Choosing the Best Children's Hospital: Why Rankings Matter (with Ben Harder)

WEBVTT

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what matters when you're measuring it.

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And that was the first thing that popped

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in mind was, you know,

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you're treating the whole person and

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you're treating the whole family.

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And that's,

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that's often a little different when

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you're, when you're treating adults.

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Oh, absolutely.

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Yeah.

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The entire family comes with them.

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That's it.

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And no family is the same and everybody

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comes with their own experiences.

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And I won't keep this part of the

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interview,

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but I just recorded it in case before

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I forget.

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Like, you know,

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I'll have a family come in and the

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parent will say, oh,

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I'm such a hard stick.

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It takes forever to get blood on me.

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And then that kind of puts it on

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the child, too.

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So we really are taking care of the

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whole family when they come in and.

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I'm glad that your family was able to

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get child life services during that time.

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But thank you for sharing that personal

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anecdote with me.

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That means a lot.

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Wonderful.

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Well,

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I have about nine questions at my sleeve.

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They'll be so easy for you because you're

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just such a natural or expert at this.

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And then I'll wrap it all up and

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permissions are allowed that I can post

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this on Tuesday.

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Is that correct?

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Yeah, yeah, exactly.

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The embargo limits at midnight Tuesday

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morning.

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Okay, wonderful.

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And then any other things that you'd like

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me to know before we get the interview

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started?

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I mean,

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I think your questions will probably leave

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me here,

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but I have a family story as well

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that I'd like to share.

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And I have permission from the family to

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share it.

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I mean, it's a relative of mine,

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but I asked the mother.

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So yeah,

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I'm very grateful for this opportunity to

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speak to your listeners and talking about

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issues that I'm passionate about.

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Thank you.

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Me too.

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Me too.

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Well,

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I'll do an additional intro after this,

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but Ben,

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why don't you just introduce us to who

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you are a little bit about yourself?

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What got you into this work and why

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I can see you're truly passionate about

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reporting on it?

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Yeah, I mean,

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a couple of different things led me here

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to being at the helm of the Best

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Children's Hospitals project at US News.

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One is that I very much wanted to

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tell stories that are meaningful to

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people.

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And so I started out after college as

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a journalist, interviewing experts,

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interviewing family members.

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I was specifically interested in medicine

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and healthcare.

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So I quickly fell into that beat.

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And I became really interested in the

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experience that patients have when they

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are critically ill or when they have

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complex medical conditions,

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which often involves one or more trips

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through the hospital.

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started reporting on hospitals and the

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medical care and the innovation that they

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have,

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but also the dangers and the challenges of

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being a patient or being a family member

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of a patient.

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And US News had been ranking hospitals.

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At that time,

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I ended up getting an editing job at

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US News,

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but it was already publishing hospital

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rankings and wanted to develop rankings of

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children's hospitals.

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And so I actually joined just as we

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were getting ready to publish our first

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edition of the best children's hospitals

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rankings.

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That was in two thousand seven.

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And we have expanded it.

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We have refined it and deepened the rigor

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of it.

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We've added a lot of information for

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families.

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And so it's been really gratifying to be

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part of that process.

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My background, again, as a journalist,

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and I've come at this through the lens

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of what do readers, listeners,

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viewers need to know

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to help them make the best decisions in

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their life.

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And that's really US News' mission as a

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whole,

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but specifically around the best

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children's hospitals rankings.

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We're designing something that families

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can use to make data-driven decisions.

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Yeah.

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Would you mind kind of walking us through

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what that methodology looks like and

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explain it to the parent who doesn't

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understand all of the way you look at

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it,

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but maybe just what are some of the

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key aspects that you look at when you're

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deciding these rankings and how do you

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come up with the results?

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Yeah.

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So we collect over a thousand data points

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for each hospital that we use to,

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we analyze to produce the rankings.

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And we

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publish an overall ranking for hospitals

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in each state in each region,

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but the real meat of the work that

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we do is around specialty specific

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rankings and the goal being to identify

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because each family is different each each

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patient is different,

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you know what the kind of care that

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a child with leukemia needs may be quite

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different than the you know and the

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hospital may in fact be different than

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a child who's born with a congenital heart

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defect or who is critically ill at birth

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and needs NICU care.

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So we want to evaluate each of these

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different service lines or specialty areas

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separately so that families can identify,

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given the needs of their child,

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which are some of the hospitals that are

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strongest in providing that kind of care.

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So we collect over a thousand data points

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per hospital.

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Those are grouped according to which

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clinical, you know,

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which specialties they're relevant to.

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And they broadly fall into kind of three

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categories that I'll just mention,

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I obviously go into detail about some of

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the specific measures,

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if you're interested as well, but broadly,

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they fall into three categories.

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One is sort of the resources,

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the structural characteristics of the

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health care

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provider, the system,

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the program that's providing the care,

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do they have enough nurses?

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Do they have the types of expertise that

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patients need to succeed and have good

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experience and good outcomes?

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Do they have access to advanced

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technologies and treatments that some of

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their patients may need?

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So those sorts of resources and structural

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ability to deliver good care for the

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child, again,

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pediatric cancer patient or what have you.

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The second area is processes of care.

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Does this hospital follow best practices?

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Are there providers

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you know,

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good and consistent about washing their

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hands to prevent infections?

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Do they, you know,

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do they make sure that medicines are

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administered when appropriate to the right

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patients and not given at the wrong dose

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and that sort of thing?

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So those kinds of processes of care,

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you know,

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following

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following sort of the guidance that

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experts have developed and honed over many

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studies,

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many years of practice and experience.

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That's kind of a second group of quality

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measures that we collect.

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And then the third one,

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which is really most important to

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patients,

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to families and to doctors and other

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providers is outcomes, right?

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And so,

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did this child survive the bone marrow

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transplant

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not just the surgery itself,

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but the follow-up care and the

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complications that so often emerge.

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Did this patient have a long length of

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stay after their heart surgery and so on?

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Were they able to get home,

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back to the comfort of their home,

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start their recovery,

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maybe go back to school if they're of

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school age?

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So those sorts of outcomes are, of course,

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really important and very meaningful.

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There's sometimes a little bit outside the

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control of even the best medical team.

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And so for that reason,

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that's not the only thing that matters

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when we're assessing quality.

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We do care about the processes that I

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talked about and the structural

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characteristics,

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the resources that the hospital can bring

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to bear as well.

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Wonderful.

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So it's kind of these three pillars that

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you're able to look at over a thousand

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different data points.

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And then I know there's some almost,

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I don't know if it's narrative,

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but maybe data that comes from work groups

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that look to give expert opinion on this

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as well.

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Is that correct?

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Yes,

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we enlisted help of almost two hundred

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experts who make up about a dozen work

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groups that we have,

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and they don't provide direct input on

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which hospitals are best at one specialty

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or another.

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But what they do provide and what is

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really critical and they all serve as

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volunteers.

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I mean,

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these are these are busy clinicians and

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researchers who are doing this out of the

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goodness of their heart and because they

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care about making sure that the data that

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we collect

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and the way that we analyze it and

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present it to families is meaningful and

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reflects what families need to know about

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the quality of care.

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So I'm enormously grateful for their

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contributions,

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their intellectual contributions and their

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contribution of time.

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So these doctors, mostly doctors,

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there are some other types of experts that

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we bring into these working groups,

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but these experts,

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bring their expertise.

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They hail from all over the country,

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many different health care systems in the

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country.

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And what they what they advise us on

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is what data points to collect and very

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specifically how to define those data

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points,

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because we survey hospitals and we tell

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them, you know,

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we need to know how many patients of

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the following diagnoses did you treat and

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how many of them had a readmission within

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thirty days of a surgery or

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you know,

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survived the initial hospitalization with

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at least this level of function or

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whatever the outcome measure that we are

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looking at.

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And so they help us define exactly which

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patients should be included in the

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measure,

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what the outcomes of interest are.

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And there are technical sort of like codes

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that healthcare systems use to record

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these things.

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And so we need their expertise to help

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us think through exactly how do we define

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this?

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How do we capture the right data?

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How do we communicate that to hospitals so

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that they're giving us the slice of data

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that we need to analyze them in a

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fair and meaningful way for family?

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Got it.

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That makes a lot of sense.

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And especially when you're coming up with

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those diagnosis-specific rankings or

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specific populations that you're working

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with, their input is incredibly important.

00:10:07.668 --> 00:10:10.690
Do you see a future where families,

00:10:11.149 --> 00:10:11.791
parents,

00:10:11.910 --> 00:10:14.251
or even former patients might also be a

00:10:14.331 --> 00:10:16.994
part of shaping how hospitals are

00:10:17.033 --> 00:10:17.714
evaluated?

00:10:18.475 --> 00:10:21.235
And do you think that family experience or

00:10:21.316 --> 00:10:23.557
perspectives could eventually make their

00:10:23.597 --> 00:10:25.519
way a little bit more into the rankings?

00:10:26.970 --> 00:10:27.169
Yeah,

00:10:27.210 --> 00:10:31.692
so we do get input from family members.

00:10:32.293 --> 00:10:33.335
Sometimes it's unsolicited.

00:10:33.355 --> 00:10:35.216
I mean, we have an open inbox,

00:10:35.275 --> 00:10:37.576
and people will send us letters describing

00:10:37.596 --> 00:10:40.438
their experience or recommendations.

00:10:42.480 --> 00:10:44.221
and we try to follow those recommendations

00:10:44.260 --> 00:10:45.701
wherever feasible.

00:10:45.721 --> 00:10:46.822
I mean, sometimes it's,

00:10:48.082 --> 00:10:49.982
this measure is really important to us and

00:10:50.023 --> 00:10:51.724
we'd like you to highlight it more.

00:10:52.323 --> 00:10:53.125
Other times it's,

00:10:53.164 --> 00:10:55.184
we wish we had information about X or

00:10:55.345 --> 00:10:59.047
Y or Z and sometimes that information is

00:10:59.226 --> 00:11:00.827
gettable and sometimes it's not so

00:11:00.868 --> 00:11:02.788
gettable or we're not confident that we

00:11:02.807 --> 00:11:04.688
can really trust the data that we're able

00:11:04.729 --> 00:11:05.009
to get.

00:11:05.048 --> 00:11:06.509
And so we may not be able to

00:11:06.570 --> 00:11:09.191
fulfill every idea

00:11:10.010 --> 00:11:11.413
But nevertheless,

00:11:11.653 --> 00:11:13.614
it's a vital stream of information for us.

00:11:17.336 --> 00:11:21.620
We have at times had involved sort of

00:11:21.639 --> 00:11:23.802
family members in conversation,

00:11:23.841 --> 00:11:25.342
like formal conversations where they're

00:11:25.383 --> 00:11:27.044
interacting with clinicians and advising

00:11:27.065 --> 00:11:27.865
us simultaneously.

00:11:28.085 --> 00:11:30.126
I think we've actually found it often most

00:11:30.567 --> 00:11:32.229
meaningful to hear their stories and their

00:11:32.308 --> 00:11:35.691
ideas separately because it's often not

00:11:36.331 --> 00:11:38.493
sort of cloaked in the same medical jargon

00:11:38.833 --> 00:11:38.974
and

00:11:39.753 --> 00:11:40.192
and so on,

00:11:40.653 --> 00:11:43.154
but it's an unvarnished take on what

00:11:43.235 --> 00:11:45.917
matters to them as a parent or as

00:11:45.937 --> 00:11:46.537
a caregiver,

00:11:47.417 --> 00:11:50.099
which is incredibly helpful and very

00:11:50.119 --> 00:11:50.798
complimentary.

00:11:50.818 --> 00:11:54.280
I mean, there's one group, for example,

00:11:54.301 --> 00:11:57.482
that just comes to mind of parents who

00:11:57.602 --> 00:11:59.364
have had children with congenital heart

00:11:59.384 --> 00:11:59.904
disease.

00:12:00.424 --> 00:12:02.005
And so many of them, some of them,

00:12:03.066 --> 00:12:05.047
have children who are now young adults and

00:12:05.067 --> 00:12:06.947
have done really well and others lost

00:12:06.967 --> 00:12:09.328
their child far too young,

00:12:09.869 --> 00:12:12.169
but are still so committed to helping

00:12:12.230 --> 00:12:14.211
other families that they participate in

00:12:14.311 --> 00:12:18.993
this association of family members who are

00:12:19.092 --> 00:12:21.634
advocating for better care for congenital

00:12:21.653 --> 00:12:25.134
heart disease and are also advocating for

00:12:25.195 --> 00:12:28.297
the interests of those young patients to

00:12:28.496 --> 00:12:29.437
the clinical community.

00:12:29.476 --> 00:12:30.076
And so they have

00:12:31.738 --> 00:12:34.399
over the years brought together groups of

00:12:34.480 --> 00:12:36.061
clinicians from different hospitals to

00:12:36.100 --> 00:12:38.461
talk about what matters to families and to

00:12:38.501 --> 00:12:42.044
give them feedback on what what they need

00:12:42.065 --> 00:12:43.065
to be focused on,

00:12:43.645 --> 00:12:45.547
even data points that they would like to

00:12:45.586 --> 00:12:45.807
see

00:12:46.293 --> 00:12:48.255
hospitals put out so that U.S.

00:12:48.296 --> 00:12:49.076
News can use them.

00:12:49.096 --> 00:12:51.177
And so I've attended a number of those

00:12:51.197 --> 00:12:53.080
meetings, in fact, at their invitation,

00:12:53.100 --> 00:12:53.940
sometimes spoken there,

00:12:53.960 --> 00:12:55.301
sometimes just been there to listen,

00:12:55.861 --> 00:12:57.984
but always learning an enormous amount.

00:12:58.043 --> 00:12:59.745
And so I think that's just an example

00:12:59.784 --> 00:13:03.248
of the power of families to guide both

00:13:03.567 --> 00:13:05.690
medical care itself and how U.S.

00:13:05.730 --> 00:13:08.392
News interprets that medical care for the

00:13:08.412 --> 00:13:10.374
benefit of all families.

00:13:10.433 --> 00:13:11.595
Yeah, absolutely.

00:13:11.940 --> 00:13:13.681
From that family perspective,

00:13:14.301 --> 00:13:16.221
what is really your goal at U.S.

00:13:16.282 --> 00:13:18.484
News for how families should use and look

00:13:18.504 --> 00:13:19.423
at these rankings?

00:13:19.624 --> 00:13:20.304
For example,

00:13:20.725 --> 00:13:22.346
if they notice that the hospital that

00:13:22.365 --> 00:13:24.147
they've been attending doesn't fall within

00:13:24.167 --> 00:13:26.288
that top ten honor roll or perhaps within

00:13:26.307 --> 00:13:27.748
that specific population,

00:13:28.369 --> 00:13:30.049
what are some things that they can start

00:13:30.230 --> 00:13:32.390
asking to that hospital that they're going

00:13:32.451 --> 00:13:34.432
to or maybe they should be thinking about

00:13:34.471 --> 00:13:36.633
when they're looking at these rankings?

00:13:37.193 --> 00:13:38.653
Yeah, that's a fantastic question.

00:13:38.693 --> 00:13:39.455
So, you know, I...

00:13:44.249 --> 00:13:48.450
When a family faces an unknown situation

00:13:48.490 --> 00:13:49.789
with their child's health,

00:13:51.390 --> 00:13:53.890
my experience is that the parents tend to

00:13:53.971 --> 00:13:55.331
seek information everywhere.

00:13:56.111 --> 00:13:58.773
There is no patient or family member I

00:13:58.812 --> 00:14:05.234
know who is more motivated than the mom

00:14:05.274 --> 00:14:07.034
or dad with a sick child.

00:14:09.640 --> 00:14:12.844
consistently amazed at how much they have

00:14:12.903 --> 00:14:15.066
educated themselves about the condition

00:14:15.086 --> 00:14:16.947
affecting their child and how many

00:14:17.006 --> 00:14:18.969
different resources they've sought out to

00:14:19.129 --> 00:14:20.529
make sure that they know everything they

00:14:20.549 --> 00:14:22.331
need to know to take care of their

00:14:22.371 --> 00:14:22.751
child.

00:14:23.712 --> 00:14:27.115
That really has stood out to me because

00:14:27.155 --> 00:14:29.136
we also evaluate hospitals and all kinds

00:14:29.197 --> 00:14:30.738
of adult concerns.

00:14:31.558 --> 00:14:33.000
And those patients are very engaged.

00:14:33.019 --> 00:14:35.062
It's themselves on the line in many cases.

00:14:36.354 --> 00:14:38.357
but none of them can hold a candle

00:14:38.538 --> 00:14:41.745
as a group to how parents approach taking

00:14:41.785 --> 00:14:42.889
care of their children.

00:14:44.918 --> 00:14:48.679
And so I think we know that the

00:14:48.840 --> 00:14:51.601
rankings that we publish are and should be

00:14:51.922 --> 00:14:54.543
only part of the information that they use

00:14:54.864 --> 00:14:57.445
to help guide their child through that

00:14:57.644 --> 00:14:58.686
very challenging journey.

00:14:59.346 --> 00:14:59.826
Obviously,

00:15:00.447 --> 00:15:03.889
they need to consult their child's doctor

00:15:03.948 --> 00:15:05.549
and the care team that they've already

00:15:05.570 --> 00:15:06.070
established.

00:15:06.110 --> 00:15:07.610
Sometimes it's just a primary care doctor

00:15:07.650 --> 00:15:09.471
or a specialist who's made a diagnosis and

00:15:09.491 --> 00:15:10.373
said,

00:15:10.552 --> 00:15:11.854
this is unfortunately something you're

00:15:11.874 --> 00:15:13.934
gonna need to get specialized care for.

00:15:15.278 --> 00:15:16.740
I might be able to help support you,

00:15:16.799 --> 00:15:19.162
but you may need to go to a

00:15:19.201 --> 00:15:19.642
hospital.

00:15:20.123 --> 00:15:21.744
Perhaps it's right here in our town,

00:15:21.803 --> 00:15:23.125
or maybe it's a few towns away,

00:15:23.184 --> 00:15:24.505
or maybe it's across state lines,

00:15:25.105 --> 00:15:26.888
but you need specialized care here.

00:15:27.707 --> 00:15:30.190
And so we want to be complimentary to

00:15:30.230 --> 00:15:31.650
that and provide

00:15:32.892 --> 00:15:34.453
information that families can use,

00:15:34.494 --> 00:15:35.595
but obviously in conjunction with

00:15:35.615 --> 00:15:36.176
everything else.

00:15:36.196 --> 00:15:36.355
I mean,

00:15:36.375 --> 00:15:37.736
they have to think about travel time.

00:15:37.797 --> 00:15:39.658
They have to think about which hospitals

00:15:39.678 --> 00:15:41.200
are covered by their insurance plan.

00:15:41.640 --> 00:15:43.282
They have to think about the time off

00:15:43.302 --> 00:15:45.664
from work to get to and from appointments

00:15:45.804 --> 00:15:48.147
or the time away from school if it's

00:15:48.167 --> 00:15:48.847
going to require

00:15:49.583 --> 00:15:51.346
The whole family, you know,

00:15:51.365 --> 00:15:53.407
relocating which which sometimes it does.

00:15:54.347 --> 00:15:55.849
But to try to help them on that

00:15:55.889 --> 00:15:57.409
journey I mentioned that we we rank

00:15:57.450 --> 00:15:58.811
hospitals in different specialties,

00:15:59.010 --> 00:16:00.932
so that they can identify the the

00:16:00.952 --> 00:16:02.594
specialty ranking that's most relevant to

00:16:02.614 --> 00:16:03.794
their child's diagnosis.

00:16:04.475 --> 00:16:07.116
But we also rank hospitals regionally to

00:16:07.177 --> 00:16:08.957
identify those that are close to home that

00:16:08.977 --> 00:16:10.539
may be convenient that they may have.

00:16:11.501 --> 00:16:13.823
providers within their community who have,

00:16:14.083 --> 00:16:14.323
you know,

00:16:14.683 --> 00:16:16.524
are affiliated with those healthcare

00:16:16.905 --> 00:16:18.826
organizations and can therefore kind of

00:16:18.846 --> 00:16:19.606
coordinate care,

00:16:19.626 --> 00:16:21.849
which is really important for any any kind

00:16:21.869 --> 00:16:23.289
of chronic disease, as you know.

00:16:24.429 --> 00:16:24.691
And so,

00:16:25.331 --> 00:16:28.232
so I would recommend that families start

00:16:28.653 --> 00:16:29.933
on the usnews.com website,

00:16:29.953 --> 00:16:31.495
everything that we publish about hospitals

00:16:31.595 --> 00:16:32.615
is freely available,

00:16:32.676 --> 00:16:33.817
so they don't have to subscribe or

00:16:33.836 --> 00:16:34.157
anything.

00:16:35.638 --> 00:16:37.438
And look up the hospitals in their

00:16:38.105 --> 00:16:39.767
in their region, their state,

00:16:39.846 --> 00:16:41.469
or the state surrounding them.

00:16:43.350 --> 00:16:44.791
And also look at our rankings by

00:16:44.831 --> 00:16:45.412
specialty.

00:16:45.491 --> 00:16:48.293
If their child has an orthopedic concern,

00:16:49.174 --> 00:16:50.556
we have an orthopedics ranking.

00:16:52.136 --> 00:16:55.659
If they have an issue with their kidney,

00:16:55.700 --> 00:16:57.500
we have a nephrology ranking, and so on.

00:16:59.605 --> 00:17:02.506
between those two pieces of what we've

00:17:02.567 --> 00:17:03.006
published,

00:17:03.727 --> 00:17:05.308
they can identify hospitals that they

00:17:05.328 --> 00:17:06.230
think might be suitable,

00:17:06.529 --> 00:17:08.770
and then they can drill down into the

00:17:09.571 --> 00:17:11.252
rich information that we've published on

00:17:11.272 --> 00:17:12.354
those hospitals profiles,

00:17:12.394 --> 00:17:17.298
which is organized by specialty and broken

00:17:17.337 --> 00:17:18.858
up into different categories that they may

00:17:18.878 --> 00:17:19.398
be interested in,

00:17:19.538 --> 00:17:21.059
including things like outcomes that we

00:17:21.079 --> 00:17:22.000
talked about before.

00:17:23.386 --> 00:17:24.648
Thank you for clarifying that.

00:17:24.910 --> 00:17:26.993
And I love that this is just a

00:17:27.034 --> 00:17:28.817
part of the decision-making and there are

00:17:28.856 --> 00:17:30.661
so many different factors that have to go

00:17:30.721 --> 00:17:31.501
in for families.

00:17:32.058 --> 00:17:33.880
when they're choosing the care for their

00:17:33.920 --> 00:17:34.279
child.

00:17:34.299 --> 00:17:36.060
And that's one of the soap boxes I

00:17:36.102 --> 00:17:38.103
always have is that you actually can pick

00:17:38.143 --> 00:17:39.222
your child's care team,

00:17:39.844 --> 00:17:41.625
especially when it comes to specialized

00:17:41.684 --> 00:17:42.005
care.

00:17:42.305 --> 00:17:43.865
And you can try to interview some

00:17:43.905 --> 00:17:44.406
physicians,

00:17:44.446 --> 00:17:45.928
see which ones feel best to you,

00:17:46.008 --> 00:17:47.648
what care team takes the best care of

00:17:47.669 --> 00:17:48.229
your child,

00:17:48.689 --> 00:17:51.050
which ones are listening to your mom or

00:17:51.090 --> 00:17:51.671
dad gut.

00:17:52.131 --> 00:17:53.912
And those are also part of the decisions

00:17:53.952 --> 00:17:56.213
to make when it comes to really finding

00:17:56.253 --> 00:17:57.775
the best care team for your child.

00:17:59.728 --> 00:18:01.189
I want to transition a little bit over

00:18:01.249 --> 00:18:01.769
into, I think,

00:18:01.890 --> 00:18:03.510
what would be that first pillar that you

00:18:03.530 --> 00:18:04.171
described,

00:18:04.270 --> 00:18:06.471
and that's the resources that are

00:18:06.511 --> 00:18:07.873
available to families.

00:18:08.513 --> 00:18:09.594
And, you know,

00:18:09.673 --> 00:18:12.195
it's great to see that Child Life Services

00:18:12.296 --> 00:18:14.798
are part of this overall scorecard with

00:18:15.678 --> 00:18:18.118
chaplains and access to support groups and

00:18:18.179 --> 00:18:20.299
family advisory boards and interpreter

00:18:20.339 --> 00:18:21.060
services.

00:18:21.921 --> 00:18:25.222
And what do you see about the data

00:18:25.323 --> 00:18:26.804
on those types of services?

00:18:27.023 --> 00:18:29.845
And do they move the needle for hospitals

00:18:30.046 --> 00:18:32.586
in their hospital rankings?

00:18:32.606 --> 00:18:33.907
Do they get closer to the top of

00:18:33.928 --> 00:18:36.328
the list if they have those services?

00:18:37.588 --> 00:18:38.588
Yeah, that's a great question.

00:18:38.648 --> 00:18:39.169
So I mean,

00:18:39.209 --> 00:18:41.089
so each of the measures that we use

00:18:41.150 --> 00:18:42.769
can move the needle for a particular

00:18:42.809 --> 00:18:43.329
hospital.

00:18:43.750 --> 00:18:43.970
Right.

00:18:44.650 --> 00:18:47.151
And so, you know,

00:18:47.411 --> 00:18:50.271
even if hospitals are if most hospitals

00:18:50.352 --> 00:18:53.112
have a service and one doesn't have a

00:18:53.152 --> 00:18:53.491
service,

00:18:53.511 --> 00:18:55.972
that may make it more challenging for them

00:18:56.053 --> 00:18:58.752
to achieve that that ranking in a

00:18:58.873 --> 00:19:01.753
specialty or in multiple specialties.

00:19:02.998 --> 00:19:03.878
And I think that has a couple of

00:19:03.898 --> 00:19:04.219
effects.

00:19:04.338 --> 00:19:05.480
One is, first of all,

00:19:05.640 --> 00:19:08.001
it makes sure that the first hospitals

00:19:08.041 --> 00:19:09.702
that parents may consider if they're

00:19:09.722 --> 00:19:11.984
consulting our rankings are more likely to

00:19:12.025 --> 00:19:15.807
have a broad suite of the services that

00:19:15.827 --> 00:19:17.429
you just mentioned and others.

00:19:18.289 --> 00:19:19.730
The second thing is that for hospital

00:19:19.770 --> 00:19:20.231
leaders,

00:19:21.132 --> 00:19:24.055
seeing that they are missing something

00:19:24.134 --> 00:19:26.316
that other hospitals have and that is

00:19:26.336 --> 00:19:28.357
associated with a higher ranking because

00:19:28.377 --> 00:19:29.278
it's associated with

00:19:29.798 --> 00:19:32.119
better care for children can be a very

00:19:32.180 --> 00:19:33.681
motivating insight.

00:19:34.261 --> 00:19:36.123
And so we have a lot of health

00:19:36.163 --> 00:19:37.983
care executives who pour over our data.

00:19:38.023 --> 00:19:39.964
We actually do have a portal where they

00:19:39.984 --> 00:19:42.286
can can view that information in great

00:19:42.326 --> 00:19:44.646
detail and they can compare themselves to

00:19:45.688 --> 00:19:48.269
peer groups that they create of of

00:19:48.388 --> 00:19:50.329
hospitals that that they see themselves as

00:19:50.369 --> 00:19:54.292
sort of sort of peers of or aspirationally

00:19:55.032 --> 00:19:56.173
want to be similar to.

00:19:57.153 --> 00:20:00.215
And we have absolutely heard from from

00:20:00.276 --> 00:20:01.517
leaders saying, you know,

00:20:01.576 --> 00:20:03.377
we don't have this service and we've

00:20:03.438 --> 00:20:06.578
identified that as a gap because most of

00:20:06.659 --> 00:20:09.441
our peer hospitals do have that service.

00:20:09.500 --> 00:20:10.942
And so we're going to we're going to

00:20:11.162 --> 00:20:13.163
devote resources to getting that.

00:20:13.323 --> 00:20:14.683
It's interesting because that also has

00:20:15.498 --> 00:20:18.480
a certain effect in terms of the

00:20:18.539 --> 00:20:20.059
clinicians themselves.

00:20:20.661 --> 00:20:21.020
Obviously,

00:20:21.060 --> 00:20:24.022
they are thinking about which services are

00:20:24.042 --> 00:20:24.423
important.

00:20:24.462 --> 00:20:25.784
And that's part of what our work group

00:20:25.824 --> 00:20:29.566
does is advise us on what are the

00:20:29.965 --> 00:20:32.386
areas of expertise that a care team needs

00:20:32.426 --> 00:20:34.188
to have to ensure, say,

00:20:34.968 --> 00:20:36.990
that a child born with congenital heart

00:20:37.009 --> 00:20:39.471
disease has a good outcome.

00:20:39.550 --> 00:20:42.932
And I'm just naming that as one example.

00:20:44.153 --> 00:20:45.732
we get recommendations from that work

00:20:45.772 --> 00:20:46.713
group and we, you know,

00:20:46.733 --> 00:20:49.814
with their input decide which, you know,

00:20:49.834 --> 00:20:50.894
which job functions,

00:20:50.933 --> 00:20:52.674
which areas of expertise need to be,

00:20:54.214 --> 00:20:55.654
are included in our survey and our data

00:20:55.674 --> 00:20:56.434
collection effort,

00:20:56.634 --> 00:20:58.476
and therefore something that hospitals

00:20:58.855 --> 00:21:00.096
really do focus on.

00:21:00.955 --> 00:21:01.435
And as a result,

00:21:01.476 --> 00:21:03.557
it actually gives some power back to

00:21:03.596 --> 00:21:05.997
frontline clinicians and care providers,

00:21:06.396 --> 00:21:08.978
because if they feel something is

00:21:09.018 --> 00:21:10.837
important and they put it on our survey,

00:21:11.480 --> 00:21:13.981
And maybe it's not a revenue driver for

00:21:14.021 --> 00:21:14.563
hospitals.

00:21:14.603 --> 00:21:17.546
And so many hospitals haven't invested in

00:21:18.066 --> 00:21:18.767
having that,

00:21:20.788 --> 00:21:22.309
having enough chaplains or having enough

00:21:22.329 --> 00:21:23.411
child life specialists.

00:21:24.471 --> 00:21:28.434
It can give the executive suite some pause

00:21:28.615 --> 00:21:31.438
if they're not at the same level on

00:21:31.498 --> 00:21:33.420
some of these metrics as their peer group.

00:21:33.940 --> 00:21:35.781
And so sometimes we've had

00:21:36.640 --> 00:21:38.060
You know, our expert working groups say,

00:21:38.080 --> 00:21:39.422
you know, you should add this measure,

00:21:39.563 --> 00:21:40.983
even though most hospitals have it,

00:21:41.344 --> 00:21:42.384
there are some laggards,

00:21:42.724 --> 00:21:43.705
and they need to know that they're

00:21:43.746 --> 00:21:45.086
laggards and that's an important thing

00:21:45.106 --> 00:21:46.468
like they need to close that gap.

00:21:46.807 --> 00:21:49.210
And so by making this a measure that

00:21:49.269 --> 00:21:49.789
matters,

00:21:50.871 --> 00:21:53.833
you'll raise the level of care at

00:21:53.893 --> 00:21:56.494
hospitals that can do this but haven't

00:21:56.536 --> 00:21:57.155
made that decision.

00:21:58.205 --> 00:21:59.186
Yeah,

00:21:59.207 --> 00:22:00.448
thank you so much for bringing that

00:22:00.468 --> 00:22:02.490
because as a child life specialist,

00:22:02.730 --> 00:22:04.731
I'm so glad that we're a part of

00:22:04.771 --> 00:22:07.134
this scorecard and to see our profession

00:22:07.153 --> 00:22:08.935
there listed as part of the support

00:22:08.976 --> 00:22:10.317
services that are necessary.

00:22:10.356 --> 00:22:12.118
But from my experience,

00:22:12.318 --> 00:22:14.019
child life specialists can often be

00:22:14.240 --> 00:22:15.260
overlooked services.

00:22:16.383 --> 00:22:18.566
Regardless of the data that shows that we

00:22:18.605 --> 00:22:20.448
reduce sedation and save costs,

00:22:20.508 --> 00:22:21.910
improve patient outcomes,

00:22:21.990 --> 00:22:23.833
enhance family experience and improve

00:22:23.853 --> 00:22:24.814
staff workflow.

00:22:25.434 --> 00:22:26.776
Why do you think it has been a

00:22:26.816 --> 00:22:28.979
bit of an uphill battle to embrace the

00:22:29.019 --> 00:22:31.281
importance of these specialties and

00:22:31.301 --> 00:22:31.883
services?

00:22:31.923 --> 00:22:33.144
And why aren't they more well-known?

00:22:35.136 --> 00:22:37.357
You know, that is a great question,

00:22:37.397 --> 00:22:40.059
and I have some informed guesses about it.

00:22:40.819 --> 00:22:44.182
They're not necessarily linked to the data

00:22:44.202 --> 00:22:46.144
that we're using in our rankings,

00:22:46.243 --> 00:22:48.644
but I've absorbed a fair amount over the

00:22:48.664 --> 00:22:50.605
years talking to families and talking to

00:22:50.665 --> 00:22:53.208
clinicians and hospital leaders, you know,

00:22:53.931 --> 00:22:56.211
Even though most healthcare is not for

00:22:56.271 --> 00:22:56.672
profit,

00:22:58.112 --> 00:23:00.032
making sure that the lights stay on is

00:23:00.153 --> 00:23:02.294
critically important to all organizations.

00:23:03.614 --> 00:23:04.355
And I think when,

00:23:04.634 --> 00:23:05.755
especially when times are tight,

00:23:05.775 --> 00:23:07.015
and I think times are getting tight for

00:23:07.035 --> 00:23:07.796
a lot of hospitals,

00:23:07.836 --> 00:23:09.215
particularly children's hospitals,

00:23:09.375 --> 00:23:12.336
as some Medicaid policy changes and other

00:23:12.376 --> 00:23:13.057
things take effect,

00:23:14.998 --> 00:23:17.939
there tends to be a focus on revenue

00:23:17.979 --> 00:23:20.559
generating functions and, you know,

00:23:21.655 --> 00:23:23.016
doctors who can bill,

00:23:23.056 --> 00:23:25.436
who perform services that are billable,

00:23:26.336 --> 00:23:27.157
generate revenue.

00:23:27.678 --> 00:23:29.458
And in some sense,

00:23:29.939 --> 00:23:31.898
everyone else is a cost center.

00:23:32.318 --> 00:23:33.839
That includes the hospital executives

00:23:33.859 --> 00:23:36.039
themselves, who, if they have a clinic,

00:23:36.079 --> 00:23:37.040
it might be once a month,

00:23:38.516 --> 00:23:40.817
but it also includes the support functions

00:23:40.837 --> 00:23:42.199
that though they may reduce cost,

00:23:42.239 --> 00:23:44.160
it may be very hard for a hospital

00:23:44.559 --> 00:23:46.001
to account for that and say, well,

00:23:46.201 --> 00:23:48.563
this child life specialist saved us a

00:23:48.623 --> 00:23:49.203
readmission,

00:23:49.243 --> 00:23:50.644
which would have driven up costs this

00:23:50.744 --> 00:23:51.025
much.

00:23:51.184 --> 00:23:53.287
And therefore, you know, thank you.

00:23:53.467 --> 00:23:56.388
Like that was worth the investment and

00:23:56.409 --> 00:23:56.888
then some.

00:23:57.930 --> 00:24:01.613
And so there can be difficulty kind of,

00:24:01.653 --> 00:24:02.053
you know,

00:24:02.113 --> 00:24:02.913
with an organization

00:24:03.353 --> 00:24:05.614
kind of knowing and remembering that

00:24:05.634 --> 00:24:09.674
there's value here in the individuals and

00:24:09.694 --> 00:24:10.914
in the job functions that aren't

00:24:11.035 --> 00:24:13.336
necessarily explicitly generating revenue.

00:24:13.615 --> 00:24:14.175
And so I think that's,

00:24:14.395 --> 00:24:16.855
especially with the cycles of

00:24:16.895 --> 00:24:18.977
reimbursement being where they are today,

00:24:19.277 --> 00:24:20.717
it is something I'm concerned about,

00:24:21.637 --> 00:24:23.617
that hospitals make sure that they're

00:24:24.038 --> 00:24:26.618
keeping the full team on board,

00:24:28.338 --> 00:24:30.000
even when there may be pressures on them

00:24:30.059 --> 00:24:31.180
to find ways to cut costs.

00:24:32.252 --> 00:24:33.713
Yeah, it's critically important,

00:24:33.733 --> 00:24:36.816
but you raise such a good point about

00:24:37.435 --> 00:24:39.718
revenue generating versus cost centers and

00:24:39.758 --> 00:24:42.159
how that does play a role ultimately in

00:24:42.199 --> 00:24:43.140
the care of families.

00:24:43.920 --> 00:24:46.122
And you've been in this field for a

00:24:46.182 --> 00:24:47.242
long time, as you said,

00:24:47.303 --> 00:24:49.144
and reporting on a lot of different

00:24:49.163 --> 00:24:49.503
things.

00:24:49.564 --> 00:24:50.865
And we've talked, I think,

00:24:50.884 --> 00:24:53.026
a lot about some of the things that

00:24:53.046 --> 00:24:55.587
are going really well and some of the

00:24:55.627 --> 00:24:58.769
things that our hospitals are doing really

00:24:58.809 --> 00:24:58.970
well.

00:25:00.037 --> 00:25:02.157
What do you think is maybe broken and

00:25:02.298 --> 00:25:12.444
some hospitals need to fix?

00:25:12.464 --> 00:25:14.925
Can I answer that by sharing a personal

00:25:14.965 --> 00:25:15.385
story?

00:25:16.027 --> 00:25:17.708
I would be honored to hear your personal

00:25:17.748 --> 00:25:18.048
story.

00:25:18.107 --> 00:25:18.708
Absolutely.

00:25:23.288 --> 00:25:27.109
My cousin, who is now in his fifties,

00:25:27.971 --> 00:25:29.971
was born with a congenital heart defect.

00:25:30.892 --> 00:25:33.193
It's a fairly rare and pretty serious one.

00:25:33.233 --> 00:25:33.874
Even today,

00:25:34.453 --> 00:25:38.876
it's considered a high risk congenital

00:25:39.277 --> 00:25:40.017
malformation.

00:25:40.998 --> 00:25:42.699
Fifty years ago when he was born,

00:25:42.898 --> 00:25:47.441
it was a very challenging thing to treat.

00:25:48.701 --> 00:25:50.343
And there was no

00:25:51.460 --> 00:25:53.643
US News Best Children's Hospitals rankings

00:25:53.722 --> 00:25:55.064
for him to turn to or for his

00:25:55.124 --> 00:25:56.365
parents, I should say, to turn to.

00:25:58.307 --> 00:26:00.150
And they they found, you know,

00:26:00.605 --> 00:26:01.906
through their doctor,

00:26:01.946 --> 00:26:03.106
through their cardiologist,

00:26:03.166 --> 00:26:05.528
a heart surgeon who was ready to take

00:26:05.587 --> 00:26:08.849
the case and was confident in his skills

00:26:08.950 --> 00:26:09.390
to do it.

00:26:11.250 --> 00:26:12.730
And what they couldn't have possibly known

00:26:12.830 --> 00:26:16.653
at the time was that that hospital didn't

00:26:16.673 --> 00:26:19.673
really have the structure, the team,

00:26:19.733 --> 00:26:22.734
the experience to achieve a great outcome

00:26:22.756 --> 00:26:23.276
for their child.

00:26:23.316 --> 00:26:24.695
The surgeon was very skilled.

00:26:24.736 --> 00:26:26.196
And by all accounts, the surgery went

00:26:26.880 --> 00:26:28.141
really well.

00:26:28.401 --> 00:26:30.963
But there was a complication in the ICU

00:26:31.124 --> 00:26:32.664
afterward that left him with a permanent

00:26:32.704 --> 00:26:33.645
brain injury.

00:26:34.946 --> 00:26:39.431
And it's my belief that had they had

00:26:39.451 --> 00:26:41.412
the kind of resource that US News now

00:26:41.472 --> 00:26:42.532
provides to families,

00:26:42.973 --> 00:26:45.056
that they might have identified that that

00:26:45.076 --> 00:26:47.817
hospital didn't have adequate experience

00:26:48.018 --> 00:26:50.619
treating that condition didn't have the

00:26:50.660 --> 00:26:52.382
whole team and the

00:26:54.209 --> 00:26:56.951
depth in their bench to support that child

00:26:57.050 --> 00:26:59.472
after the surgery and make sure that they

00:26:59.512 --> 00:27:00.374
had the right outcome.

00:27:01.535 --> 00:27:02.635
And they might have, in fact,

00:27:02.655 --> 00:27:07.960
chosen a different hospital if they had a

00:27:08.000 --> 00:27:10.122
resource to point them in the right

00:27:10.142 --> 00:27:10.663
direction.

00:27:12.844 --> 00:27:14.806
And I think about that a lot when

00:27:14.846 --> 00:27:17.407
we are gathering the data that we gather,

00:27:17.448 --> 00:27:18.628
when we're analyzing it,

00:27:18.709 --> 00:27:20.790
when we're putting together the rankings

00:27:20.851 --> 00:27:21.731
and making sure that

00:27:22.522 --> 00:27:25.325
families know about the data that's

00:27:25.345 --> 00:27:27.487
available at usnews.com because I really

00:27:27.527 --> 00:27:29.248
wish that my aunt and uncle had had

00:27:29.667 --> 00:27:31.430
access to a resource like that,

00:27:31.650 --> 00:27:33.892
fifty years ago when they were trying so

00:27:33.932 --> 00:27:36.574
hard to get the right care for their

00:27:36.614 --> 00:27:38.855
child and the information just wasn't

00:27:38.954 --> 00:27:39.576
available to them.

00:27:41.797 --> 00:27:42.917
Thank you for sharing that.

00:27:42.938 --> 00:27:44.779
And please thank your family for allowing

00:27:44.799 --> 00:27:46.661
you to share that because it does mean

00:27:46.701 --> 00:27:50.104
so much to have validated resources in the

00:27:50.223 --> 00:27:51.785
age of having access to so much

00:27:51.865 --> 00:27:54.708
information that is disguised as opinions

00:27:54.807 --> 00:27:55.428
and facts.

00:27:55.969 --> 00:27:56.888
It's amazing.

00:27:57.068 --> 00:27:59.211
And I have so much gratitude for people

00:27:59.230 --> 00:28:00.913
like you who make it their life's work

00:28:01.432 --> 00:28:04.776
to give us clear data as one of

00:28:04.816 --> 00:28:06.596
the parts of the decision process that we

00:28:06.656 --> 00:28:08.419
make when it comes to kids and families.

00:28:10.435 --> 00:28:11.877
Before we hopped on this call,

00:28:11.917 --> 00:28:13.740
you shared a personal anecdote about

00:28:13.920 --> 00:28:16.403
having your child have access to a child

00:28:16.423 --> 00:28:17.202
life specialist.

00:28:17.784 --> 00:28:19.205
And I want to thank you for sharing

00:28:19.226 --> 00:28:22.068
that with me because there's not enough of

00:28:22.148 --> 00:28:23.150
us to go around.

00:28:23.329 --> 00:28:23.890
Unfortunately,

00:28:23.990 --> 00:28:26.593
only six thousand here in the United

00:28:26.633 --> 00:28:28.115
States and not all of us are working

00:28:28.154 --> 00:28:28.796
full time.

00:28:29.375 --> 00:28:30.978
Over twenty nine million kids go.

00:28:31.701 --> 00:28:33.642
go to the ER alone that doesn't even

00:28:33.662 --> 00:28:35.303
account for NICU stays and

00:28:36.002 --> 00:28:38.844
hospitalizations and so as part of our

00:28:38.884 --> 00:28:40.944
mission here is to provide support to

00:28:40.984 --> 00:28:43.986
parents and a safe space to share their

00:28:44.006 --> 00:28:46.146
story our other mission is about spreading

00:28:46.166 --> 00:28:48.528
about the importance and the efficacy of

00:28:48.607 --> 00:28:51.950
child life services here so you speaking

00:28:51.990 --> 00:28:53.871
with me today sharing your personal

00:28:53.911 --> 00:28:55.971
stories and giving your amazing insight

00:28:56.011 --> 00:28:56.551
means the world

00:28:57.211 --> 00:28:58.673
And thank you for letting us be a

00:28:58.732 --> 00:29:01.054
part of the conversation to have access to

00:29:01.074 --> 00:29:01.314
this.

00:29:01.394 --> 00:29:03.555
And as I was reviewing the information

00:29:03.595 --> 00:29:04.715
before our interview today,

00:29:05.215 --> 00:29:06.896
I noticed there were some specialties that

00:29:06.936 --> 00:29:08.297
called out Child Life Services

00:29:08.356 --> 00:29:09.917
specifically, you know,

00:29:09.998 --> 00:29:12.038
and some of the scorecards, if you will,

00:29:12.618 --> 00:29:12.818
you know,

00:29:12.858 --> 00:29:14.859
Child Life Services was included in the

00:29:14.980 --> 00:29:16.060
overall support group.

00:29:16.300 --> 00:29:17.821
But then there were some disciplines like

00:29:17.961 --> 00:29:21.442
asthma care or cancer or nephrology that

00:29:21.482 --> 00:29:22.384
called out Child Life.

00:29:22.943 --> 00:29:24.365
And so I hope that we can continue

00:29:24.384 --> 00:29:26.007
to be a part of these powerful

00:29:26.047 --> 00:29:26.886
conversations.

00:29:27.988 --> 00:29:29.490
As we know, it makes such a difference.

00:29:30.269 --> 00:29:31.590
When I'm talking with families on the

00:29:31.631 --> 00:29:32.231
podcast,

00:29:32.711 --> 00:29:34.473
they'll look back and they remember,

00:29:35.835 --> 00:29:37.355
we were talking about parents

00:29:37.415 --> 00:29:39.478
understanding and becoming medical experts

00:29:39.538 --> 00:29:41.859
overnight is truly miraculous that they

00:29:41.880 --> 00:29:43.801
can essentially go to med school in just

00:29:43.821 --> 00:29:45.423
a couple of weeks and become experts on

00:29:45.442 --> 00:29:46.743
their child's diagnosis.

00:29:47.545 --> 00:29:49.987
But a lot of the things they remember

00:29:50.686 --> 00:29:51.307
are how they felt.

00:29:52.660 --> 00:29:54.862
And that they felt taken care of and

00:29:54.882 --> 00:29:57.223
that maybe the child's outcome wasn't what

00:29:57.263 --> 00:29:59.305
everyone wanted and there was a death or

00:29:59.345 --> 00:29:59.865
bereavement,

00:30:00.385 --> 00:30:01.567
but the way the care team made them

00:30:01.586 --> 00:30:03.667
feel has a real impact on how they

00:30:03.708 --> 00:30:04.769
move throughout their life.

00:30:05.369 --> 00:30:05.650
You know,

00:30:06.451 --> 00:30:08.632
your child who had access to a child

00:30:08.652 --> 00:30:10.493
life specialist and now remembers the toy

00:30:10.513 --> 00:30:12.674
that they gave that builds on their

00:30:12.694 --> 00:30:14.557
healthcare experiences from here on out

00:30:14.876 --> 00:30:16.198
and they can develop that trust.

00:30:16.458 --> 00:30:17.499
So, um,

00:30:18.230 --> 00:30:19.612
I thank you for your insight.

00:30:19.632 --> 00:30:20.912
You kept that toy for many years.

00:30:20.932 --> 00:30:22.893
You may still have it, in fact.

00:30:22.913 --> 00:30:23.212
Yeah.

00:30:23.373 --> 00:30:23.512
Yeah.

00:30:23.553 --> 00:30:23.772
I mean,

00:30:23.813 --> 00:30:25.854
my daughter had a burn on her face

00:30:25.973 --> 00:30:28.734
and we had to go to the ER

00:30:28.815 --> 00:30:30.276
and she still sleeps with that blanket

00:30:30.316 --> 00:30:32.156
every night from three years ago.

00:30:32.576 --> 00:30:34.478
So those are the things that aren't

00:30:34.498 --> 00:30:36.318
revenue producing, so to speak,

00:30:36.338 --> 00:30:38.038
that we can count or measure that well,

00:30:38.459 --> 00:30:40.180
but are really important and impactful

00:30:40.200 --> 00:30:42.020
when we think about the human experience.

00:30:42.972 --> 00:30:45.654
The human touch is never more important

00:30:45.674 --> 00:30:46.955
than in pediatric care.

00:30:48.076 --> 00:30:50.758
It's both the child and it's the parent

00:30:50.778 --> 00:30:52.659
who's watching their child go through

00:30:54.099 --> 00:30:55.060
something life-altering.

00:30:55.800 --> 00:30:59.002
And I remember the child life specialist

00:30:59.063 --> 00:31:01.105
and how sweet and tender she was.

00:31:01.684 --> 00:31:03.886
And I also remember how calming and

00:31:04.067 --> 00:31:07.209
soothing and reassuring the

00:31:07.308 --> 00:31:08.549
anesthesiologist was.

00:31:08.589 --> 00:31:09.349
And as a parent,

00:31:10.090 --> 00:31:12.311
I was deeply anxious about

00:31:13.277 --> 00:31:14.478
having my child put under.

00:31:15.878 --> 00:31:19.362
He was too young to even know or

00:31:19.382 --> 00:31:20.282
to anticipate that.

00:31:20.323 --> 00:31:21.023
But for me,

00:31:21.963 --> 00:31:24.866
just seeing the easy manner that that

00:31:25.366 --> 00:31:29.550
physician struck with my child made me

00:31:29.590 --> 00:31:32.173
feel better about the whole experience,

00:31:32.212 --> 00:31:35.035
both during and after.

00:31:35.134 --> 00:31:35.736
That's wonderful.

00:31:36.286 --> 00:31:36.465
Well,

00:31:36.905 --> 00:31:38.365
I want to ask you just one final

00:31:38.405 --> 00:31:39.767
question before we close.

00:31:39.846 --> 00:31:43.627
And I'm thinking about the parents who are

00:31:43.688 --> 00:31:46.367
choosing health care for their child and

00:31:46.468 --> 00:31:47.509
deciding where to go.

00:31:48.388 --> 00:31:49.828
From your perspective,

00:31:49.949 --> 00:31:54.150
what kind of trends or maybe not trends

00:31:54.170 --> 00:31:55.049
is the right word,

00:31:55.089 --> 00:31:57.730
but what should families come to expect

00:31:57.770 --> 00:32:00.211
when it comes to a level of service?

00:32:00.230 --> 00:32:01.332
And I'm not saying they have to feel

00:32:01.352 --> 00:32:02.211
like they're at the Ritz.

00:32:03.491 --> 00:32:05.993
But what should they expect when it comes

00:32:06.054 --> 00:32:09.096
to family support resources and what can

00:32:09.115 --> 00:32:11.938
they ask for?

00:32:12.479 --> 00:32:13.779
That's a great question.

00:32:14.480 --> 00:32:16.201
You may be better positioned with your

00:32:16.260 --> 00:32:20.463
expertise to set their expectations on

00:32:20.523 --> 00:32:22.625
what they can and should ask for.

00:32:25.748 --> 00:32:27.568
My sense is that they should ask for

00:32:27.608 --> 00:32:27.930
whatever

00:32:29.167 --> 00:32:30.669
think they need whatever they think their

00:32:30.689 --> 00:32:32.770
their child needs the worst that can they

00:32:32.790 --> 00:32:35.272
can hear is no um or that's not

00:32:35.292 --> 00:32:37.034
available or it's not available right now

00:32:37.094 --> 00:32:38.494
but we'll see if we can you know

00:32:38.575 --> 00:32:42.919
try to arrange it um i mentioned before

00:32:42.959 --> 00:32:47.001
that you know no one is more motivated

00:32:47.082 --> 00:32:49.442
and becomes a an expert faster than a

00:32:49.483 --> 00:32:52.425
parent with a with a sick child um

00:32:52.445 --> 00:32:53.967
but i also think that

00:32:54.844 --> 00:32:57.405
Those same parents are the best health

00:32:57.425 --> 00:32:58.807
care advocates in the world.

00:33:00.750 --> 00:33:07.395
Adults can be shy and not feel comfortable

00:33:07.556 --> 00:33:09.037
asking for something for themselves.

00:33:09.518 --> 00:33:11.279
But when you see your child in a

00:33:11.339 --> 00:33:13.701
gown on a bed looking nervous,

00:33:15.507 --> 00:33:16.867
You're going to go to bat for them.

00:33:17.307 --> 00:33:19.268
And I would just say,

00:33:19.688 --> 00:33:21.648
I want to give parents permission to do

00:33:21.689 --> 00:33:21.969
that.

00:33:22.709 --> 00:33:25.670
They should not hold back one bit if

00:33:25.750 --> 00:33:27.631
they feel like they need to advocate for

00:33:27.651 --> 00:33:29.172
their child in anything,

00:33:29.372 --> 00:33:33.053
for their emotional needs during the

00:33:33.093 --> 00:33:34.833
psychological trauma of going through

00:33:35.374 --> 00:33:36.153
hospitalization.

00:33:37.364 --> 00:33:39.684
or for their physical wellbeing if they

00:33:39.724 --> 00:33:42.987
have any concerns about some change in the

00:33:43.007 --> 00:33:45.387
vitals or just the kid saying they don't

00:33:45.448 --> 00:33:45.968
feel right.

00:33:46.208 --> 00:33:48.548
Those are cues that parents are inclined

00:33:48.808 --> 00:33:49.368
to listen to.

00:33:50.569 --> 00:33:51.670
I don't need to coach them on that,

00:33:51.769 --> 00:33:53.411
but I want them to lean into that

00:33:53.510 --> 00:33:54.372
because that is,

00:33:54.731 --> 00:33:56.392
it could be life-saving for their child.

00:33:56.952 --> 00:33:59.854
And good care providers want to hear that.

00:33:59.874 --> 00:34:02.115
They want the family engaged.

00:34:03.020 --> 00:34:05.041
And they're appreciative when the family

00:34:05.722 --> 00:34:06.522
catches something,

00:34:06.923 --> 00:34:09.605
sees something that might need attention

00:34:10.344 --> 00:34:13.626
before the nurse or the other member of

00:34:13.666 --> 00:34:14.487
the care team does.

00:34:14.726 --> 00:34:16.487
They are part of the care team and

00:34:17.489 --> 00:34:19.170
they know their child better than anybody.

00:34:20.010 --> 00:34:21.150
And they're the strongest possible

00:34:21.190 --> 00:34:22.172
advocate for their child.

00:34:22.211 --> 00:34:24.693
So I would tell them, don't hold back.

00:34:26.507 --> 00:34:26.987
I love that.

00:34:27.007 --> 00:34:28.530
And there has to be a little bit

00:34:28.570 --> 00:34:30.610
of a generational switch there for us,

00:34:30.650 --> 00:34:31.791
because I know growing up,

00:34:32.012 --> 00:34:33.432
you don't question the medical doctor.

00:34:33.954 --> 00:34:35.114
They're the ones who know everything.

00:34:35.635 --> 00:34:36.715
But when you come at it with the

00:34:36.755 --> 00:34:37.876
lens of not questioning,

00:34:37.916 --> 00:34:40.699
but collaborating and giving your insight

00:34:40.759 --> 00:34:41.780
and your expertise,

00:34:41.820 --> 00:34:44.742
it's easier to transition from bystander

00:34:44.842 --> 00:34:45.603
to advocate.

00:34:46.402 --> 00:34:48.523
And I always think it's so interesting

00:34:48.563 --> 00:34:49.485
about how, as parents,

00:34:49.525 --> 00:34:51.485
we may be able to advocate very easily

00:34:51.525 --> 00:34:53.407
to the coach and our child hasn't got

00:34:53.427 --> 00:34:54.887
to play infield in three innings.

00:34:54.927 --> 00:34:56.449
And why are they still in the outfield?

00:34:57.010 --> 00:34:58.349
But when it comes to the health care

00:34:58.391 --> 00:34:58.710
system,

00:34:58.751 --> 00:35:00.692
we can sometimes initially want to take a

00:35:00.731 --> 00:35:02.472
backseat because you feel like you don't

00:35:02.532 --> 00:35:03.313
know as much.

00:35:03.853 --> 00:35:06.155
But that is the exact reason you should

00:35:06.335 --> 00:35:07.695
ask and should advocate.

00:35:07.775 --> 00:35:09.496
And I just want to appreciate for someone

00:35:09.556 --> 00:35:11.838
with your experience and looking at all

00:35:11.898 --> 00:35:13.019
these different data points,

00:35:13.079 --> 00:35:14.500
validating that for families.

00:35:14.681 --> 00:35:15.240
So thank you.

00:35:16.876 --> 00:35:17.516
Yeah,

00:35:18.036 --> 00:35:19.838
there's no harm in asking a question to

00:35:19.878 --> 00:35:21.820
what's going on or why are you doing

00:35:21.860 --> 00:35:22.019
this?

00:35:22.039 --> 00:35:22.199
I mean,

00:35:24.442 --> 00:35:25.541
no one is going to expect you to

00:35:25.561 --> 00:35:27.903
be an expert in what's happening in the

00:35:27.983 --> 00:35:28.885
ICU or, you know,

00:35:30.925 --> 00:35:32.927
but you have every right to ask and

00:35:32.947 --> 00:35:33.507
to understand.

00:35:33.527 --> 00:35:35.630
Wonderful.

00:35:35.690 --> 00:35:38.192
Well, Ben, the rankings are available now.

00:35:38.472 --> 00:35:39.972
Where should families go to look for this

00:35:40.052 --> 00:35:42.135
information and how,

00:35:42.255 --> 00:35:43.074
if they want to learn more,

00:35:43.114 --> 00:35:43.835
can they do that?

00:35:44.813 --> 00:35:46.572
Yeah, usnews.com, as I said,

00:35:46.652 --> 00:35:48.673
it's freely available to anyone.

00:35:49.693 --> 00:35:51.994
They can find our hospital rankings there,

00:35:52.054 --> 00:35:54.235
usnews.com slash hospitals will guide them

00:35:54.255 --> 00:35:55.094
in the right direction.

00:35:55.554 --> 00:35:58.775
And they can search by where they live,

00:35:59.175 --> 00:36:00.516
by what specialty they need,

00:36:00.916 --> 00:36:03.335
by both those things and more to find

00:36:03.396 --> 00:36:05.036
hospitals that we think,

00:36:05.115 --> 00:36:07.657
based on our analysis of thousands of data

00:36:07.697 --> 00:36:08.036
points,

00:36:08.197 --> 00:36:10.157
are among the strongest in the area that

00:36:10.197 --> 00:36:11.838
they may need help for their child.

00:36:12.858 --> 00:36:13.257
Wonderful.

00:36:13.297 --> 00:36:14.617
Well, thank you for being with us today.

00:36:15.362 --> 00:36:15.824
Thank you.

00:36:16.106 --> 00:36:16.728
Appreciate it.

00:36:17.913 --> 00:36:19.157
I'm going to go ahead