify your analysis to reflect this important distinction.

Jeff of AL 1:26PM June 21, 2012