Rady ranks 2nd nationwide in orthopedics

Radiology technologist Natalie McNeil prepares patient Diana Mondragon for a scan in the EOS imaging system at Rady Children's Hospital Tuesday. The low-dose system is used to create whole-body digital models used to plan treatment for orthopedic patients with conditions such as scoliosis.

Rady Children’s Hospital ranks second nationwide in orthopedics, and is one of 21 hospitals recognized in 10 different specialties, according to a closely watched hospital report released Tuesday.

The rankings appear in the ninth annual “Best Children’s Hospitals” published by U.S. News and World Report, one of several programs that assess hospital quality using a range of often-conflicting criteria.

U.S. News ranks the top 50 pediatric hospitals across 10 categories of care from cancer to urology, drawing from a survey of 183 facilities nationwide.

In 2015, as it has for several years, Rady made the top 50 in all 10 specialties and regained the No. 2 ranking in orthopedics, which it last held in 2012.

However, Rady’s rankings slipped from the previous year in eight of 10 categories considered. Only its orthopedics ranking increased, and the hospital was not among a dozen named to the magazine’s “Hospital Honor Roll,” reserved for those that scored in the top 10 percent in at least three different specialties.

Rady Children's Hospital

Boston Children’s Hospital was the top-ranked facility nationwide, and Children’s Hospital Los Angeles had the best results in California, coming in at No. 7.

Dr. Donald Kearns, Rady’s chief executive, said the report’s recognition, and especially the orthopedic ranking, validates the work of doctors, nurses and staffers who care for patients. “We’re ecstatic that we continue to be rated in all 10 specialties,” Kearns said.

He added that the hospital will comb through the report to determine why some rankings slid compared with last year.

“We will be spending a significant amount of time figuring out where the issues were,” he said.

U.S. News uses a host of criteria for its rankings. Hospitals are given points for offering a broad range of services within individual specialties and also get credit for outcomes, including the number of patients who contracted infections, or died, during treatment.

Physician opinions count for 16.7 percent of the overall calculation.

For Rady, orthopedics has been a consistently high performer. The program has been among the top 10 for years, moving from third to second this year after being listed seventh in 2013 and second in 2012.

Its prominence dates to 1976, when the late Dr. David Sutherland opened the Motion Analysis Laboratory at what was then called San Diego Children’s Hospital. The lab was the first to use computers to recognize human gait patterns, an approach that eventually led to new surgical techniques for patients with cerebral palsy and spina bifida.

Dr. Dennis Wenger and Dr. Scott Mubarak, who worked closely with Sutherland, continued to build the program, innovating new techniques in areas like pediatric hip surgery.

Most recently the hospital was the first in the nation to use a new kind of imaging system called EOS that is shown to deliver a 50-fold lower dose of radiation to scoliosis patients.

Dr. Peter Newton, chief of the orthopedics and scoliosis division at Rady, said the hospital’s orthopedic fellowships have been in demand for decades, which contributes to its performance in the rankings.

"Trainees get a breadth of exposure here and then end up going out all over the world,” Newton said.

Dr. David Scher, a fellow in Rady’s class of 2000 who now practices at the Hospital for Special Surgery in New York, said Rady’s reputation is understood throughout the community of pediatric orthopedists.

“For many of us around the country, and colleagues around the world, the San Diego program is really the root of the tree that forms our pediatric orthopedic genealogy,” Scher said.

Hospitals, including Rady, are not shy about using the rankings to promote themselves. Though facilities do not pay to be ranked, they do pay U.S. News a licensing fee to use results in promotional material.

This stream of revenue has caused some industry observers to note that publishers have an incentive to rank a large number of hospitals because it increases the chance they will receive licensing revenue from advertising campaigns.

And, while there has been an increase in the number of health ratings and ranking systems, they often measure different things and end up delivering different results.

A study published in March examined four national ranking systems and found that only 10 percent of 844 hospitals rated as a high performer by one program were rated as highly by another system.

Anne Weiss, a director with the Robert Wood Johnson Foundation, said this multiplicity of results does not necessarily mean that ratings systems are flawed but that consumers should realize that they measure different things. For example, U.S. News includes physician opinions, while The Leapfrog Group focuses on safety and Consumer Reports incorporates patient satisfaction reports.

In the end, she said, looking at multiple ratings systems is probably a better idea.

“You have to be an active consumer and understand what they’re measuring and what they’re not,” she said.

Maribeth Shannon, director of the California Health Care Foundation, added that there is a side benefit for consumers even if they tune out ratings and rankings.

“They to provide an incentive for hospitals to get better because they care about how they look in these rankings,” she said.

Weiss agreed.

“There are studies that show that when the information is made public, you see greater improvements in the quality of care,” she said.

Source:  utsandiego, 09th June 2015