Best Children’s Hospitals 2013-14: Overview and Honor Roll

By Kimberly Leonard for U.S. News & World Report
U.S. News & World Report has released its seventh annual Best Children’s Hospitals rankings, a guide to the best care for children who face life-threatening, rare or demanding conditions or procedures.

In the 2013-14 rankings, 87 different hospitals are listed among the top 50 in at least one of 10 specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and GI surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology. For high scores in three or more specialties, 10 hospitals were named to the Honor Roll.

[See the Honor Roll in pictures or check out an interactive map of all 87 ranked children’s hospitals.]

How U.S. News constructed the rankings

The rankings were built from a lengthy clinical survey sent to selected hospitals and a reputational survey sent to pediatric specialists and subspecialists. RTI International, a North Carolina research and consulting firm that also generates the Best Hospitals rankings, directed the surveys and analyzed the results.

[See all Best Children’s Hospitals.]

The data survey was sent to 179 pediatric centers, most of which are members of the Children’s Hospital Association (CHA). They are freestanding children’s hospitals — a few focus on cancer or another specialty but most offer many specialties — or large, multispecialty pediatric departments of major health centers, run with their own staffs, operating rooms, labs and other facilities as if they were a separate hospital within a hospital. A small number of other children’s facilities do not fit these categories but were surveyed because they were previously ranked or were recommended by trusted sources.

Of the 179 hospitals, 110 provided enough information on the survey to be considered for ranking in at one or more specialties. “Going through the data-gathering process to complete the survey is expensive and time-consuming,” says U.S. News Health Rankings Editor Avery Comarow. “That so many hospitals do it speaks to a real commitment to quality.”

[Read more about how we ranked Best Children’s Hospitals in our FAQ.]

Some survey questions, such as the number of nurses and the extent and success of programs that prevent different infections, touched on all 10 specialties. Others, such as complications from kidney biopsies and three-year survival for certain cancers, were specialty-specific.

Whether a hospital was ranked and how high depended on its performance in three areas: clinical outcomes such as cancer survival and rates of various infections; efficiency and coordination of care delivery, which included results from the reputational survey, compliance with “best practices” and steps to control infection; and care-related resources such as adequate numbers of nurses and availability of programs tailored to particular illnesses and conditions. Each of the three major areas contributed one-third of a hospital’s score.

For the physician survey, which alone made up a quarter of a hospital’s score, 150 specialists and subspecialists in each of the 10 specialties were asked to name up to 10 hospitals they consider best for children with serious or difficult problems without regard to price or location. More than half of the surveyed physicians responded, an extraordinary showing for such a poll by survey standards.

The 10 children’s hospitals on the 2013-14 Honor Roll ranked at or near the top in three or more specialties. The Honor Roll is ordered by total points. A hospital scored 2 points if it ranked among the highest 5 percent of all of the hospitals in a specialty and 1 point if among the highest 6 to 10 percent. With 2 points in every specialty, Children’s Hospital of Philadelphia is No. 1 on this year’s Honor Roll, breaking last year’s tie with Boston Children’s Hospital for the top spot. “No argument with CHOP at the top,” says Comarow. “But all of the hospitals in our rankings, in and out of the Honor Roll, perform at an exceptionally high level.”

How U.S. News analyzed the data and put it together is fully described in the Best Children’s Hospitals Methodology Report, a viewable and downloadable PDF.

See rankings in all 10 pediatric specialties:

• Cancer
• Cardiology & Heart Surgery
• Diabetes & Endocrinology
• Gastroenterology & GI Surgery
• Neonatalogy
• Nephrology
• Neurology & Neurosurgery
• Orthopedics
• Pulmonology
• Urology