by James Nataro, MD PhD MBA, Chair, Department of Pediatrics
By now, most of you know that UVA Children’s was once again named the number one Children’s Hospital in the state of Virginia. This is the second year in a row in which we have received that distinction, and of course it is only the second year when the US News has named top children’s hospitals by state. Of course all of us at UVA Children’s have long considered ourselves the number one Children’s Hospital in the Commonwealth, so the formal designation is no surprise to us. Nevertheless, it is always fun and gratifying to receive national attention for the work we do every day.
In addition to the number one ranking, six of our subspecialties also rank in the top 50 nationally. These are neonatology, cardiology and heart surgery, diabetes and endocrinology, gastroenterology, neurology and neurosurgery, and pediatric pulmonology. Indeed of the 10 pediatric subspecialties that are ranked by US News, UVA Children’s has been ranked at one time or another in nine of these. This is a spectacular achievement for Children’s Hospital in a population center of our size.
Many of you may be curious as to exactly what criteria are considered in the rankings. For all specialties except cardiology, the criteria fall into equal thirds. One third of the criteria relate to specific clinical outcomes, like survival and surgical complication rates, as well as hospital-wide metrics such as CLABSI. The second third embraces the process of care, such as best clinical practices, reputation and infection prevention metrics. This bin also includes a new metric for diversity, equity, and inclusion. The last third embraces hospital structure, specifically targeting hospital resources that are directly related to patient care, such as nurse-patient ratio. For the heart subspecialty clinical outcomes are weighted slightly more than process-of-care with hospital structure remaining one third.
You might also be interested in areas where UVA particularly shines. Some that stood out include our NICU CLABSI, where we scored five out of a possible five points, along with our spectacular liver transplant survival rate. In cardiology we scored a spectacular 20th nationally, driven almost entirely by top-tier outcome data. Our Norwood surgery survival score attained 23/24 possible points, and absolutely stratospheric accomplishment.
So, what are some areas of weakness for us? What stands out most is that our reputation is far below what we want on the basis of our superior outcomes. The reason is not entirely clear. Some of the reputation score is driven by long-standing tradition which may not reflect current reality. Moreover, investment in marketing or even simply the number of a program’s fellowship trainees in current clinical practice can lead to high undeserved reputation scores. We are hoping that with consistently high clinical excellence and additional marketing efforts, our reputation will begin to approach what we truly deserve.
The U.S. News & World Report rankings do not tell the whole story of Children’s Hospital excellence but they do provide some value. Many of the criteria considered, particularly clinical outcome, should be the main drivers of patient and family choice. We at UVA Children’s are justifiably proud of the national attention we receive and I know that pride translates to greater satisfaction for us and for patients. I’m proud to work with all of you every day.
Filed Under: Features