U.S. News & World Report's Best Hospitals 2023

GUIDE TO TOP CARE

Right now, you have cancer.

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Here, world-class research leads to the most advanced treatments available anywhere. It starts with more than 1,000 clinical trials conducted each year, leading to patient tumors and teams that only treat your type of cancer, you can be sure you’re receiving the most innovative treatments, personalized just for you. It’s leading-edge care delivered with compassion that has led us to being named a U.S. News & World Report top 10 cancer center for the 22nd year in a row.

FORMER

On Medicine’s Front Lines

12 In Short Supply

A growing shortage of health care workers is being called America’s top patient safety concern.

18 On the Verge of Collapse

Emergency room overcrowding is a symptom of a much bigger problem nationwide.

20 Photo Essay: Looking Back COVID-19 has pushed the country to the brink. Key moments from the trenches of these difficult times.

28 Virtual Reality for Chronic Pain Patients are finding a new path to relief, and the science is showing encouraging results.

50 The Future of mNRA Vaccines

These shots hold promise for everything from flu to cancer.

52 Telemedicine’s PostPandemic Role

Since 2020, virtual care has exploded in popularity. But is it here to stay?

83 Best Hospitals for Maternity Care

What makes a hospital great for childbirth? Our inaugural ratings identify 237 centers that excel.

92 11 Signs You Should Fire Your Doctor

If you’re noticing these red flags, it could be time to move on.

56

Erasing Race in Medicine

Renewed efforts are underway to eliminate race from some aspects of patient care.

CHAPTER TWO

Patient Power

80 Welcoming Baby Safely

Consider these factors before choosing a maternity hospital.

96 Aging Successfully: Yes You Can!

At least six factors are entirely within your control.

99 Eating the Mediterranean Way

One expert’s view of the pleasures of following a U.S. News top diet.

103 The Merits of Strength Training

Hint: It’s about so much more than building muscle size.

Amazing is going from heart failure to heart transplant in one month.

Peter Killinger went to his local hospital and found out he'd had a heart attack and his heart was in failure. They rushed him to NewYork-Presbyterian, where our team put him on life support and performed a heart transplant within a month. nyp.org/heart

Children’s

Boosting Your Baby’s Bugs

Making Youth Sports More Equitable for All Kids

The U.S. News Rankings

Best Children’s

Best Regional Hospitals

Texas Children’s Hospital is unstoppable!

ranked #2 in the nation.

We’re honored and humbled to be ranked #2 among the best children’s hospitals in the nation by U.S. News & World Report. This recognition starts and ends with having the best team possible offering the best care imaginable.

We’re also proud to announce all ten of our specialties are

Heart

No.

Cancer

GI Surgery

Endocrinology

texaschildrens.org/best

Here’s What’s @usnews.com

find a wealth of advice on staying well and finding care

NUTRITION & LIFESTYLE

Best Diets

A look at some of the most popular and most researched diets, with reviews by a panel of health experts. Discover the top diets for weight loss, diabetes manage ment and heart health, as well as the best plant-based and commercial diets. usnews.com/bestdiets

Eat + Run

Eating healthfully and staying in shape can be tough to manage. We regularly serve up expert advice to support you. usnews.com/eat-run

INSURANCE

Best Medicare Advantage Plans

State-by-state ratings of insurers offer ing Medicare Advantage and Medicare Part D plans, plus tips on choosing one of these plans vs. original Medicare. usnews.com/medicare

POPULATION HEALTH

Healthiest Communities

An interactive platform featuring news, analysis and county-level rankings that examine how social factors shape America’s health and well-being. usnews.com/ healthiestcommunities

BEST HOSPITALS HONOR ROLL

A Visual Tour of the Top 20

See the best of the Best Hospitals –20 centers that lead the pack in a host of specialties, procedures and conditions, ex celling in both breadth and depth of care. usnews.com/hospitalphototour

BEST HOSPITALS

In Specialties, Procedures & Conditions

We’ve evaluated more than 4,500 hospitals on up to 20 common procedures and conditions, including hip replacement, knee replacement, heart bypass surgery, colon cancer surgery, diabetes and stroke, as well as 15 medical specialties from cancer care to orthopedics to cardiology and heart surgery. usnews.com/best-hospitals

SENIOR CARE Best Nursing Homes

We’ve analyzed government data and published ratings of nearly 15,000 facilities nationwide. usnews.com/nursinghomes

PHARMACIST PICKS

Top Recommended Health Products

Which over-the-counter products do pharmacists prefer? Check out Top Recommended Health Products to make your next trip to the drugstore easier. usnews.com/tophealthproducts

PHYSICIAN SEARCH TOOL

Doctor Finder

A searchable directory of more than 900,000 doctors. Patients can find and research doctors who have the training, certification, practical experience and hospital affiliation they want – and can see ratings based on other patients’ experience. With free registration, physicians can update the profile patients see. usnews.com/doctors

My son has cancer

When treating cancer, precision is crucial. That’s why Robert Wood Johnson University Hospital, in partnership with Rutgers Cancer Institute of New Jersey, is proud to o er proton therapy for adults and children. This pinpoint-accurate, non-invasive treatment targets the exact location of the cancer, with fewer e ects on surrounding areas. It’s just one of many innovations you can expect to find at New Jersey’s only NCI-designated Comprehensive Cancer Center. Visit rwjbh.org/beatcancer or call 844-CANCERNJ to learn more.

Let’s beat cancer together.

but he also has advanced technology to fight it: Proton Therapy.

Stanford Hospital is ranked among the top ten hospitals in the nation by U.S . News & World Repor t .

Thank you to the team at Stanford Health Care for your s teadfas t dedication to healing humanit y through science and compas sion, one patient at a time.

When you care as much as we do, people not ice.

Congratulations to the Platinum Recipients of the

2022 Performance Achievement Award

Providence Alaska Medical Center Anchorage, AK

CHI St. Vincent Hospital Hot Springs Hot Springs, AR

Mercy Health System of Northwestern Arkansas Rogers, AR

NEA Baptist Memorial Hospital Jonesboro, AR

CHI St.Vincent Infirmary Little Rock, AR

Adventist Health Bakersfield Bakersfield, CA

Dignity Health St. Joseph’s Medical Center Stockton, CA

El Camino Health Mountain View, CA

Memorial Medical Center Modesto Modesto, CA

Palomar Medical Center Escondido, CA

Pomona Valley Hospital Medical Center Pomon, CA

Salinas Valley Memorial Healthcare System Salinas, CA

Temecula Valley Hospital Temecula, CA

California Pacific Medical Center San Francisco, CA

Littleton Adventist Hospital Littleton, CO Medical Center of Aurora Aurora, CO

Medical Center of the Rockies Loveland, CO

Mercy Regional Medical Center Durango, CO

National Jewish/SCL Saint Joseph Hospital Denver, CO

North Colorado Medical Center Greeley, CO

Parker Adventist Hospital Parker, CO

Parkview Medical Center Pueblo, CO

Poudre Valley Hospital Fort Collins, CO

Saint Mary’s Hospital and Regional Medical Center Grand Junction, CO

SCL Health Good Samaritan Medical Center Lafayette, CO

Hospitals receiving this award have demonstrated the highest standards of care for heart attack patients and are recognized by the Chest Pain – MI Registry for their sustained achievement and commitment to excellence with the Platinum Performance Achievement Award. View all award recipients in the “Heart of Quality Patient Care” insert in this issue of U.S. News & World Report. Look for the hospitals that have the triangle; Platinum, Gold, and Silver.

Scan this QR code to find the full listing of Performance Achievement Award recipients.

Sky Ridge Medical Center

Lone Tree, CO

St. Anthony Hospital Lakewood, CO

Swedish Medical Center Englewood, CO

Lutheran Medical Center Wheat Ridge, CO

McKee Medical Center Loveland, CO

Platte Valley Medical Center Brighton, CO

Christiana Care Health System Newark, DE

The George Washington University Hospital Washington, DC

Bayfront Health Saint Petersburg St. Petersburg, FL

UF Health Jacksonville Jacksonville, FL

Piedmont Fayette Hospital Fayetteville, GA

Piedmont Henry Hospital Stockbridge, GA

Piedmont Newnan Hospital Newnan, GA

St. Joseph’s Hospital Savannah,GA

St. Mary’s Health Care Systems Athens, GA

Carle BroMenn Medical Center Normal, IL

Memorial Hospital Carbondale Carbondale, IL

Northwestern Lake Forest Hospital Lake Forest, IL

Northwestern Medicine Huntley Hospital Huntley, IL

Northwestern Medicine McHenry Hospital McHenry, IL

Riverside Health Care Kankakee, IL

Rush - Copley Hospital Aurora, IL

Loyola University Medical Center Maywood, IL

Memorial Hospital Shiloh Shiloh, IL

OSF HealthCare Saint Francis Medical Center Peoria, IL

OSF Saint Joseph Medical Center Bloomington, IL

Protestant Memorial Medical Center Belleville, IL

Columbus Regional Hospital Columbus, IN

Deaconess Gateway Heart Hospital Newburgh, IN

Deaconess Hospital Evansville, IN

Indiana University Health Arnett Hospital Lafayette, IN

Indiana University Health Bloomington, IN

Indiana University Health Methodist Hospital Indianapolis, IN

Indiana University Health North Hospital Carmel, IN

Indiana University Health Saxony Hospital Fishers, IN

Indiana University Health West Hospital Avon, IN

Goshen Hospital Goshen, IN

Indiana University Health Ball Memorial Hospital Muncie, IN

Allen Memorial Hospital Waterloo, IA

St. Luke’s Hospital Cedar Rapids, IA

Trinity Regional Medical Center Ft. Dodge, IA

UnityPoint Health - St. Luke’s Sioux City Sioux City, IA

Mercy Iowa City Iowa City, IA

MercyOne Siouxland Medical Center Sioux City, IA

Trinity Medical Center - Bettendorf Bettendorf, IA

Advent Health Shawnee Mission Shawnee Mission, KS

Hays Medical Center Hays, KS

Olathe Medical Center Olathe, KS

Stormont Vail Health Topeka, KS

University of Kansas Health System

St. Francis Campus Topeka, KS

Providence Medical Center Kansas City, KS

Baptist Health Corbin Corbin, KY

Baptist Health Lexington Lexington, KY

Baptist Health Louisville Louisville, KY

Pikeville Medical Center Pikeville, KY

Saint Elizabeth Healthcare Edgewood Edgewood, KY

Christus St. Patrick Hospital Lake Charles, LA

St. Tammany Health System Covington, LA

Luminis Health Anne Arundel Medical Center Annapolis, MD

UPMC Western Maryland Cumberland, MD

Spectrum Health

Grand Rapids, MI

MidMichigan Medical Center Midland, MI

CentraCare Heart & Vascular Center Saint Cloud, MN

Essentia Health - St. Mary’s Medical Center Duluth, MN

Anderson Regional Medical Center Meridian, MS

Baptist Memorial Hospital - Desoto Southaven, MS

Baptist Memorial HospitalGolden Triangle Columbus, MS

Baptist Memorial HospitalNorth Mississippi Oxford, MS

Forrest General Hospital Hattiesburg, MS

Magnolia Regional Health Center Corinth, MS

Merit Health Wesley Medical Center

Hattiesburg, MS

Mississippi Baptist Medical Center Jackson, MS

North Mississippi Medical Center

Tupelo, MS

Barnes Jewish HospitalWashington University Saint Louis, MO

Christian Hospital BJC Healthcare St. Louis, MO

Cox Medical Center Branson

Branson, MO

Freeman Health System

Joplin, MO

Heartland Regional Medical Center

St. Joseph, MO

Liberty Hospital

Liberty, MO

Mercy Hospital Joplin Joplin, MO

Mercy Hospital Springfield Springfield, MO

Mercy Hospital St. Louis St. Louis, MO

North Kansas City Hospital North Kansas City, MO

Research Medical Center

Kansas City, MO

Southeast Missouri Hospital

Cape Girardeau, MO

St. Mary’s Medical Center Blue Springs, MO

Centerpoint Medical Center Independence, MO

Saint Francis Medical Center Cape Girardeau, MO

Logan Health Kalispell, MT

St. James Health Care Butte, MT

St. Vincent Healthcare Billings, MT

Billings Clinic Billings, MT

Nebraska Medicine Omaha, NE

Renown Regional Medical Center Reno, NV

Bayshore Community Hospital Holmdel, NJ

Jersey Shore University Medical Center Neptune, NJ

Riverview Medical Center Red Bank, NJ

JFK Medical Center Edison, NJ

Ocean Medical Center Brick, NJ

Presbyterian Healthcare Services Albuquerque, NM

Bronx Care Health System Bronx, NY

Jamaica Hospital Medical Center Jamaica, NY

The Mount Sinai Medical Center New York, NY

UR Medicine Strong Memorial Hospital Rochester, NY

Alamance Regional Medical Center Burlington, NC

Atrium Health Cabarrus Concord, NC

Atrium Health Pineville Charlotte, NC

Atrium Health Carolinas Medical Center Charlotte, NC

CarolinaEast Medical Center New Bern, NC

Duke Raleigh Hospital Raleigh, NC

Duke University Hospital Durham, NC

Frye Regional Medical Center Hickory, NC

Moses H. Cone Memorial Hospital Greensboro, NC

Nash UNC Healthcare Rocky Mount, NC

New Hanover Regional Medical Center Wilmington, NC

Rex Hospital Raleigh, NC

UNC Medical Center

Chapel Hill, NC

WakeMed Cary Hospital Cary, NC

WakeMed Health and Hospitals Raleigh, NC

Wayne UNC Healthcare Goldsboro, NC

Altru Health System

Grand Forks, ND

Essentia Health - Fargo Fargo, ND

Sanford Medical Center Bismarck Bismarck, ND

Sanford Medical Center Fargo Fargo, ND

Aultman Hospital Canton, OH

Firelands Regional Medical Center Sandusky, OH

ProMedica Toledo Hospital Toledo, OH

Southwest General Health Center

Middleburg Heights, OH

The MetroHealth System Cleveland, OH

University Hospitals St. John Medical Center Westlake, OH

Asante Medford, OR

UPMC Hanover Hanover, PA

Butler Memorial Hospital Butler, PA

Doylestown Hospital Doylestown, PA

Penn State Health St. Joseph Reading, PA

Sharon Regional Medical Center Sharon, PA

UPMC Harrisburg Harrisburg, PA

UPMC Memorial York, PA

UPMC West Shore Mechanicsburg, PA

West Penn Hospital Pittsburgh, PA

Spartanburg Regional Healthcare System Spartanburg, SC

AnMed Health Anderson, SC

Bon Secours St. Francis Health System Greenville, SC

Lexington Medical Center West Columbia, SC

McLeod Regional Medical Center Florence, SC

Self Regional Healthcare Greenwood, SC

Avera Heart Hospital of South Dakota Sioux Falls, SD

Avera St. Luke’s Aberdeen, SD

Monument Health Rapid City, SD

Sanford USD Medical Center

Sioux Falls, SD

Tennova -Turkey Creek Medical Center

Knoxville, TN

Baptist Memorial Hospital - Memphis Memphis, TN

Blount Memorial Hospital Maryville, TN

Bristol Regional Medical Center Bristol, TN

Chattanooga - Hamilton County Hospital Authority Chattanooga, TN

Holston Valley Medical Center Kingsport, TN

Jackson Madison County General Hospital Jackson, TN

Methodist Hospital University Memphis, TN

Baylor Scott & White Health Temple, TX

Shannon Medical Center San Angelo, TX

Tarrant County Hosp DistrictJPS Health Network Fort Worth, TX

Texas Health Heart and Vascular Hospital Arlington, TX

Texas Health Presbyterian Hospital Plano Plano, TX

University of Texas Southwestern Medical Center Dallas, TX

Advent Health Central Texas Killeen, TX

Baylor Scott & White - Grapevine Grapevine TX

Baylor Scott & White Heart and Vascular - Dallas Dallas, TX

Baylor Scott & White Medical CenterCollege Station College Station, TX

Baylor Scott & White Medical CenterRound Rock Round Rock, TX

Baylor Scott and White All Saints Medical Center Fort Worth, TX

CHI/Baylor St. Luke’s Medical Center Houston, TX

CHRISTUS Mother Frances Hospital Tyler, TX

Dallas Regional Medical Center Mesquite, TX

Harris Health System Houston, TX

Memorial Hermann Memorial City Hospital Houston, TX

Memorial Hermann Sugar Land Sugar Land, TX

North Central Baptist Hospital San Antonio, TX

Texas Health Harris Methodist Fort Worth Fort Worth, TX

Texas Health Harris Methodist HEB Bedford, TX

Texas Health Harris Methodist Hospital Southwest Fort Worth, TX

The Hospitals of Providence Sierra Campus El Paso, TX

University Health San Antonio, TX

St. Marks Hospital/Northern Utah Healthcare Corp.

Salt Lake City, UT

University of Utah Health Salt Lake City, UT

Inova Alexandria Hospital Alexandria, VA

Inova Loudoun Hospital

Leesburg, VA

Sentara Martha Jefferson Hospital Charlottesville, VA

Augusta Health Fishersville, VA

Carilion Roanoke Memorial Hospital Roanoke, VA

Chesapeake Regional Medical Center Chesapeake, VA

Inova Fairfax Medical Campus IHVI Falls Church, VA

Reston Hospital Center

Reston, VA

Sentara Careplex Hospital Hampton, VA

Sentara Leigh Hospital Norfolk, VA

Sentara Norfolk General Hospital Norfolk, VA

Sentara Northern Virginia Medical Center Woodbridge, VA

Sentara Rockingham Memorial Hospital

Harrisonburg, VA

Sentara Virginia Beach General Hospital Virginia Beach, VA

MultiCare Good Samaritan Hospital Puyallup, WA

MultiCare Auburn Medical Center Auburn, WA

MultiCare Tacoma General Hospital Tacoma, WA

Virginia Mason Medical Center Seattle, WA

St. Mary’s Medical Center Huntington, WV

Wheeling Hospital Wheeling, WV

Marshfield Medical Center - Weston Weston, WI

Aurora BayCare Medical Center Green Bay, WI

Aurora Grafton Grafton, WI

Aurora Medical Center Summit Summit, WI

Aurora St. Luke’s Medical Center Milwaukee, WI

Marshfield Medical Center Marshfield, WI

UW Health Madison, WI

Wyoming Medical Center Casper, WY

Campbell County Health Gillette, WY

Hospital Israelita Albert Einstein Sao Paulo, Brazil

Tabba Heart Institute Karachi/Gulberg, Pakistan

In Short Supply

A growing shortage of health care workers is being called the nation’s top patient safety concern

by Steven Ross Johnson  ©

A

S THE PANDEMIC STRETCHES on with no clear end in sight, one of the biggest unan swered questions is what this experience has meant, and ultimately will mean, for those who’ve been on the front lines throughout –the nation’s health care workforce – and the patients they serve.

An estimated 1.5 million health care jobs were lost in the first two months of COVID-19 as the country raced to curb the novel coronavirus by temporarily closing clinics and restricting nonemergency services at U.S. hospitals. Though many of those jobs have since returned, health care employment remains below pre-pandemic levels, with the number of workers down by 1.1%, or 176,000, compared to February 2020, per the U.S. Bureau of Labor Statistics.

Yet the need for health care workers has never been greater. Staffing shortages are now the nation’s top patient safety concern, forcing Americans to endure longer wait times when seeking care “even in life-threatening emergencies,” or to be turned away en tirely, according to ECRI, a nonprofit patient safety organization.

In a letter sent in March 2022 to the House Energy and Com merce Committee, the American Hospital Association called the workforce shortage hospitals were experiencing a “national emergency,” projecting the overall shortage of nurses to reach 1.1 million by the end of the year. And it’s not just nurses: Profession als from medical lab workers to paramedics are in short supply.

ON MEDICINE’S FRONT LINES

The effects are being felt throughout the entire care continuum. In certain parts of the country, whole hospitals and medical departments have shuttered amid such shortfalls, leaving patients with less ac cess to vital health care, including labor and delivery services and inpatient care for children.

With fewer clinicians working in the field, practitioners are finding them selves responsible for a larger number of patients, fueling soaring burnout levels that experts say raise the risk of medical errors and, consequently, potential harm to Americans. The number of central line-associated bloodstream infections in creased 28% in the second quarter of 2020 compared to the same period in 2019, ac cording to the New England Journal of Medicine, while rates of falls rose by 17% and pressure injuries increased by nearly 42% at skilled nursing facilities during the same period.

The strain hasn’t let up. A February 2022 survey conducted by USA Today and Ipsos of more than 1,100 health care work ers found nearly a quarter of respondents said they were likely to leave the field in the near future due to the pandemic.

Low morale has already translated into departures. Results of a September 2021 poll of 1,000 health care workers revealed that, since February 2020, 18% had quit their jobs.

Patients are feeling the sting in several ways. In January 2022, Saint Alphonsus Health System – a primary care provider for a region with a population of more than 1 million in Idaho and parts of Or egon – decided to temporarily close weekend opera tions at three of its urgent care centers and cut back hours at all 11 of its urgent care clinics for a couple of weeks when several staff members contracted COVID19 and had to isolate. Though the situation has since normalized there, sudden, temporary staff losses have become par for the course during a pandemic that has sickened workers across all corners of the U.S. health care landscape.

Other staff cutbacks have been more permanent. In April 2022, Memorial Hospital of Carbon County, in Rawlins, Wyoming, announced it was ending its labor and delivery services due to staffing challenges. Now, the closest facility for expectant parents is about an hour and a half away at Ivinson Memorial Hospital, in Laramie, Wyoming.

“The cost of traveling nurses has played a significant role” in the decision, said Rod Waeckerlin, chair of the

MHCC Board of Trustees, in a press release. “Labor and Delivery is a unique service line that requires intensive staffing. Unfortunately, as a result of the pandemic, MHCC has lost a number of nursing staff, forcing a re liance on traveling nurses and creating a financial imbal ance operationally.”

The escalating demand for health care professionals has also led to a sharp rise in labor costs, as hospitals vying for workers must dangle larger pay packages. Hospital labor costs rose 37% between 2019 and March 2022, according to a recent report from consulting firm Kaufman Hall.

Evolving challenges

For hospital systems like Northwell Health in New York, the fluctuating labor market has presented both imme diate and longer-term workforce challenges that have evolved as the nature of the pandemic has changed.

By the start of 2021, Northwell’s staffing focus shifted. It went from managing the influx of severely ill COVID19 patients flooding its emergency departments and in patient beds to adding personnel at its outpatient set tings to treat more moderate cases.

With COVID cases ticking up once again at press time, Matthew Kurth, deputy chief people officer for Northwell Health, says the health system has pivoted to ensuring testing centers and processing laboratories are staffed up enough to meet the demand.

But just as workers have adapted, many patients are changing how they access their health care due to the pandemic, which has created both opportunities and pitfalls.

For example, many patients have become accustomed to using digital tools like telehealth to tend to their pri mary care needs, a practice Kurth says will likely con tinue beyond the pandemic. But while fewer people are

being hospitalized for severe COVID-19, more patients are showing up with se vere ailments, creating a backlog of cases at myriad facilities nationwide. Many of these cases stem from delayed care –people having postponed treatment either due to contagion fears or care restrictions enacted at the height of the pandemic.

“I think that first wave definitely had an impact across the entire spectrum,” says Dr. John D’Angelo, chief of integrated op erations for Northwell Health.

A heavy burden

Although hospital staffing issues have evolved with each new COVID wave, one concern has remained constant: the mental and physical burden that has been placed on health care workers.

At Henry Ford Health in Michigan, pandemic-related burnout and stress has led some professionals to leave in pursuit of more lucrative jobs contracting with staff ing agencies while others have opted to exit the field altogether, says Jan HarringtonDavis, the organization’s vice president of talent acquisition and workforce diversity. She estimates the health system has ap proximately 3,000 open positions.

“I don’t think there’s any area that you could name that hasn’t seen a huge amount of turnover,” Harrington-Davis says.

Michelle Gaskill-Hames, chief operat ing officer for Kaiser Permanente’s South ern California and Hawaii markets, says though the situation has improved since the early months of COVID-19 in terms of cases and deaths, there remains a vital need for hospitals to address the anguish workers have experienced since Day One.

“As our surges are becoming smaller, more people are vaccinated and hospitalizations are down, many people are looking to put the pandemic behind them, but in the health care space, it’s not that easy,” Gaskill-Hames says. “There are just layers of anxiety, stress and fear. That doesn’t just go away.”

To help workers recover from pandemic-induced trau ma, the health system launched Rise & Renew, an initia tive that provides employees with counseling support.

At Mount Sinai Health System in New York, staff have been offered 14 one-on-one behavioral health counseling sessions and group workshops at no charge since June 2020, when the organization launched its Center for Stress, Resilience, and Personal Growth.

According to Jane Maksoud, the health system’s chief human resources officer, this program, coupled with ef forts to allow as many as 10,000 team members to work

ON MEDICINE’S FRONT LINES

remotely, is part of a broader retention strategy that hinges on meeting workers where they are to engage them with sup port, and allowing flexibility to whatever extent possible.

However, even as the country enters a less acute phase of the pandemic, some experts are skeptical that enough is being done nationwide to combat the enduring trauma of having worked on the front lines throughout COVID-19.

“My concern is that even though it’s getting talked about a lot, I don’t know if the support is reaching the clinical staff,” says Dr. Rajnish Jaiswal, associate chief of emergency medicine at NYC Health + Hospitals-Metropolitan in Manhattan. “Wellness programs that keep that in mind and allow folks to actually utilize them – I think that’s going to be the next big step.”

Jaiswal says getting back to a state of “normal” for many hospitals will mean facing the same staffing problems that were present before COVID-19.

A coordinated response Creative staffing solutions have also emerged from the pandemic. In the thick of initial COVID-19 surges, some hospitals addressed workforce gaps through rapid redeployment of existing staff to help in areas of high need. Medi cal specialists whose services were put on hold to stem the spread of the virus began pitching in to assist colleagues in caring for COVID-19 patients. Groups of nurses and physicians led by intensive care unit clinicians were established to manage sicker patients.

“In some instances, we had physicians working for nurses because a lot of the burden was on the nursing teams to re ally deliver that consistent bedside care,” Maksoud says.

Similar tactics are being adopted at Saint Alphonsus, for example. To ad dress its nursing shortage and ideally reduce wait times, the medical center is launching a pilot program that creates nursing care teams made up of registered nurses, licensed practical nurses and certified nursing assistants. With fewer nurses available to care for patients in that region, the goal of the program is to have fewer RNs be in charge of a larger pool of patients than they would tradi

tionally without lowering care quality or safety standards.

“It’s kind of a way to spread that care team a little broader,” says David Mc Fadyen, president of Saint Alphonsus Regional Medical Center.

At Virginia Mason Franciscan Health in Washington State, virtual care is proving helpful. Chief Nursing Officer Dianne Aroh says a centralized mission control center and virtual hospital that went into effect in 2019 provides realtime, systemwide surveillance that has helped deploy personnel more rapidly to departments experiencing capacity issues, while easing patient-flow bottle necks and wait times.

“That’s a system I think that we will need to leverage in the future,” she says.

The road ahead

medical units have

Entire hospitals and closed their doors.

Whether due to labor costs, ill ness or burnout, the long-term ramifications of current health care workforce shortages are likely to be felt well after the pandemic ends.

Nationally, staffing shortages threaten to exacerbate what projections for years have char acterized as a looming crisis. By 2025, the U.S. is estimated to have a shortage of around 446,000 home health aides, 95,000 nursing assistants, 98,700 medical and lab technologists and technicians, and more than 29,000 nurse practitioners, according to a 2021 report from Mercer, an industry market analytic firm.

Meanwhile, the need for health care is only going to rise as the elderly pop ulation grows. The 65-and-older set is projected to jump from 54 million in 2019 to more than 80 million by 2040, according to the Department of Health and Human Services. The prevalence of chronic illnesses among younger people and children has also grown over time, with more than 40% of school-age chil dren and adolescents having at least one chronic health condition.

While technology and workforce in novations may provide short-term relief, a diminished workforce signals a future where patients will likely have to become more active participants in their health care to achieve good outcomes. l

The Mount Sinai Hospital is proud to be named to the U.S. News & World Report

Best Hospitals Honor Roll for the seventh consecutive year.

A System on the Verge of Collapse

by Dr. Sharon Anoush Chekijian

OFTEN FEEL like the proverbi al canary in the coal mine, acutely aware of how broken medicine is in this country and wondering if anyone else has noticed.

I’ve been an emergency physi cian for the last 19 years, but increasingly, my job has felt different from what I trained to do. Emer gency physicians are self-described adrenaline junkies. Our world revolves around trauma, stroke, sepsis and heart attacks. Little by little, however, our world has changed.

Even before the pandemic, it felt like the emer gency department was shouldering the lion’s share of primary care: We’d treat hypertension, refill pre scriptions when calls to the doctor’s office went un answered and manage chronically elevated blood sugar. Behavioral health patients with nowhere else to go would arrive one after the other by ambulance. Eager to help our patients, we started offering drug and alcohol treatment programs. Victims of our suc cess, we find that primary care physicians now seem likelier to send patients to the ED than to try treat ing them in their office. And it’s understandable, given the inaccessibility of outpatient radiologic and lab testing for urgent issues.

In dire straits. The U.S. medical system has long been tenuous, with signs of malfunction ev erywhere. Despite exorbitant spending, this country lags behind peer nations in critical health indicators such as life expectancy and chronic disease burden.

When the Affordable Care Act was enacted in 2010, we were hopeful. The system was about to

be overhauled and streamlined, with optimism that all patients eventually would have a primary care home with electronic records that would follow them every where and seamlessly interface with multiple systems. Except that quantum leap never came.

Now COVID-19 has laid bare medicine’s house of cards. We are on the brink of disaster.

In the ED where I work, days typically start with 120 patients – most of them “boarding,” or waiting for a bed upstairs in the hospital. Our ED only has 53 beds to begin with. This means having nowhere to see the new patients who start floating into the waiting room that, if we are lucky, has just been emptied from the day before. By the time the floodgates open at 11 a.m., we are bursting at the seams.

More recently, we’ve stationed physicians, physician as sistants and nurses in the waiting room to see patients. We even see them in the ambulance bay. Sometimes patients stay there for hours, unable to move into the ED. Because there is little hope a room will open anywhere in the ED to afford them the care they need, we start caring for them wherever we can – hallways, triage bays and waiting rooms included.

We take chances when we send patients home, hoping their oxygen level will hold, that someone else can take a look at their skin infection the following day after starting antibiotics, that they understood our instructions on how to manage their high blood sugar.

It may sound like we have a local problem in our ED only. There must be a management issue, a quick fix that an astute

hospital administrator can improvise, and we will be back to normal, caring for patients at the standard to which we are all accustomed. The truth is: This has become a national problem. Our ED is not alone. On social media, colleagues from all over the country are bemoaning the same situation.

Medicine’s house of cards has already started its crashing descent into collapse. We didn’t go into emergency medicine to care for patients this way, and they certainly didn’t come to us expecting the care we are struggling to provide. So what are the solutions?

Sounding the alarm. Institutional leaders, insurers and lawmak ers need to recognize emergency department crowding as a critical patient safety issue. Triggers that activate disaster protocols should be expanded to include indicators of crowding so resources can be directed toward minimizing boarding. Financial incentives must be aligned to encourage swift discharges with appropriate and timely follow-up. If the system is unable to accommodate adequate, timely outpatient testing for urgent complaints that are not life-threatening, then we need to find the pain points and create solutions. Capacity and turnaround times for outpatient labs and radiology must be ex amined and improved.

In addition, both public and private insurers must incentivize every

one of their patients to have a primary care physician. In turn, primary care doctors’ offices must increase capacity and access for urgent cases. Primaries and specialists should consider judiciously whether to urge their patients to seek care in the emergency department for imaging and testing that could be accomplished on an outpatient basis. Patients them selves need to consider responsible use of the ED, though it’s not simple, especially for those without easy access to medical care.

Our fundamental system must change, or the pen alty will be the collapse of not only the system but the doctors, physician assistants and nurses who have been waging this Sisyphean battle as well. Instead of waiting for someone to sound the alarm, I am doing it now. Consider yourselves warned. l

Dr. Sharon Anoush Chekijian is an assistant professor of emergency medicine in the Yale School of Medicine and a Public Voices Fellow with The OpEd Project.

Looking

Back

THE PANDEMIC has pushed the country to the brink. But it has also revealed the enormous dedication, compassion and resilience of America’s health care workforce, as well as the fighting spirit displayed by everyday people in the face of a ceaseless threat. The following pages revisit a few moments from these difficult times.

WALKERSVILLE, MD. MAY 27, 2022 | FORMER NURSE PRACTITIONER MALLORY STANISLAWCZYK, BESET BY LONG COVID, RECEIVES AN IV DRIP AT HOME WHILE CUDDLING HER DAUGHTER. MATT ROTH – THE WASHINGTON POST / GETTY IMAGES

Photo Editing by U.S. News Staff ©

ON

FRONT LINES

WASHINGTON, D.C. JUNE 21, 2022 | COVID-19 VACCINES WERE OK’D FOR KIDS AS YOUNG AS 6 MONTHS IN JUNE 2022. HERE, A NURSE GIVES THE SHOT TO 14-MONTH-0LD ADA HEDGE. BILL O’LEARY – THE WASHINGTON POST / GETTY IMAGES

WEST PALM BEACH, FLA. – MARCH 16, 2020 | MEDICAL WORKERS STAFF DRIVE-THROUGH TEST SITES, ENABLING AMERICANS TO GET SWABBED FOR THE NOVEL CORONAVIRUS. CHANDAN KHANNA – AFP / GETTY IMAGES

LOS ANGELES – APRIL 6, 2020 | SAILORS BRING A PATIENT ABOARD THE HOSPITAL SHIP USNS MERCY, WHICH WAS DEPLOYED TO SUPPORT LOCAL HOSPITALS BY TAKING CARE OF NON-COVID PATIENTS AND FREEING UP BEDS. RYAN BREEDEN – U.S. NAVY / GETTY IMAGES

FULLERTON, CALIF. – JULY 31, 2020 | ST. JUDE MEDICAL CENTER NURSE MICHELE YOUNKIN COMFORTS ROMELIA NAVARRO AT THE BEDSIDE OF HER DYING HUSBAND, ANTONIO NAVARRO. JAE C. HONG – AP

SEATTLE – DECEMBER 15, 2020 | DR. THUAN ONG (CENTER), WHOSE TEAM AT UW MEDICINE WAS THE FIRST TO TREAT COVID PATIENTS AT LONG-TERM CARE FACILITIES IN THE AREA, SPEAKS OF THEM, REMEMBERING PARTICULARLY THOSE WHO HAD DIED, WITH THEN-CHIEF MEDICAL OFFICER DR. TIM DELLIT. ELAINE THOMPSON – AP

MONUMENT VALLEY, ARIZ. – MAY 21, 2020 | A NURSE AT A COVID-19 TESTING CENTER IN THE HARD-HIT NAVAJO NATION CHECKS THE VITALS OF A WOMAN COMPLAINING OF VIRUS SYMPTOMS. MARK RALSTON – AFP / GETTY IMAGES

TARZANA, CALIF. –SEPTEMBER 2, 2021 | A CLINICAL TEAM AT PROVIDENCE CEDARS-SINAI TARZANA MEDICAL CENTER FLIPS A 45-YEAR-OLD UNVACCINATED PATIENT ONTO HIS STOMACH IN THE INTENSIVE CARE UNIT WHILE ADMINISTERING TREATMENT. APU GOMES – AFP / GETTY IMAGES

FRONT LINES

A

New World

Virtual reality is being explored for chronic pain

by Paul Wynn  ©

WEARING VIRTUAL reality goggles is not just trendy among video gamers, but also has found popularity with researchers interested in exploring how the technology can help peo ple living with chronic pain. When combined with cognitive behavioral therapy, virtual re ality – or VR – has been shown to decrease pain intensity.

VR has been used for decades to help people overcome phobias and anxiety disorders. One of its first applications was developed in the mid-90s to distract burn victims from the agonizing pain of changing their wound dressings. A virtual environment called SnowWorld was developed by cognitive psychologist Hunter Hoffman to ease the pain from severe burns.

More recently, VR research has focused on both acute and chronic pain, and has been tested in people with post-traumatic stress disorder, idiopathic facial pain, cancer pain, complex regional pain syndrome and other conditions like irritable bowel syndrome.

What is virtual reality? VR has come a long way since it was first developed in the 1960s by the U.S. Air Force. Once thought of as a sci-fi gimmick with static and monotonous visuals, today’s VR features high-definition images using dy namic light to give each scene a sense of beginning and end. Many VR technologies use dramatic and immersive sound, and many systems monitor breathing so they can guide users through deep-breathing exercises. Patients wear headsets for 10 to 20 minutes once a day that transport them into 3D worlds; scenes vary from swimming with dolphins and ocean exploration to watching Cirque du Soleil and touring exotic destinations. In some cases, VR is used as a way to exercise and increase fitness.

Mainstream use of VR in entertainment and teaching has led to its increased popularity. Sleeker and low-cost versions have revolutionized VR technology and made them more ac cessible to the public. Oculus Quest 2 from Meta Platforms Inc. (formerly Facebook) is one of the more popular headsets because it’s light, well built, easy to use and more affordable than previous versions.

Several hundred hospitals across the country are assessing the use of VR, including Hospital for Special Surgery in New York and Boston Children’s Hospital. Cedars-Sinai Medical Center has been on the cutting edge of using VR to treat people with chronic pain. The VR program there, led by gastroenter ologist Dr. Brennan Spiegel, professor of medicine and public health, has treated more than 3,000 patients.

Spiegel has spearheaded several VR studies since 2015. One study followed 100 patients suffering from pain due to a variety of causes. The team at Cedars-Sinai found that

Quality Care You Can Trust

How to find heart and stroke care near you, measured by the American Heart Association.

Time-sensitive health crises like heart attack or stroke need the right care at the right time for the chance at a better outcome. The science of the American Heart Association sets the standards for highquality care, and access to that care is something that all patients deserve.

Each year, the American Heart Association recognizes hospitals across the country for consistently following

up-to-date, research-based guidelines to ensure all patients have access to the best practices and lifesaving care. Read more about the recognition categories from the American Heart Association and find an awardwinning hospital near you.

This content is produced by or on behalf of our sponsor; it is not written by and does not necessarily reflect the view of U.S. News & World Report editorial staff. Learn more at mediakit.usnews.com.

Heart disease and stroke are the No. 1 and No. 5 causes of death in the United States, respectively.

Every 40 seconds, someone in America has a stroke or heart attack.

A Big Thanks to Our Sponsors.

These organizations are sponsors of American Heart Association’s health care quality improvement programs.

American Heart Association gives hospitals up-to-date treatment guidelines with its Get With The Guidelines program.

More than 2,600 hospitals participate in AHA’s GWTG initiative, a 20-plus year effort to bring research-based care to heart and stroke patients.

Bed-Nubaia

PHOTO: ADOBE

Hospital-Carlotta Zampini

Key to the Awards

Gold Plus Achievement B B

These hospitals are recognized for two or more consecutive calendar years of 85% or higher adherence on all achievement measures and 75% or higher adherence to an additional set of quality measures in heart failure and/or stroke.

Gold Achievement A A A A

These hospitals are recognized for adherence for two or more consecutive calendar years of 85% or higher adherence on all achievement measures applicable to each program.

Silver Plus Achievement D D

These hospitals are recognized for one calendar year of 85% or higher adherence on all achievement measures and 75% or higher adherence to an additional set of quality measures in heart failure and/or stroke.

Silver Achievement C C C C

These hospitals are recognized for one calendar year of 85% or higher adherence on all achievement measures applicable to each program.

* These hospitals received Get With The Guidelines®-Resuscitation awards from the American Heart Association for two or more patient populations. These hospitals are recognized for 10 or more consecutive calendar years of Gold Plus achievement in Get With The Guidelines®-Stroke and/or Get With The Guidelines®-Heart Failure.

STEMI: Gold Plus Receiving or Silver Plus Receiving B D

These hospitals are recognized for compliance to FMC at or before first hospital arrival to PCI ≤ 120 minutes for transferred STEMI patients for two or more consecutive, calendar years (Gold Plus) or one calendar year (Silver Plus), in addition to current Gold or Silver Mission: Lifeline status.

STEMI: Gold Receiving or Silver Receiving A C

These hospitals are recognized for two or more consecutive, calendar years (Gold) or one calendar year (Silver) of 75% compliance on each performance measure and 50% on arrival to first facility to PCI ≤ 120 minutes for patients transferred for primary PCI.

STEMI: Gold Plus Referring or Silver Plus Referring B D

These hospitals are recognized for compliance to Door In / Door Out in 30 minutes or less for transferred STEMI patients for two or more consecutive, calendar years (Gold Plus) or one calendar year (Silver Plus), in addition to current Gold or Silver Mission: Lifeline status.

STEMI: Gold Referring or Silver Referring A C

These hospitals are recognized for two or more consecutive, calendar years (Gold) or one calendar year (Silver) of 75% or higher compliance on each performance measure.

NSTEMI: Gold or Silver A C

These hospitals are recognized for achieving 65% adherence to Dual Antiplatelet prescription at discharge and 85% or higher compliance on each of the four performance measures for two or more consecutive calendar years (Gold) or one calendar year (Silver).

Target: Heart FailureTM Honor Roll G

These hospitals are recognized for 50% or higher adherence to all relevant Target measures in addition to their current Gold or Silver Get With The Guidelines®-Heart Failure status.

Target: StrokeTM Honor Roll Elite Plus F

These hospitals are recognized for treating 75% or more of their eligible stroke patients in 45 minutes or less∆ AND 50% of their eligible stroke patients in 30 minutes or less,∆ in addition to their current Gold or Silver Get With The Guidelines®-Stroke status.

Target: StrokeTM Honor Roll – Elite E

These hospitals are recognized for treating 85% or more of their eligible stroke patients in 60 minutes or less∆ in addition to their current Gold or Silver Get With The Guidelines®-Stroke status.

Target: StrokeTM Honor Roll G

These hospitals are recognized for treating 75% or more of their eligible stroke patients in 60 minutes or less,∆ in addition to their current Gold or Silver Get With The Guidelines®-Stroke status.

Target: StrokeTM Honor Roll Advanced Therapy J

In addition to participating in Get With The Guidelines®-Stroke measuring, these hospitals are recognized for Door To Device (DTD) times in at least 50% of applicable patients within 90 minutes for direct arriving and within 60 minutes for transfers.

Target: Type 2 DiabetesTM Honor Roll I

A national honor roll program for hospitals participating in Get With The Guidelines® (HF, Stroke) to reinforce evidence-based guidelines with hospitals that qualify for a Silver level or higher achievement award in the related Get With The Guidelines module. These hospitals must be able to demonstrate adherence for 12 consecutive months (calendar year) for the “Overall Diabetes Cardiovascular Initiative Composite Score” measure in the selected module.

Brookwood

Coosa Valley

Medical

Regional Medical

Hospital,

North Alabama Medical

Baptist

Riverview Regional

Shelby Baptist Medical

Health Medical

Hospital,

Health

Regional

Abrazo

Campus,

Abrazo Central Campus,

West

Banner Baywood Medical Center,

Boswell Medical

Banner Del E Webb Medical

Desert Medical

Banner Estrella Medical Center,

Banner Thunderbird Medical Center,

Banner University Medical Center

Banner University Medical Center

St. Mary’s Hospital,

Dignity Health

Health

Mercy Gilbert

Flagstaff Medical Center,

HonorHealth Deer Valley Medical

HonorHealth John

HonorHealth Scottsdale

HonorHealth Scottsdale

HonorHealth Scottsdale

Medical

Medical

Tucson Medical Center,

Medical

ARKANSAS

Health Medical Center

Health Medical

Vincent

Mary’s

CALIFORNIA

Adventist Health - Glendale, Glendale

Adventist Health and Rideout, Marysville..........................................................

Adventist Health Bakersfield, Bakersfield

Adventist Health Hanford, Hanford

Adventist Health Lodi Memorial,

Adventist Health Simi Valley, Simi Valley

Adventist Health White Memorial,

Seton Medical Center,

Alameda Hospital, Alameda

Alta Bates Summit Medical Center

Summit Campus, Oakland

Alvarado Hospital Medical Center, San Diego

Antelope Valley Hospital, Lancaster

Arrowhead

Medical

Heart Hospital,

Hospital,

Hospital Medical Center,

Medical

Cedars-Sinai

Medical Center,

Centinela Hospital Medical Center,

Community Regional Medical Center,

Corona Regional Medical Center,

Dameron Hospital, Stockton

Desert Regional Medical Center,

Desert Valley Hospital, Victorville

Dignity Health Arroyo Grande

Dignity Health Bakersfield Memorial Hospital,

Dignity Health Dominican Hospital,

Dignity Health Marian Regional Medical Center,

Dignity Health Mercy Hospital of Folsom,

Dignity Health Mercy Hospitals of Bakersfield,

Dignity Health Mercy Medical Center Merced,

Dignity Health Mercy Medical Center Redding,

Dignity Health Northridge Hospital Medical Center,

Dignity Health Saint Francis Memorial Hospital,

Dignity Health Sequoia Hospital, Redwood

Dignity Health Sierra Nevada Memorial Hospital,

Dignity Health St. Bernardine Medical Center,

Dignity Health St. John’s Pleasant Valley Hospital,

Dignity Health St. John’s Regional Medical Center,

Dignity Health St. Joseph’s Medical Center,

Dignity Health St. Mary’s Medical Center,

Dignity Health Woodland Memorial Hospital,

Doctors Medical Center, Modesto

Eden Medical Center, Castro

Eisenhower Health, Rancho Mirage

El Camino Health, Mountain

Emanate Health-Queen of

Encino Hospital Medical Center,

Enloe Medical Center,

Fairchild Medical Center,

Fountain Valley Regional Hospital

Garden Grove Hospital Medical Center,

Garfield Medical Center, Monterey

Good Samaritan Hospital, San

Hazel Hawkins Memorial Hospital, Hollister

Hemet Global Medical Center, Hemet

Henry Mayo Newhall Hospital,

Hoag Hospital Irvine, Irvine

Hoag Memorial Hospital

Huntington Beach Hospital,

Huntington Hospital, Pasadena

JFK Memorial Hospital, Indio

John Muir Medical Center

John Muir Medical Center

Kaiser Foundation Hospital - Antioch,

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital - South Sacramento, Sacramento

Kaiser Foundation Hospital - South San Francisco

San Francisco

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Kaiser Foundation Hospital

Vacaville, Vacaville

Vallejo, Vallejo

Walnut Creek, Walnut

Kaiser Permanente Baldwin Park Medical Center, Baldwin Park

Kaiser Permanente Downey Medical Center, Downey

Kaiser Permanente Fontana Medical Center, Fontana

Kaiser Permanente Los Angeles Medical Center, Los Angeles

Kaiser Permanente Moreno Valley Medical Center, Moreno Valley

Kaiser Permanente Ontario Medical Center, Ontario

Kaiser Permanente Orange County, Anaheim

Kaiser Permanente Panorama City Medical Center, Panorama City

Kaiser Permanente Riverside Medical Center, Riverside

Kaiser Permanente San Diego Medical Center, San Diego

Kaiser Permanente South Bay, Harbor City

Kaiser Permanente West Los Angeles, Los Angeles

Kaiser Permanente Woodland Hills, Woodland Hills

Kaiser Permanente Zion Medical Center, San Diego

Kaweah Delta Health Care District, Visalia

Keck Hospital of USC, Los Angeles

Kern County Hospital Authority, Bakersfield

La Palma Intercommunity Hospital, La Palma

Lakewood Regional Medical Center, Lakewood...............................................

Loma Linda University Children’s Hospital, Loma

Loma Linda University Medical Center, Loma

Long Beach Medical Center, Long Beach

Los Alamitos Medical Center, Los Alamitos

Los Robles Regional Medical Center, Thousand Oaks

MarinHealth Medical Center,

Marshall Medical Center, Placerville

Memorial Hospital Los Banos, Los Banos

Memorial Medical Center, Modesto, Modesto

Mercy General Hospital, Sacramento

Mercy San Juan Medical Center, Carmichael

Methodist Hospital of Sacramento,

Methodist Hospital of Southern California, Arcadia

Mills-Peninsula Medical Center, Burlingame.................................................

Mission Hospital Regional Medical Center, Mission Viejo........................

Montclair Hospital Medical Center, Montclair

NorthBay Healthcare Group, Fairfield

Novato Community Hospital, Novato

O’Connor Hospital, San Jose

Orange County Global Medical Center, Santa Ana.....................................

Oroville Hospital, Oroville

Paradise Valley Hospital, National City

PIH Health Downey Hospital, Downey

PIH Health Good Samaritan Hospital, Los Angeles

Pomona Valley Hospital Medical Center, Pomona

Providence Cedars Sinai Tarzana Medical Center, Tarzana

Providence Holy Cross Medical Center, Mission Hills

G

F I

E I

F I

Regional Medical Center

Riverside Community Hospital,

Riverside University Health System

Medical

Agnes Medical Center,

Salinas Valley Memorial Healthcare

San Antonio Regional Hospital,

Dimas

Hospital,

San Joaquin General Hospital,

San Ramon Regional Medical

Santa Barbara Cottage Hospital,

Santa Clara Valley Medical Center,

Santa Monica - UCLA Medical Center

Scripps Green Hospital,

Scripps Memorial Hospital

Scripps Memorial Hospital

Scripps Mercy Hospital

Scripps Mercy Hospital

Sharp Chula Vista Medical Center,

Sharp Grossmont Hospital,

Sharp Memorial Hospital,

Shasta Regional Medical Center,

Sherman Oaks Hospital,

Sierra View Medical Center,

Sierra Vista Regional Medical Center,

Sonoma Valley Hospital,

Southwest Healthcare System - Inland

Rancho Springs Medical Center,

St. Elizabeth’s Community Hospital,

St. Francis Medical Center, Lynwood

St. Joseph Hospital, Orange

St. Jude Medical Center,

St. Louise Regional Hospital,

St. Rose Hospital - Hayward,

Stanford Childrens Health, Menlo

Stanford Health Care - ValleyCare,

Stanford Health Care, Stanford

Sutter Amador Hospital,

Sutter Auburn Faith Hospital,

Sutter Davis Hospital,

Sutter Delta Medical Center,

Sutter Medical Center,

Sutter Roseville Medical Center,

Sutter Santa Rosa Regional Hospital,

Sutter Solano Medical Center,

Sutter Tracy Community Hospital,

Temecula Valley Hospital,

Torrance Memorial Medical Center,

Tri-City Medical Center,

Twin Cities Community Hospital,

UC San Diego Health

UC San Diego Health

UCI Health,

University of California

University of California,

Presbyterian Hospital,

County Medical Center/Santa

COLORADO

Boulder Community Health Foothills Hospital, Boulder

Centura Health - Avista Adventist Hospital, Louisville

Centura Health - Castle Rock Adventist Hospital, Castle Rock

Centura Health - Littleton Adventist Hospital, Littleton

Centura Health - Longmont United Hospital, Longmont

Centura Health - Parker Adventist Hospital, Parker

Centura Health - Penrose Hospital, Colorado Springs

Centura Health - Porter Adventist Hospital, Denver

Centura Health - St. Anthony Hospital, Lakewood

Centura Health - St. Anthony North Hospital, Westminster

Centura Health - St. Francis Medical Center, Colorado Springs

Good Samaritan Medical Center, Lafayette

B I

B E I

North Colorado Medical Center, Greeley........................................................... B G I

North Suburban Medical Center, Thornton

Parkview Medical Center, Pueblo

Platte Valley Medical Center, Brighton

B E I

B B G E II

B F I

Presbyterian/St. Luke’s Medical Center, Denver........................................ B D G I

Rose Medical Center, Denver

Saint Joseph Hospital, Denver

SCL Health - Lutheran Medical Center,

Ridge

SCL Health - St. Mary’s Medical Center, Grand

Sky Ridge Medical Center,

Swedish Medical Center, Englewood

The Medical Center of Aurora, Aurora

UCHealth - Longs Peak Hospital, Longmont

UCHealth Highlands Ranch Hospital, Highlands Ranch..................................

UCHealth Medical Center of the Rockies, Loveland

UCHealth Memorial Hospital North, Colorado

UCHealth Memorial Hospital,

UCHealth Poudre

Hospital,

CONNECTICUT

Bridgeport Hospital, Bridgeport

Charlotte Hungerford Hospital, Torrington

Connecticut Children’s Medical Center, Hartford

Danbury Hospital,

Greenwich Hospital,

Griffin Hospital,

Hartford Hospital,

Lawrence

of Nuvance Health, Danbury

Memorial Hospital,

Midstate Medical Center, Meriden

New Milford Hospital,

Norwalk Hospital

London

of Nuvance Health,

of Nuvance Health,

Saint Francis Hospital and Medical Center,

Sharon Hospital,

St. Vincent’s

Francisco

B E I

Milford....................................

DISTRICT OF COLUMBIA

AdventHealth

AdventHealth Apopka,

AdventHealth

AdventHealth

AdventHealth

AdventHealth DeLand,

AdventHealth East Orlando,

AdventHealth Fish Memorial,

AdventHealth Kissimmee,

AdventHealth New Smyrna

AdventHealth North Pinellas, Tarpon

AdventHealth Ocala, Ocala

AdventHealth Orlando,

AdventHealth Palm Coast,

AdventHealth Waterman, Tavares

AdventHealth Wesley Chapel, Wesley

AdventHealth Winter Park, Winter

AdventHealth Zephyrhills, Zephyrhills

Baptist Hospital of Miami, Miami

Baptist Medical Center - Beaches

Baptist Medical Center - Jacksonville

Baptist Medical Center - South

Baptist Medical Center of Nassau,

Bay Medical Center-Sacred Heart Health

Bayfront Health St. Petersburg, St.

Bethesda Memorial Hospital, Boynton

Boca Raton Regional Hospital,

Broward Health Imperial Point,

Broward Health Medical Center,

Broward Health North, Pompano

Cape Canaveral Hospital, Cocoa

Cape Coral Hospital, Cape

Cleveland Clinic Florida,

Cleveland Clinic Indian River Hospital,

Cleveland Clinic Martin Health,

Cleveland Clinic Tradition Hospital,

Delray Medical Center,

Flagler Hospital,

Gulf Breeze Hospital,

Gulf Coast Medical Center,

Halifax Health Medical Center

HCA Florida Aventura Hospital,

HCA Florida Bayonet Point Hospital,

HCA Florida Blake Hospital,

HCA Florida Brandon Hospital,

HCA Florida Citrus Hospital,

HCA Florida Fawcett Hospital,

Charlotte

HCA Florida Fort Walton-Destin Hospital, Fort Walton Beach.....................

HCA Florida Gulf Coast Hospital, Panama

HCA Florida JFK Hospital,

HCA Florida Kendall Hospital, Miami

HCA Florida Lake Monroe Hospital, Sanford

HCA Florida Largo Hospital,

HCA Florida Memorial Hospital,

HCA Florida North Florida Hospital,

I

E I

B I

B F I

HCA Florida Northside Hospital, St. Petersburg...............................................B G I

HCA Florida Oak Hill Hospital, Brooksville.........................................................D F I

HCA Florida Ocala Hospital,

HCA Florida Orange Park Hospital, Orange Park

HCA Florida Osceola Hospital, Kissimmee

HCA Florida Sarasota Doctors Hospital, Sarasota

HCA Florida South Tampa Hospital, Tampa

HCA Florida St. Lucie Hospital,

Saint

HCA Florida West Hospital, Pensacola

HCA Florida West Marion Hospital,

F J I

A A F II

B F I

B E

D I

E I

E

part of HCA Florida Ocala Hospital,

HCA Florida Westside Hospital, Plantation.......................................................

Health Park Medical Center, Fort Myers

E I

F I

E I

I Holy Cross Hospital,

Holmes Regional Medical Center,

B G F J II Homestead Hospital,

F I

E I Jackson Memorial Hospital, Miami

Jackson South Medical Center, Miami

James A. Haley Veterans’ Hospital, Tampa

Jupiter Medical Center, Jupiter

Lakeland Regional Health Medical Center, Lakeland

Lakewood Ranch Medical Center, Bradenton..................................................

Lee Memorial Hospital, Fort Myers

Lower Keys Medical Center, Key West

Manatee Memorial Hospital, Bradenton

Mayo Clinic Florida, Jacksonville

Memorial Hospital Miramar, Miramar

Memorial Hospital Pembroke, Pembroke

Memorial Hospital West, Pembroke Pines

Memorial Regional Hospital, Hollywood

Morton Plant Hospital, Clearwater

Mount Sinai Medical Center, Miami Beach

NCH Healthcare System,

Nicklaus Children’s Hospital, Miami.............................................................................

Health

Orlando Health

Orlando Health

Dr. P. Phillips Hospital,

Orlando Regional Medical Center,

South Lake Hospital, Clermont

Orlando Health Arnold Palmer Hospital for Children, Orlando

Orlando Health Inc.

Health Central Hospital,

Orlando Health South Seminole Hospital, Longwood..........................................

Palm Bay Hospital,

Palm

Sacred

St. Joseph’s

Mary’s

Vincent’s

Vincent’s

Vincent’s

General

West Boca Medical Center,

West Kendall Baptist

Winter Haven

GEORGIA

AdventHealth Gordon,

AdventHealth Murray,

Atrium Health

Medical Center,

Candler Hospital,

Colquitt Regional Medical Center,

Doctors Hospital Augusta,

East Georgia Regional Medical Center,

Effingham Health System,

Emory Decatur Hospital,

Emory Hillandale,

Emory Johns Creek Hospital,

Emory Saint Joseph’s Hospital,

Emory University Hospital

Emory University Hospital,

Fairview Park Hospital, Dublin

Grady Health System,

Habersham Medical Center,

Hamilton Medical Center,

Houston Healthcare,

Memorial University Medical Center,

Northeast Georgia Medical Center,

Northeast Georgia Medical Center,

Northeast Georgia medical Center,

Northside Hospital Atlanta,

Northside Hospital Cherokee,

Northside Hospital

Northside Hospital

Northside Hospital

Perry Hospital,

Phoebe Putney Memorial Hospital,

Piedmont Athens Regional Medical

Piedmont Augusta Hospital,

Piedmont Cartersville Medical Center,

Piedmont Henry Hospital,

Piedmont Hospital,

Piedmont Macon Medical Center,

Piedmont Mountainside Hospital,

Piedmont Newnan Hospital,

Piedmont Newton Hospital,

Piedmont Rockdale Hospital,

Walton Hospital,

Polk Medical Center,

South Georgia Medical Center, Valdosta.....................................................

Southeast Georgia Health System, Brunswick

Southern Regional Medical Center, Riverdale

St. Francis - Emory Healthcare, Columbus

St. Joseph’s Hospital, Savannah

St. Mary’s Good Samaritan Hospital,

St. Mary’s Hospital, Athens

St. Mary’s Sacred Heart Hospital,

Tanner Medical Center/Carrollton, Carrollton

Tift Regional Medical Center,

Wellstar Cobb Hospital,

Wellstar Douglas Hospital, Douglasville

WellStar

Hospital,

GUAM

HAWAII

Adventist

IDAHO

Lutheran General

Sherman Hospital,

South Suburban

Memorial Hospital

Alexian Brothers,

Resurrection,

Saint Alexius,

Saint Francis,

Saint Joseph Chicago,

Hospital,

Carle BroMenn Medical Center,

Carle Foundation Hospital,

Cook County Health,

Decatur Memorial Hospital,

Edward Hospital, Naperville

Memorial Hospital,

Herrin Hospital,

HSHS St. Elizabeth’s Hospital,

HSHS St. John’s Hospital, Springfield

HSHS St. Mary’s Hospital, Decatur

Humboldt Park Health, Chicago

Javon Bea Hospital - Riverside,

Loyola University Medical Center,

MacNeal Hospital, Berwyn

Memorial Hospital of Carbondale,

Mount Sinai Hospital, Chicago

Northwest Community Hospital,

Northwestern Medicine Central DuPage Hospital,

Northwestern Medicine Delnor Hospital,

Northwestern Medicine Huntley, Huntley

Northwestern Medicine Kishwaukee Hospital,

Northwestern Medicine Lake Forest Hospital,

Northwestern Medicine McHenry, McHenry

Northwestern Memorial Hospital, Chicago.............................

OSF HealthCare Little Company of Mary Medical

Evergreen Park

OSF HealthCare Saint Anthony’s Health

OSF Saint Anthony Medical Center, Rockford

OSF Saint Francis Medical Center, Peoria

OSF St. Joseph Medical Center, Bloomington

Palos Community Hospital, Palos

Riverside Medical Center, Kankakee

Rush Copley Medical Center,

Rush Oak Park Hospital, Oak Park

Rush University Medical Center, Chicago

Springfield Memorial Hospital,

SSM Health Good Samaritan,

SSM Health St. Mary’s Hospital,

Medicine,

Health,

Health- Methodist,

Health

Medical Center

St. Vincent Hospital,

Health Floyd,

Regional Hospital,

Heart and Vascular,

Community Hospital, Community Healthcare System,

Community South, Indianapolis...............................................................................

Deaconess Gateway Hospital,

Deaconess Hospital, Evansville

Elkhart General Hospital, Elkhart

Eskenazi Health, Indianapolis

Franciscan Health

Crown Point, Crown Point

Franciscan Health Indianapolis, Indianapolis

Franciscan Health Lafayette East, Lafayette

Franciscan Health Michigan City, Michigan

Franciscan Health Mooresville,

Good Samaritan,

Indiana University Health Arnett, Lafayette

Indiana University Health Ball Memorial Hospital, Muncie

Indiana University Health Bloomington Hospital, Bloomington

Indiana University Health Methodist Hospital, Indianapolis

Indiana University Health North Hospital,

Indiana University Health West Hospital,

Lutheran Hospital, Fort Wayne

Memorial Hospital

Bend

Memorial Hospital and Health Care Center, Jasper

Methodist Hospitals, Inc., Gary

Parkview Health, Fort Wayne

Reid Health, Richmond

St. Catherine Hospital, Inc., East Chicago

St. Mary Medical Center, Hobart

St. Vincent Evansville, Evansville

Vincent Kokomo,

Hospital,

IOWA

Allen Hospital,

CHI Health Mercy Hospital Council Bluffs,

Genesis Health System - Davenport, Davenport

Hancock County Memorial Hospital,

Mercy Iowa City

affiliate of MercyOne, Iowa City........................................

Mercy Medical Center-Cedar Rapids, Cedar Rapids

MercyOne Des Moines Medical

MercyOne Dubuque

Center,

MercyOne North Iowa Medical Center,

MercyOne,

Methodist Jennie Edmundson Hospital, Council

Montgomery County Memorial Hospital, Red Oak

Myrtue Medical Center, Harlan

Southeast Iowa Regional Medical Center, West

The Finley Hospital, Dubuque

Trinity Bettendorf,

UnityPoint Health

UnityPoint Health

UnityPoint Health

University

KANSAS

Luke’s

Luke’s,

AdventHealth Shawnee

Ascension

Centura

KENTUCKY

Baptist Health Corbin,

Baptist Health Deaconess

Baptist Health Hardin,

Baptist Health LaGrange,

Baptist Health Lexington Hospital,

Baptist Health Louisville,

Baptist Health Paducah,

Clark Regional Medical Center,

Frankfort Regional Medical Center,

King’s Daughters Medical Center,

Mercy Health Lourdes Hospital,

Norton Audubon Hospital,

Norton Brownsboro Hospital,

Norton Hospital,

Owensboro Health,

Medical Center,

Saint Joseph Hospital,

St. Elizabeth Edgewood,

St. Elizabeth Florence,

St. Elizabeth Ft. Thomas,

The Medical Center at

TriStar Greenview Regional

Health

LOUISIANA

Hospital,

Jefferson General Hospital

General Medical

Regional Medical

Leonard J. Chabert Medical

Orleans East Hospital,

Baptist,

Health

Jefferson Medical Center,

MAINE

Maine

Maine Medical Center,

Medical

Light Mercy

Bay Medical

MARYLAND

Adventist HealthCare

Adventist HealthCare

Grove Medical Center,

Oak Medical Center, Silver Spring

Ascension Saint Agnes Hospital, Baltimore

CalvertHealth Medical Center,

Carroll Hospital Center, Westminster

ChristianaCare

Frederick

Union Hospital, Elkton

Doctors Community Medical Center, Lanham

Frederick Health Hospital, Frederick

Greater Baltimore Medical Center, Baltimore

Holy Cross Germantown Hospital, Germantown

Holy Cross Hospital, Silver Spring

Howard County General Hospital, Columbia

Johns Hopkins Bayview Medical Center, Baltimore

Luminis Health Anne Arundel Medical Center, Annapolis

MedStar Franklin Square Medical Center, Baltimore

MedStar Good Samaritan Hospital, Baltimore

E

E I

A A G I

A E

A E

A F J I

MedStar Harbor Hospital, Baltimore.......................................................................

MedStar Montgomery Medical Center, Olney

MedStar Southern Maryland Hospital Center, Clinton

MedStar St. Mary’s Hospital,

MedStar Union Memorial Hospital,

Mercy Medical Center, Baltimore

Meritus Medical Center, Hagerstown

Northwest Hospital, Randallstown

Sinai Hospital of Baltimore, Baltimore.................................

Suburban Hospital Johns Hopkins Medicine, Bethesda

The Johns Hopkins Hospital, Baltimore............................................

TidalHealth Peninsula Regional, Salisbury

University of Maryland Baltimore Washington Medical Center, Glen Burnie

University of Maryland Capital Region Medical Center, Largo

University of Maryland Charles Regional Medical Center, La Plata..............

University of Maryland Harford Memorial Hospital, Havre De Grace

University of Maryland Medical Center, Baltimore.......................................

University of Maryland Shore Medical Center at Easton, Easton

University of Maryland St. Joseph Medical Center, Towson

University of Maryland Upper Chesapeake Medical Center, Bel

UPMC Western Maryland, Cumberland

MASSACHUSETTS

Lady

Beth Israel Deaconess Hospital

Beth Israel Deaconess Medical Center,

Hospital,

Boston Children’s Hospital,

Medical Center,

and Women’s

and Women’s Hospital,

Cooley Dickinson Hospital,

Hospital,

Fairview Hospital, Great

Hospital,

Good Samaritan Medical Center,

Holy Family Hospital - Haverhill,

Holy Family Hospital - Methuen,

Holyoke Medical Center,

Lahey Hospital & Medical Center,

General Hospital,

Lowell General Hospital - Main Campus,

Lowell General Hospital - Saints Campus,

Massachusetts General Hospital,

Melrose-Wakefield Hospital,

Mercy Medical Center,

MetroWest Medical Center - Framingham

Milford Regional Medical Center,

Mount Auburn Hospital,

Newton-Wellesley Hospital,

North Shore Medical Center

Saint Vincent Hospital,

Signature Healthcare Brockton Hospital,

Southcoast Health Charlton Memorial Hospital,

Southcoast Health St. Luke’s Hospital,

Southcoast Health Tobey Hospital,

Steward St. Elizabeth’s Medical Center,

Sturdy Memorial Hospital,

Tufts Medical Center,

UMass Memorial - Marlborough Hospital,

UMass Memorial HealthAlliance-Clinton Hospital,

UMASS Memorial HealthAlliance-Clinton Hospital,

UMass Memorial Medical Center -

UMass Memorial Medical Center,

MICHIGAN

Ascension Borgess Hospital,

Macomb

Providence Hospital

Providence Hospital

St. John

Ascension St. Mary’s Hospital,

Beaumont

Henry Ford Allegiance Health, Jackson

Henry Ford Hospital and Health Network, Detroit...........................................

Henry Ford Macomb Hospital, Clinton

Henry Ford West Bloomfield Hospital, West Bloomfield

Henry Ford Wyandotte Hospital, Wyandotte

Hurley Medical Center,

McLaren Bay Region,

Flint,

McLaren Greater Lansing, Lansing

McLaren Lapeer Region,

Macomb, Mount

McLaren Northern Michigan, Petoskey

McLaren Port Huron Hospital, Port Huron

Mercy Health Partners d/b/a Trinity Health Muskegon Hospital, Muskegon

Metro Health - University of Michigan Health, Wyoming

MidMichigan Medical Center-Midland

System, Midland

Munson Medical Center, Traverse City

affiliate of MidMichigan

ProMedica Charles and Virginia Hickman Hospital,

Sparrow Hospital, Lansing

Spectrum Health Blodgett Hospital, Grand Rapids....................................................

Spectrum Health Butterworth, Grand Rapids

Spectrum Health Lakeland: St. Joseph and Niles, Saint Joseph...................

Spectrum Health United Hospital, Greenville

Spectrum Health Zeeland Community Hospital, Zeeland

St. Mary Mercy Hospital, Livonia

Trinity Health Saint Mary’s - Grand Rapids, Grand Rapids

Trinity Health St. Joseph Mercy Oakland, Pontiac

University of Michigan Health System, Ann Arbor

MINNESOTA

Abbott Northwestern Hospital, Minneapolis

CentraCare St. Cloud Hospital, Saint Cloud

Essentia Health East. St. Mary’s Medical Center, Duluth

Hennepin Healthcare System, Inc., Minneapolis

Lakeview Memorial Hospital, Stillwater

M Health Fairview Southdale Hospital, Edina

I

I

E I

F

E

E J I

B A G E J II

M Health Fairview University of Minnesota Medical Center, Minneapolis

Mayo Clinic Hospital, Saint Marys Campus, Rochester

Mercy Hospital, Coon Rapids

Park Nicollet Methodist Hospital, Saint Louis Park

Regions Hospital,

St. Francis Regional Medical

St. Luke’s,

Hospital,

MISSISSIPPI

Baptist Memorial Hospital

Baptist Memorial

General

Leflore

Singing River Hospital,

Dominic Memorial Hospital,

Mississippi

Barnes-Jewish Hospital, Saint

Boone Hospital Center, Columbia

Capital Region Medical Center,

Cass Regional Medical Center,

Centerpoint Medical Center,

Cox Medical Center Branson,

Cox Medical Center South,

Cox Monett Hospital Inc,

Freeman Health System, Joplin

Lake Regional Health System, Osage

Mercy Hospital Jefferson, Crystal

Mercy Hospital Joplin, Joplin

Mercy Hospital Lincoln,

Mercy Hospital South, Saint Louis

Mercy Hospital Springfield, Springfield

Mercy Hospital St. Louis, Saint Louis

Mercy Hospital Washington, Washington

Missouri Baptist Medical Center, Saint

Missouri Baptist Sullivan Hospital,

Mosaic Life Care d/b/a Heartland

New Liberty Hospital District, Liberty

North Kansas City Hospital, North

Parkland Health Center, Farmington

Phelps Health, Rolla

Research Medical Center, Kansas City

Saint Francis Medical Center, Cape

Saint Luke’s East Hospital, Lees Summit

Saint Luke’s Hospital of Kansas City, Kansas

Saint Luke’s North Hospital, Kansas

Health, Cape Girardeau

SSM Health DePaul Hospital,

SSM Health

Louis

SSM Health St. Mary’s Hospital,

SSM Health, St. Clare Hospital,

SSM St. Joseph Hospital Lake St. Louis,

Joseph Medical Center,

Luke’s

Peres Hospital,

Mary’s Health Center,

St. Mary’s Medical Center,

Missouri Health

Health

Health

Health

Health

Health

Regional

Kearney Regional Medical Center,

Medicine

Medicine,

Methodist Hospital,

NEVADA

Centennial Hills Hospital Medical Center, Las Vegas

Desert Springs Hospital Medical Center, Las Vegas

Dignity Health St. Rose Dominican Hospital - San Martin Campus, Las Vegas

Dignity Health St. Rose Dominican Hospital - Siena Campus,

ER at Blue Diamond, Las

Henderson Hospital,

MountainView Hospital, Las

North Vista

Nevada

Saint Mary’s

Hills

Valley Hospital

Summerlin Hospital Medical

Hospital

Hospital

NEW HAMPSHIRE

NEW JERSEY

Hackensack

Hackensack

Hackensack

Hackensack

Hackensack

Hackensack

Hackensack

Hackensack

Pascack

Hackettstown Medical Center,

Medical Center,

Hunterdon Healthcare,

Inspira Medical Center

Inspira Medical Center

Cherry Hill

Stratford Hospital,

Jersey City Medical Center,

Monmouth Medical Center,

Morristown Medical Center,

Newark Beth Israel Medical Center,

Newton Medical Center,

Overlook Medical Center,

Penn Medicine Princeton Medical Center,

Robert Wood Johnson University

Robert Wood Johnson

Saint Clare’s Health,

Saint Peter’s University Hospital,

St. Francis Medical Center, Trenton

St. Joseph’s University Medical Center,

St. Joseph’s Wayne Medical Center,

St. Luke’s Warren Hospital,

St. Mary’s General Hospital,

The Valley Hospital,

Trinitas Regional Medical Center,

Hospital,

Virtua Marlton Hospital,

Virtua Memorial Hospital of Burlington

Virtua Our Lady of Lourdes

Virtua Voorhees Hospital,

Virtua Willingboro Hospital,

NEW MEXICO

Eastern New Mexico Medical Center,

Medical Center,

MountainView Regional Medical

Presbyterian Healthcare Services,

NEW YORK

Albany Med,

Catholic Health - Sisters of

Medical Center,

Children’s

Memorial Hospital,

Hospital,

Medicine,

F.F. Thompson Hospital,

St. Luke’s Healthcare,

System,

Flushing Hospital Medical

Health Medical

Health Medical

Gates Vascular Institute

General Hospital,

Cove Hospital, Glen

Falls Hospital,

of Mohawk Valley

General Medical Center,

Good Samaritan Hospital Medical Center, West

Samaritan Hospital,

HealthAlliance: Broadway Campus

Hospital, Rochester

Hospital, Huntington

of

Health, Suffern

Member of

Hospital Medical Center, Richmond

Kingsbrook Jewish Medical Center, Brooklyn

Lenox Hill Hospital, New York

LIJ Medical Center at Forest Hills, Forest Hills

LIJ Valley Stream, Valley Stream

Island Community Hospital,

Long Island Jewish Medical Center,

Maimonides Medical Center,

Mather Hospital Northwell Health,

Mercy Medical Center, Rockville Centre

WMC Health Network,

MidHudson Regional Hospital of WMC Health, Poughkeepsie

Montefiore Medical Center - Moses Campus, Bronx

Montefiore Mount Vernon Hospital, Mount Vernon

Montefiore New Rochelle Hospital, New Rochelle

Montefiore Nyack Hospital, Nyack

Montefiore St. Luke’s Cornwall, Newburgh

Mount Sinai Beth Israel, New York

Mount Sinai Brooklyn, Brooklyn

Mount Sinai Morningside, New York

Mount Sinai Queens, Astoria

Mount Sinai South Nassau, Oceanside...........................................

Mount Sinai West, New York

Nassau University Medical Center, East Meadow

New York Community Hospital, Brooklyn

Newark-Wayne Community Hospital, Newark

A

B G E

E I

B B G E II

NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn

NewYork-Presbyterian Hudson Valley Hospital, Cortlandt Manor

NewYork-Presbyterian Queens, Flushing

NewYork-Presbyterian/Columbia University Medical Center, New York.......................................................................................................

NewYork-Presbyterian/Lawrence

NewYork-Presbyterian/Lower

North

E I

A E

E J I

NYC Health

NYC Health

NYC Health

NYC Health

NYC Health

Health

NYC Health

Health

NYC Health

Hospitals/Harlem,

Hospitals/Jacobi,

Hospitals/Lincoln,

Hospitals/Metropolitan,

Hospitals/Queens,

Hospitals/Woodhull,

Langone Hospital

NYU Langone Hospital

NYU Langone Hospitals,

Our Lady of Lourdes Memorial Hospital,

Peconic Bay Medical Center

Hospital, Northwell

Plainview Hospital, Plainview

Richmond University Medical Center,

Rochester General Hospital,

Rochester Regional Health

Rome Memorial Hospital,

Saint Joseph’s Medical Center,

Samaritan Hospital,

Saratoga Hospital, Saratoga

SBH Health System,

Soldiers & Sailors Memorial Hospital,

South Shore University Hospital,

Southampton Hospital,

St. Catherine of Siena Medical Center,

St. Charles Hospital, Port Jefferson

St. Francis Hospital, The Heart

St. John’s Episcopal Hospital,

St. John’s Riverside Hospital,

St. Joseph Hospital,

St. Joseph’s Health,

St. Peter’s Hospital,

Staten Island University Hospital

Staten

Staten Island University Hospital,

Stony Brook University Hospital,

Syosset Hospital,

Brooklyn Hospital

Mount

University

Hospital

Vermont

University

NORTH CAROLINA

Atrium Health

Atrium Health

Atrium

Atrium Health

Atrium Health Stanly,

Atrium Health Union,

Atrium Health University City,

Atrium Health Wake Forest Baptist High Point Medical Center,

Atrium Health Wake Forest Baptist Lexington Medical Center, Lexington

Atrium Health Wake Forest Baptist Medical Center, Winston-Salem

Atrium Health’s Carolinas Medical Center, Charlotte

Blue Ridge Regional Hospital, Spruce Pine

Cape Fear Valley Medical Center, Fayetteville

CarolinaEast Medical Center, New Bern

CaroMont Regional Medical Center, Gastonia

Carteret Health Care Medical Center, Morehead City

Central Carolina Hospital, Sanford

Columbus Regional Healthcare,

Cone Health - Alamance Regional, Burlington

Cone Health, Greensboro

Davis Regional Medical Center, Statesville

Duke Raleigh Hospital, Raleigh

Duke Regional Hospital, Durham

Duke University Hospital, Durham........................................

Durham VA HealthCare System, Durham

A

A

E I

B B A A G G II

B I

D

I

A F J I

D I

B E I

D E I

B B A G E II

ECU Health Beaufort Hospital - A Campus of ECU Health Medical Center, Washington

ECU Health Bertie Hospital, Windsor

ECU Health Chowan Hospital, Edenton

ECU Health Medical Center, Greenville

ECU Health Roanoke-Chowan Hospital, Ahoskie

FirstHealth Moore Regional Hospital - Hoke, Raeford

FirstHealth Moore Regional Hospital, Pinehurst

Frye Regional Medical Center, Hickory

Hugh Chatham Memorial Hospital, Elkin

Johnston Health, Smithfield

Mission Hospital McDowell, Marion

Mission Hospitals, Inc., Asheville

DI

I

D I

I

A A C F J I

E I

I

G I

B B A G G II

B E I

E I

E I

F J I

Nash UNC Health Care, Rocky Mount...................................................... B A A E I

Northern Regional Hospital, Mount Airy

Novant Health Brunswick Medical Center, Bolivia

Novant Health Forsyth Medical Center, Winston-Salem........

Novant Health Huntersville Medical Center, Huntersville

Novant Health Kernersville Medical Center, Kernersville

Novant Health Matthews Medical Center, Matthews

Novant Health Mint Hill Medical Center, Charlotte

Novant Health New Hanover Regional Medical Center, Wilmington

Novant Health Presbyterian Medical Center, Charlotte

Novant Health Rowan Medical Center, Salisbury

Novant Health Thomasville Medical Center,

Memorial Hospital,

Pardee Hospital,

Albemarle Medical

Transylvania Regional Hospital,

E I

NORTH DAKOTA

OHIO

Ashtabula County Medical Center,

Atrium Medical Center,

Aultman Alliance Community Hospital,

Hospital,

Blanchard Valley Health System,

Cleveland Clinic Akron General Medical Center,

Cleveland Clinic Avon Hospital,

Cleveland Clinic Euclid Hospital,

Cleveland Clinic Fairview Hospital,

Cleveland Clinic Hillcrest Hospital,

Cleveland Clinic Marymount Hospital,

Cleveland Clinic Medina Hospital,

Cleveland Clinic Mercy Hospital,

Cleveland Clinic South Pointe Hospital,

Cleveland Clinic,

Coshocton Regional Medical Center,

Fairfield Medical Center, Lancaster

Firelands Regional Medical Center,

Fisher Titus Medical Center, Norwalk

Genesis Healthcare System, Anesville

Good Samaritan Hospital, Cincinnati

Kettering Health Dayton, Dayton

Kettering Health Greene Memorial,

Kettering Health Hamilton, Hamilton

Kettering Health Main Campus, Dayton

Kettering Health Miamisburg, Miamisburg

Kettering Health Troy, Troy........................................................................................

Licking Memorial Hospital, Newark

Lima Memorial Health System, Lima

Louis Stokes Cleveland VA Medical Center,

McLaren St. Luke’s, Maumee

Mercy Health - Anderson Hospital,

Mercy Health - Fairfield Hospital

Mercy Health - St. Elizabeth Youngstown

Mercy Health West Hospital, Cincinnati

Mercy St. Vincent Medical Center, Toledo

Miami Valley Hospital, Dayton

Mount Carmel Health System, Columbus

Mount Carmel St. Ann’s, Westerville

Ohio State University Wexner Medical Center,

OhioHealth Doctors Hospital, Columbus

OhioHealth Grant Medical Center, Columbus

OhioHealth Mansfield Hospital, Mansfield

OhioHealth Marion General Hospital, Marion

OhioHealth Riverside Methodist Hospital,

Pomerene Hospital, Millersburg

ProMedica Flower Hospital, Sylvania

Toledo Hospital,

Soin Medical Center,

Southwest General Health Center, Middleburg Heights

Springfield Regional Medical Center, Springfield

St. Rita’s Medical Center, Lima

Summa Akron City Hospital, Akron

The Christ Hospital, Cincinnati

The Jewish Hospital Mercy Health, Cincinnati......................................................

The MetroHealth System, Cleveland

The University of Toledo Medical Center, Toledo

TriHealth Bethesda North Hospital, Cincinnati

Regional Hospitals, Bedford Medical Center and

Medical Center, Richmond Heights

University Hospitals Ahuja Medical Center, Beachwood

University Hospitals Cleveland Medical Center, Cleveland

University Hospitals Elyria Medical Center, Elyria

University Hospitals Geauga Medical Center, Chardon

University Hospitals Geneva Medical Center, Geneva

University Hospitals Parma Medical Center, Parma

University Hospitals Portage Medical Center, Ravenna

University Hospitals Samaritan Medical Center, Ashland

F I

E I

E I

G I

I

I University Hospitals Tripoint Medical Center/ University Hospitals

University Hospitals St. John Medical Center, Westlake

West Medical Center, Painesville

University of Cincinnati Medical Center, Cincinnati

Upper Valley Medical Center, Troy

West Chester Hospital, West Chester

Western Reserve Hospital, LLC, Cuyahoga Falls

Community Hospital,

OKLAHOMA

Ascension St. John Medical Center, Tulsa

Comanche County Memorial Hospital, Lawton

Hillcrest Hospital South, Tulsa

Hillcrest Medical Center, Tulsa.................................................................

INTEGRIS Baptist Medical Center, Oklahoma City

Southwest Medical Center,

Hospital

Norman Regional Health System,

Northeastern Health System,

OU Health University of Oklahoma Medical Center,

Saint Francis Hospital Muskogee, Muskogee

Saint Francis Hospital,

Anthony Hospital,

OREGON

Center,

GE

B G E J I

PUERTO RICO

RHODE ISLAND

Hospital,

Medical

Hospital,

Roger Williams Medical

SOUTH CAROLINA

Aiken Regional Medical Center,

Health,

Beaufort Memorial Hospital,

Bon Secours St. Francis

Bon Secours

Secours

Carolina Pines Regional Medical Center,

Coastal Carolina Hospital,

Conway Medical Center,

East Cooper Medical Center,

Grand Strand Medical Center,

Hampton Regional Medical Center,

Hilton Head Hospital,

Lexington Medical Center,

McLeod Health Cheraw, Cheraw

McLeod Health Dillon,

McLeod Health Seacoast,

McLeod Regional Medical Center,

Mount Pleasant Hospital, Mount

MUSC Health - Lancaster Medical Center,

MUSC Health, Charleston

Pelham Medical Center,

Piedmont Medical Center,

Prisma Health Baptist Easley Hospital,

Prisma Health Baptist Hospital,

Prisma Health Baptist Parkridge Hospital,

Prisma Health Greenville

Prisma Health Greer Memorial Hospital,

Prisma Health Hillcrest Hospital,

Prisma Health Laurens County Hospital,

Prisma Health Oconee Memorial

Prisma Health Richland Hospital,

Ralph H. Johnson VA Medical

Regional Medical Center

Roper

SOUTH DAKOTA

TENNESSEE

Baptist Memorial Hospital Memphis,

Blount Memorial Hospital, Maryville

CHI Memorial Hospital

CHI Memorial Hospital Hixson, Hixson

Erlanger Baroness Hospital, Chattanooga

Fort Sanders Regional Medical Center, Knoxville

Holston Valley Medical Center, Kingsport

Jackson-Madison County General Hospital, Jackson

Johnson City Medical Center, Johnson

LeConte Medical Center, Sevierville

Maury Regional Medical Center, Columbia

Methodist Germantown Hospital, Germantown

Methodist Medical Center, Oak Ridge

Methodist North Hospital, Memphis

Methodist South Hospital, Memphis

Methodist University Hospital, Memphis

Morristown-Hamblen Healthcare System, Morristown

Newport Medical Center,

North Knoxville Medical Center,

NorthCrest Medical Center,

Parkridge Medical Center, Chattanooga

Parkwest Medical Center, Knoxville

Roane Medical Center, Harriman

Saint Francis Hospital - Memphis, Memphis

Saint Thomas Midtown Hospital, Nashville................................................

Saint Thomas Rutherford Hospital, Murfreesboro

Saint Thomas West Hospital, Nashville

St. Francis Hospital - Bartlett, Bartlett

The University of Tennessee Medical Center, Knoxville

TriStar Centennial Medical Center, Brentwood

TriStar Hendersonville Medical Center, Hendersonville

TriStar Skyline Medical Center, Nashville

TriStar Southern Hills Medical Center, Nashville

TriStar Stonecrest Medical Center, Smyrna......................................................

TriStar Summit Medical Center,

TEXAS

Baptist Hospitals of Southeast Texas, Beaumont

Baylor Scott & White All Saints Medical Center

Baylor Scott & White Heart and Vascular Hospital

Baylor Scott & White Medical Center - Centennial,

Worth,

Dallas,

Baylor Scott & White Medical Center - College Station,

Baylor Scott & White Medical Center - Grapevine,

Baylor Scott & White Medical Center - Hillcrest,

Baylor Scott & White Medical Center - Irving,

Baylor Scott & White Medical Center - Lake Pointe, Rowlett

Baylor Scott & White Medical Center - Marble Falls, Marble

Baylor Scott & White Medical Center - McKinney, McKinney.........................

Baylor Scott & White Medical Center - Pflugerville, Pflugerville

Baylor Scott & White Medical Center - Plano, Plano..................................

Baylor Scott & White Medical Center

Round Rock,

Baylor Scott & White Medical Center - Temple, Temple

Baylor Scott & White Medical Center - Waxahachie, Waxahachie

Baylor Scott & White The Heart Hospital - Plano, Plano

Baylor University Medical Center - Dallas, Dallas

Ben Taub Hospital, Houston

Brazosport Regional Health System,

Health System, Amarillo

Carrollton Regional Medical Center, Carrollton

Cedar Park Regional Medical Center,

CHI St. Luke’s Health - Baylor St. Luke’s Medical

Children’s Medical Center Dallas,

CHRISTUS Good Shepherd Health System

CHRISTUS Good Shepherd Health System-Marshall,

CHRISTUS Mother Frances Hospital-Tyler,

CHRISTUS Santa Rosa Health, San Antonio

CHRISTUS Spohn Hospital Corpus Christi

CHRISTUS Spohn Hospital Corpus Christi -

CHRISTUS St. Michael Health System, Texarkana

Citizens Medical Center, Victoria

Corpus Christi Medical Center, Corpus Christi

Covenant Medical Center,

Cuero Regional Hospital, Cuero

Dallas Regional Medical Center,

Del Sol Medical Center, El Paso

Dell Seton Medical Center at The University

DeTar Healthcare System, Victoria

Doctors Hospital at Renaissance, Edinburg

E I

E J

G I

B C B A G E

Houston Methodist Willowbrook Hospital, Houston

Huntsville Memorial Hospital,

JPS Health Network,

Knapp Medical Center,

Palmas Medical Center,

Medical Center Hospital,

Medical City Dallas,

Medical City Plano,

Memorial Hermann Memorial City Medical Center, Houston

Methodist Charlton Medical Center,

Methodist Dallas Medical Center, Dallas...........................................................

Methodist Hospital

Metropolitan, San

E

Harlingen Medical Center, Harlingen.......................................................................

HCA Houston Healthcare - Clear Lake,

Houston Healthcare

Houston Healthcare -

Houston Healthcare

Houston Healthcare -

Houston Healthcare -

Houston Healthcare -

Heart Hospital of Austin,

Hendrick Medical Center South,

Hendrick Medical Center,

Houston Methodist

Houston Methodist

Houston Methodist Hospital,

Houston Methodist

Houston Methodist

Houston Methodist West

B F I

Methodist Hospital

Northeast, San Antonio

Stone

B E I

B E I Methodist Hospital

Methodist Hospital, San

B E I Methodist Mansfield Medical Center, Mansfield

B E I

B B A E I Methodist Richardson Medical Center, Richardson

Midland Memorial Hospital, Midland

B I

A A Mission Regional Medical Center, Mission

Northwest Texas Healthcare System, Amarillo

B E I OakBend Medical Center Williams Way Campus, Richmond

A Odessa Regional Medical Center, Odessa

A Parkland Health

Hospital System, Dallas

B D C C II

Rio Grande Regional Hospital, McAllen

B B A G G I

B F I Shannon Medical Center, San Angelo

South Texas Health System, Edinburg............................................................... B G I

St. David’s Georgetown Hospital, Georgetown

B B A E J I

A St. David’s Medical Center, Austin

St. David’s North Austin Medical Center, Austin

St. David’s South Austin Medical Center, Austin

B B A F I

B B A E I St. David’s Round Rock Medical Center, Round Rock

B B A E I

St. Joseph Health College Station Hospital, College Station

St. Joseph Medical Center, Houston

St Luke’s Health-Memorial Lufkin, Lufkin

St. Luke’s Health - The Woodlands Hospital, The Woodlands

Texas Health Arlington Memorial Hospital, Arlington

Texas Health Harris Methodist Hospital Fort Worth, Fort Worth

Texas Health Harris Methodist Hospital Hurst-Euless-Bedford,

B B A F

B C I St. Joseph Health Regional Hospital, Bryan

B E I

B B G II

B B A G I

B E

B A F J

B B A E I

Texas Health Harris Methodist Hospital Southwest Fort Worth, Fort Worth

D A

Texas Health Heart & Vascular Hospital Arlington, Arlington.................. B B A G

Texas Health Huguley Hospital Fort Worth South, Burleson

B

Texas Health Presbyterian Hospital Dallas, Dallas............................... B B A E I Texas Health Presbyterian Hospital Denton, Denton

Texas Health Presbyterian Hospital Plano, Plano

Texas Vista Medical Center, San Antonio

Texoma Medical Center, Denison

The Hospitals of Providence East Campus, El Paso

The Hospitals of Providence Sierra Campus, El Paso

The Hospitals of Providence Transmountain Campus, El Paso

Titus Regional Medical Center, MT Pleasant..........................................

United Regional Healthcare System, Wichita Falls

University Health

University Medical

Valley

B B G I

B B A E

B E I

B F J I

B I

B G I

B

A A E I

B E

Hospital

Valley

Lakeview Hospital,

Hospital

VERMONT

University of

VIRGINIA

Augusta Health, Fishersville

Bon Secours Mary Immaculate Hospital,

Bon Secours Maryview Medical Center,

Bon Secours Memorial Regional

Bon Secours Rappahannock General

Bon Secours St. Francis Medical Center,

Bon Secours St. Mary’s Hospital,

Carilion Roanoke Memorial Hospital,

Centra Lynchburg General Hospital,

Chesapeake Regional Medical Center,

Fauquier Hospital,

HCA Chippenham Medical Center,

HCA Johnston-Willis Hospital,

Inova Alexandria Hospital, Alexandria

Inova Fair Oaks Hospital, Fairfax

Inova Fairfax Hospital, Falls Church

Inova Loudoun Hospital, Leesburg

Inova Mount Vernon Hospital,

Mary Washington Hospital,

Reston Hospital Center,

Riverside Doctors’ Hospital Williamsburg,

Riverside Regional Medical Center,

Riverside Shore Memorial Hospital,

Riverside Walter Reed Hospital,

Sentara CarePlex Hospital,

Sentara Leigh Hospital,

Sentara Martha Jefferson Hospital,

Sentara Norfolk

Sentara Northern Virginia

Sentara Princess

Sentara RMH Medical

Sentara Virginia

Sentara Williamsburg

Stafford Hospital,

StoneSprings Hospital

VCU Health

Hospital Center,

WASHINGTON

Confluence Health-Central Washington Hospital,

Medical Center,

Medical Center,

Kadlec Regional Medical Center,

Kittitas Valley Healthcare,

Legacy Salmon Creek Medical Center,

MultiCare Auburn Medical Center,

Covington Medical Center,

MultiCare Deaconess Hospital,

MultiCare Tacoma General Hospital,

Overlake Medical Center

Clinics,

PeaceHealth Southwest Medical Center,

PeaceHealth St. Joseph Medical Center, Bellingham

PeaceHealth United General Medical Center, Sedro Woolley

Providence Centralia Hospital,

Providence Holy Family Hospital, Spokane

Providence Regional Medical Center Everett, Everett

Providence Sacred Heart Medical Center

Providence St. Mary Medical Center,

Providence St. Peter Hospital,

Saint Anthony Hospital,

Saint Clare Hospital, Lakewood

Saint Joseph Medical Center,

Saint Michael Medical Center,

Seattle Children’s Hospital,

St. Anne Hospital, Burien

St. Francis Hospital,

Swedish Edmonds, Edmonds

Swedish Medical Center

Swedish Medical Center

Swedish Medical Center

Swedish Medical Center

Trios Health,

University

UW Medicine

Hill

Hill

Washington Medical Center,

Valley Medical

Hospital,

WEST VIRGINIA

Bellin Memorial Hospital,

Memorial Hospital,

Hospital,

Bay

Menomonee Falls Hospital, Menomonee Falls

Froedtert Pleasant Prairie Hospital, Pleasant Prairie............................................

West Bend Hospital, West Bend

Gundersen Lutheran Medical Center,

HSHS Sacred Heart Hospital,

Medical Center

Eau Claire,

Marshfield Medical Center, Marshfield

Mayo Clinic Health System LaCrosse, La Crosse

Mayo Clinic Health System - Eau Claire, Eau Claire

Mercy Hospital and Trauma Center, Janesville

ProHealth Care, Oconomowoc Memorial Hospital, Oconomowoc

Aspirus

Aurora BayCare

Aurora Lakeland Medical

Aurora Medical Center

Aurora Medical Center

Aurora Medical Center

Aurora Medical Center

Aurora Medical Center

Aurora Medical Center

Aurora Medical Center

Aurora Sheboygan Memorial Medical

Aurora Sinai Medical Center,

Aurora St. Luke’s Medical Center,

Aurora St. Luke’s South Shore, Cudahy

Aurora West Allis Medical Center,

C E I

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G

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ProHealth Care, Waukesha Memorial Hospital, Waukesha

Richland Hospital, Richland Center

SSM Health St. Mary’s Hospital - Madison, Madison......................................

St. Agnes Hospital, Fond Du Lac

St. Mary’s Janesville Hospital, Janesville

St. Nicholas Hospital, Sheboygan

ThedaCare Regional Medical Center - Appleton, Appleton.................................

Regional Medical Center - Neenah, Neenah

UnityPoint Health -Meriter,

University of Wisconsin Hospital and Clinics, Madison.......................

Hills Health,

WYOMING

Cheyenne Regional Medical Center,

Star Valley Health, Afton

Medical Center, Casper

ON MEDICINE’S FRONT LINES

the group that experienced VR technology reported a 24% drop in pain scores. The other 50 patients, who watched a standard, 2D nature video with relaxing scenes on a nearby screen, experienced only a 13.2% reduction in pain.

“Virtual reality has been shown to reduce pain when used within the hospital in a variety of studies,” says Spiegel, who is also director of health services research at Cedars-Sinai and author of the book, “VRx: How Vir tual Therapeutics Will Revolutionize Medicine.” “We have also developed a digital pain reduction kit, includ

ining the use of VR to ease pain in adults and children with complex regional pain syndrome, or CRPS, and patients with cerebral palsy and peripheral idiopathic facial pain.

“In the past, there were very few labs that were working in VR because it was so expensive and technically challenging, but once consumer equipment became available, many more researchers started envisioning new potential applications for virtual reality,” Won says. “There’s huge potential for VR as a therapeutic option, but we don’t want this to be oversold and people to get excited about VR treatments before they are proven effective.”

Researchers are also looking into the potential side effects of VR, such as whether it could be addictive.

“We have not seen abuse among our patients who are using it for thera peutic purposes, and in fact, what we have observed is that people don’t love using VR after 20 to 30 minutes,” Spiegel says.

The most common side effect for some patients, according to Spiegel, is “cybersickness,” the feeling of diz ziness and nausea when the patient is wearing a VR headset. Patients also have experienced side effects such as blurred vision, eye strain and head ache. He says less than 5% of patients experience these effects, which usually disappear when the headset comes off and often decrease with subsequent use and treatment sessions.

ing virtual reality, used at home to help patients improve quality of life and reduce their need for pain medications.”

DR. BRENNAN SPIEGEL PREPARES A VR HEADSET AT CEDARS-SINAI MEDICAL CENTER IN LOS ANGELES.

More study needed. Despite all the excitement around VR and its promise for managing pain and po tentially reducing the need for opi oids, the exact mode behind how VR impacts pain remains unknown. Some experts speculate that VR creates a form of analgesia by changing the activity of the body’s pain modulation system, while others postulate that VR serves as a “pain distraction,” reducing the perception of pain by absorbing and diverting attention away from the pain.

Andrea Stevenson Won believes in the potential of VR technology, but she also recognizes the need for more studies. Won is director of the Virtual Embodiment Lab at Cornell University in New York, where she’s an as sistant professor of communication with the College of Agriculture and Life Sciences. She has led studies exam

The explosion of interest in VR tech nology seems endless. In November 2021, the Food and Drug Administra tion approved the first VR technology – now called RelieVRx – for the treat ment of adult patients with diagnosed chronic lower back pain. RelieVRx uses the principles of cognitive behavioral therapy to help blunt pain.

As one of a few approved “digiceuticals,” aka digital therapeu tics, the device is intended for at-home self-use and consists of a VR headset, controller and a “breathing amplifier” attached to the headset that directs a patient’s breath toward the headset’s mi crophone for use in deep breathing exercises. The FDA approval “sets a positive pathway for future advancements,” Spiegel says, because the agency “provided a special breakthrough designation for the device.”

Several other companies have entered the VR field to discover the next generation of systems that go beyond being a distraction therapy and work by focusing the brain away from pain. One com pany, CognifiSense, is working on a completely new type of VR therapy, which has been dubbed “VR neuropsychological therapy.” This approach aims to change how the brain perceives pain and create a lasting reduction in pain.

“There are so many researchers dedicated to keeping this an evidence-based branch of medicine,” Spiegel says, “to further study where VR is appropriate and where it’s not appropriate, and how we can best help patients living with chronic pain.” l

The Future of mRNA Vaccines

shots hold promise for everything from flu to cancer

by Arlene Weintraub

IN NOVEMBER 2021, the World Health Organization classified omicron as a new COVID-19 variant of concern, after a team of South African scientists sounded alarm bells about its highly transmissible nature. Just two months later, vaccine maker Mod erna started a clinical trial to study the effectiveness of an omicron-specific booster shot.

The new mRNA technology behind the Moderna and Pfiz er-BioNTech COVID-19 vaccines is being hailed as a game changer in the future battle against infectious diseases, and even against some cancers. That’s largely because of how quickly mRNA vaccines can be developed in response to new invaders – and then tweaked if those invaders mutate to try to escape an immune attack. “There are hundreds and hundreds of diseases for which mRNA could be useful,” says Dr. Drew Weiss man, a professor of medicine at the University of Pennsylvania whose lab has developed several mRNA vaccines that are on the verge of human testing.

Next up: the flu. Making an mRNA vaccine entails taking a piece of a virus’s DNA strand –in the case of COVID, it’s the part that makes the spike protein that gives the virus that studded appearance – and using it to teach the immune system to recognize and eliminate the virus. The vaccine causes cells to make the target protein, prompting the immune system to eradicate the virus anytime it appears in the body.

One target for which the technology is considered especially promising: influenza. Manufacturing the seasonal flu vaccine currently is a laborious six-month-or-longer process that in volves growing what are predicted to be the dominant virus strains in eggs, harvesting and inactivating them, and then making vaccine doses at huge scale. If an unexpected strain pops up, the vaccine can’t be changed on a dime to cover it. An mRNA vaccine that teaches the body to recognize hemaggluti nin A or B, the proteins on the surface of flu viruses, could be developed much faster and adjusted quickly, Weissman says.

Moderna is now developing five mRNA vaccines covering four seasonal flu viruses, three of which are in human testing.

Weissman and a range of companies, including mRNA vaccine developer CureVac, are using the technology to try to develop a universal flu vaccine – a single shot that could cover most strains of the influenza A virus that emerge over time. Rather than target the “head” of the hemagglutinin pro tein, which tends to mutate every year, the vaccine would be designed to elicit an immune response to the less changeable “stem” or “stalk” region, Weissman explains.

Other targets. Moderna and BioNTech are also working on mRNA vaccines to prevent HIV, a virus that mutates quickly. The idea is to use the technology to elicit broadly neutralizing an tibodies, immune proteins that target the virus and keep it at bay even as it changes, says Dr. Rajesh Gandhi, an infectious dis eases physician and co-director of the Harvard University Center for AIDS Research.

And mRNA technologies could be applied to develop vaccines against other viruses that can hide out in the body for years, often producing no symptoms but raising the risk of other diseases. Epstein-Barr virus, or EBV, has been linked to an increased risk of multiple sclerosis and some cancers, for example. In February 2020, just before the pandemic diverted the biopharma in dustry’s attention, Moderna announced it was starting clinical trials of an mRNA vaccine to prevent EBV.

“There is increasing evidence that infectious agents may be a trigger for some of the major diseases of mankind,” says Dr. Anthony Komaroff, a professor of medicine at Harvard Medical School. “A vaccine given early in life could have an enormous protective effect.”

Other diseases for which mRNA vaccines are now in devel opment include Zika, yellow fever and tuberculosis. Therapeu tic mRNA vaccines designed to stimulate an immune response to cancer are also being explored in melanoma, prostate can cer, lung cancer and many other tumor types. Says Gandhi: “We’re on the threshold of a new revolution in vaccinology.” l

The Post-Pandemic Role of Virtual Care

After 2020’s rapid shift to telemedicine, experts think as much as half of care could be delivered remotely

by Margaret Loftus

©

AMY SHIDELER had barely put down roots in Northeast Ohio in fall 2020 when she tested positive for COVID-19. Her support system had yet to be built, and her parents, in Indiana, were recovering from the virus themselves. Beset by fa tigue and fever, she worried about being alone, especially since she had a history of asthma. “It was a very isolat ing feeling.”

But a home monitoring program at Cleveland Clinic, where Shideler is a social worker, made her feel less alone. Each day, she used the MyChart app on her smart phone to log her symptoms, temperature and oxygen level, which were then assessed by care coordinators at the clinic. Within 10 minutes of reporting shortness of breath one morning, she was called by a nurse and connected to a physician, who immediately prescribed a new inhaler. In all, the medical center’s virtual team evaluated her three times for symptoms that might otherwise have sent her to the emergency room. “It was comforting to know I was going to get what I needed right where I was,” she says.

Caring for patients where they are has long

been the promise of telemedicine, but it took unexpect ed and explosive demand in 2020 to make the promise real. Cleveland Clinic went from some 37,000 virtual visits in 2019 to 841,000 in 2021, peaking at 1.2 mil lion in 2020. Virtual care company Teladoc Health facilitated 10.6 million visits in 2020, a 156% increase over 2019; in 2021, that number climbed 38% to 15.8 million visits.

While demand has leveled off, experts predict that telemedicine – from doctor and psychotherapist visits to remote monitoring of chronic conditions – is here to stay. “Now that people have been exposed to it, it’s going to be a part of everything that we do,” says Dr. Steven Shook, a neurologist and lead for virtual health at Cleveland Clinic. Consulting firm McKinsey & Company estimated in 2020 that up to $250 billion of the U.S. health care industry has the potential to become virtual, up from a preCOVID revenue of $3 billion annually; providers estimate that as much as 50% of care could be delivered remotely.

AT CLEVELAND CLINIC, VIRTUAL VISITS SKYROCKETED FROM ABOUT 37,000 IN 2019 TO 1.2 MILLION IN 2020.

The extent to which the industry grows de pends largely on whether Congress makes per manent changes to rules that allowed for the expansion of telehealth services, such as more favorable reimbursement rates and permitting

remote care without geographic restrictions. At press time, sus taining expanded telehealth services had wide bipartisan sup port and strong backing from the Biden administration, but it’s the eventual fine print – for example, the rates at which various telehealth services are reimbursed compared to those in clinical settings – that will shape the future.

Home as clinic. To that end, a group of providers that in cludes Intermountain Healthcare, Ascension and Amazon Care formed a coalition in 2021 – called Moving Health Home – to advocate for policy changes that would designate the home as a site of clinical care. Members argue that advances in medi cal record-sharing, remote monitoring technologies and digital therapeutics have made it possible to deliver even acute care at home in many cases. Salt Lake City-based Intermountain, for example, treats patients at home who have everything from heart failure to certain cancers with a combination of technology and visits from an interdisciplinary caregiving team.

Consumers, for the most part, like the idea. McKinsey found that 40% of consumers will continue using virtual care, compared to 11% who used it pre-COVID.

To be sure, any visits that require hands-on evaluation, such

I don’t think we can go back to where we were.

she’s seeing fewer patients remotely be cause UI Health is limiting such visits due to low reimbursement rates. Ide ally, though, she finds every other visit could be replaced. “Coming into a clinic every three months can be onerous, so a quick 20-minute call is no problem,” she says. Likewise, at the Medical University of South Carolina, diabetes patients are monitored through cellular-connected glucometers that beam data via a se cure cloud to a team of nurses who can adjust insulin.

The coronavirus itself became a case study for remote monitoring. UI Health partnered with the digital health care com pany physIQ to send COVID patients home fitted with a biosensor patch to collect data on heart and respiratory rates and arrhythmias, as well as move ment. The sensor, which is connected to an Android device, sent the data to a team of nurses who checked in with patients daily. Research ers were able to identify prelimi nary markers that preceded the decline of a patient’s condition.

“This kind of technology can and should be given to patients with lots of other chronic conditions,” says Dr. David Chestek, one of the investigators and interim chief medi cal information officer at UI Health.

Predictive value. Indeed, a study in 2020 by physIQ and four VA hospitals found that such analytics accurately pre dicted hospitalization for heart failure pa tients. And because these patients often have other health issues, it also predicted adverse events such as pneumonia and renal failure.

as orthopedics, are limited in their telehealth potential. But the possibilities in other domains are wide open: Mental health visits through Teladoc Health grew more than 500% in 2020 and more than doubled in 2021.

Another promising area: chronic diseases, which drive 80% of the health care costs in the U.S. Before COVID, Dr. Rachel Caskey, a physician at UI Health in Chicago, only rarely used telehealth. Last year, she managed many of her patients with chronic conditions remotely by, for example, having those with diabetes rely on a glucometer to keep track of their blood sugar and people with hypertension use a blood pressure cuff to take their own measurements. More recently, however, Caskey says

For all its technological promise, tele medicine has the potential to foster a more patient-centered health care sys tem, proponents argue. Consider that much of routine care has been delivered in 15-minute increments once a year, says Dr. James McElligott, medical director for the Center of Telehealth at MUSC. “It’s all about one point in time, but that’s not how health and wellness work.” McEl ligott thinks telehealth will provide the opportunity to check in more often with patients where they live, with more of a focus on their functioning and wellness. “A big page has turned,” he says. “I don’t think we can go back to where we were.”

Accept Nothing Less than results and respect in equal doses.

Erasing Race in Medicine

Renewed efforts are underway to eliminate race from some aspects of patient care

by Steven Ross Johnson  ©

SEMINAL EVENTS dur ing the pandemic – such as the protests over the death of George Floyd at the hands of Minneapolis police in 2020 and the dis proportionate impact of COVID-19 on com munities of color – have brought the issues of systemic racism and injustice to the forefront.

For some health care providers, the mo ment has also presented an opportunity to leverage the national conversation into new efforts to examine how existing policies and practices in medicine may be perpetuating racial health inequities.

“We’re at a pivotal time,” says Dr. Nichola Davis, chief population health officer for NYC Health + Hospitals, New York City’s public hospital and health care system. “People’s ears are open and they are willing to hear and have these courageous conversations that they maybe weren’t able to have in 2019.”

Persistent disparities. At issue are clini cal algorithms that factor in race when as sessing a patient’s risk for a host of health conditions, ranging from death in connec tion with heart surgery to urinary tract in fections in children. Critics contend these calculations may result in patients of color

receiving less access to and poorer quality care than their white counterparts, fueling long-standing racial health disparities.

“Race was never necessary or needed” in these algorithms, says Dr. Milda Saun ders, an internal medicine physician, ethi cist, health equity researcher and associate professor of medicine at the University of Chicago. Race-based adjustments within al gorithms that help providers make clinical assessments have been around for decades. And while there is widespread acceptance that the concept of race is not based on bi ology but is instead a social construct, race correction continues to influence how pa tients are diagnosed and treated, despite the potential harms.

So ingrained are these calculations in clinical assessments that the effort to over haul them is often quite complicated, with questions over what factors can be an ad equate replacement.

“These are conversations that have been happening among certain subsets of people for years,” Davis says. “This isn’t new work for some people.”

There has been notable movement of late, however: In May 2021, for example, NYC Health + Hospitals announced its removal

ON MEDICINE’S FRONT LINES

of a patient’s race from calculations used to assess kidney function – part of the health system’s broader “Medical Era cism” initiative.

More recently, the American Academy of Pediatrics issued a policy statement promising to review and revise guide lines that factor race into clinical deci sion-making. The group said the practice is based on “flawed science” and stems from systemic and structural inequities that drive racial health disparities. “Rac ism has infiltrated and impacted health care delivery and outcomes in this coun try for more than 400 years,” states the policy, released in May 2022.

Race was first introduced in the late 1990s to calculate estimated glomerular filtration rate, or eGFR, which is com monly used by clinicians to measure the kidneys’ ability to filter waste from the blood. A higher eGFR score normally suggests better kidney function.

Black patients, though, are typically assigned a race adjustment that raises their eGFR by approximately 16% or more than non-Black patients, depend ing on the equation used. The adjust ment is tied to past findings showing higher levels of the waste product cre atinine among Black people.

“Explanations that have been given for this finding include the notion that Black people release more creatinine into their blood at baseline, in part because they are reportedly more muscular,” a 2020 article in the New England Journal of Medicine states. “Analyses have cast doubt on this claim, but the ‘race-corrected’ eGFR re mains the standard.”

A heavy toll. Davis says this adjust ment can negatively impact the quality of health care Black patients receive, causing delays in medical interventions such as referrals to a nephrologist or di alysis. One such potential consequence was outlined in a November 2021 piece published by STAT, in which Glenda V. Roberts – a woman with kidney disease who identified as Black – wrote of how the equation delayed her evaluation for a kidney transplant.

“Unfortunately, when you look at the clinical algorithms, what many of them do is they may downplay the severity of some illnesses when you do that race cor rection,” Davis says.

Recent steps to remove race from eGFR calculations were strengthened in September 2021 when the National Kid ney Foundation and American Society of Nephrology encouraged the use of a new equation that does not include race.

“The big change is that more institu tions like the hospital system, hospital leadership and administrators are more on board with efforts toward equity than they were in prior years,” says Dr. Monica Maalouf, associate director of the internal medicine residency pro gram for Loyola Medicine, a Chicago area health system.

Racism has care for over 400 years.

infiltrated U.S. health

Maalouf says Loyola is in the process of determining how to omit race as a variable from the health system’s eGFR calculations. This has involved talks with physicians and laboratory staff, as well as working with information technol ogy specialists on whether ra cial designation can be removed from the risk score’s automated reporting system.

National Kidney Foundation President Dr. Paul Palevsky says the new equation marks an im portant step toward achieving equity in health care by provid ing a more accurate, race-free approach to assessing kidney function.

“It was the most common equation used in medicine that incorporated race,” Palevsky says, estimating a race-inclusive equation for kidney function is used ap proximately 240 million times a year.

But while the change in the eGFR cal culation signifies a substantial step for ward, eliminating race correction in cal culations for other health conditions has been more challenging, despite growing recognition about the potential harms and health disparities that can come from their continued use.

“The field has realized that when we are using race as a factor in our clinical as sessments that we’re actually not using a precise measure like we would do for mea suring sex or age,” Saunders says. “But we want to find the best answer, so that may involve sort of reexamining the questions and not just saying, ‘Let’s just drop race,’ but asking what was race measuring, and then substituting that measure.”

Saunders says University of Chicago Medicine recently removed race in cal

THE HEART OF QUALITY PATIENT CARE

As the global professional organization for the entire cardiovascular care team, the American College of Cardiology (ACC) is committed to supporting patients, caregivers, and health care professionals by ensuring the highest quality care is delivered to every patient, every time.

ACC Accreditation Services™

ACC Accreditation Services links performance improvement to patient outcomes and promotes consistent processes across the care continuum. Working with hospitals, centers and health systems, ACC Accreditation Services partners to build communities of excellence by advancing the highest standards of quality patient care.

NCDR® (National Cardiovascular Data Registry)

For 25 years, the NCDR has delivered a suite of data registries to help hospitals, centers and health systems measure and improve the quality of cardiovascular care they provide. The NCDR utilizes real-world evidence to improve patient outcomes and achieve quality heart care.

MedAxiom, an ACC Company MedAxiom is the premier source for cardiovascular organizational performance solutions. MedAxiom unites the cardiovascular community via cutting-edge education, networking opportunities and best practices to transform cardiovascular care, together.

FOR CARDIOVASCULAR PROFESSIONALS, please visit CVQuality.ACC.org to learn more about ACC’s Quality Improvement for Institutions program. To learn more about cardiovascular organizational peformance solutions, visit MedAxiom.com.

FOR PATIENTS AND CAREGIVERS, please visit CardioSmart.org to learn more about ACC’s clinician-directed heart health education and resources.

The following pages list more than 2,000 hospitals, centers and health systems that rely on ACC’s NCDR and Accreditation Services. Patients and caregivers can trust hospitals and centers that participate in the NCDR, receive the ACC’s Accreditation seal of approval, and are recognized with the Chest Pain – MI Registry™ Performance Achievement Award and the HeartCARE Center™ Award for delivering the best cardiovascular patient care.

ACC ACCREDITATION SERVICES

AF Atrial Fibrillation Accreditation

Incorporates evidence-based guidelines and clinical best practices to treat patients with atrial fibrillation.

CL Cardiac Cath Lab Accreditation

Merges the latest evidence-based science and process improvement methodologies, while addressing pre-procedure, periprocedure and post-procedure care for patients undergoing treatment in the Cath Lab.

CP Chest Pain Center Accreditation

Integrates triage treatment protocols, risk stratification, and best practices for the emergency care of acute coronary syndrome patients.

EP Electrophysiology Accreditation

Links the latest science, process improvement methodologies and patient outcomes across the care continuum for patients undergoing treatment in the EP Lab.

NCDR

A AFib Ablation Registry™

(Catheter-based atrial fibrillation ablation procedures) Assesses the prevalence, demographics, acute management and outcomes of patients undergoing atrial fibrillation (AFib) catheter ablation procedures.

C CathPCI Registry®

(Diagnostic cardiac catheterization and percutaneous coronary intervention) Measures adherence to the ACC/ AHA clinical practice guideline recommendations, procedure performance standards and appropriate use criteria for coronary revascularization.

CP Chest Pain — MI Registry™

(Acute myocardial infarction treatment)

Leverages national evidence-based standards for understanding and improving the quality, safety and outcomes of care provided for heart attack patients.

E EP Device Implant Registry™

(Implantable cardioverter defibrillator and pacemaker procedures) Provides a national standard for understanding patient characteristics, treatments, outcomes, device safety and the overall quality of care for ICD/CRT-D and select novel pacemaker procedures.

IM IMPACT Registry®

(Pediatric and adult congenital treatment procedures) Assesses the prevalence, demographics, management and outcomes of pediatric and adult congenital heart disease patients who undergo diagnostic catheterizations and catheterbased interventions.

L LAAO Registry™

(Left atrial appendage occlusion procedures) Captures data on left atrial appendage occlusion (LAAO) procedures to assess real-world procedural outcomes, short and long-term safety, and comparative effectiveness.

T STS/ACC TVT Registry™

(Transcatheter valve therapy procedures) Monitors real-world outcomes on transcatheter valve therapies leading to improved patient outcomes, enhanced assessment of treatment options and results, and more informed decision making.

HF Heart Failure Accreditation

Leverages guideline-directed medical therapies and best practices to ensure greater operational efficiency and a more consistent approach to treatment.

TV Transcatheter Valve Certification

Utilizes evidence-based science, realworld patient outcomes and expert recommendations to standardize and improve care for patients requiring transcatheter valve therapies.

HONORS

Chest Pain — MI Registry™

Performance Achievement Award

Recognizes hospitals participating in Chest Pain – MI Registry that have demonstrated sustained, top level performance in quality of care and adherence to guideline recommendations.

Platinum Gold Silver HeartCARE Center™

Recognizes hospitals that have demonstrated a commitment to world-class cardiovascular care through comprehensive process improvement, disease and procedure-specific accreditation, professional excellence and community engagement.

Hospitals are listed by state and then by level of engagement with the ACC’s quality and process improvement programs.

ALABAMA

Grandview Medical Center

Huntsville Hospital

Shelby Baptist Medical Center

University of Alabama Hospital

Ascension Providence

Health Care Authority for Baptist Health

Riverview Regional Medical Center

St. Vincent’s East

St. Vincent’s Hospital

Andalusia Regional Hospital

Brookwood Medical Center

Crestwood Medical Center

DCH Regional Medical Center

Mobile Infirmary Medical Center

North Alabama Medical Center

Princeton Baptist Medical Center

Southeast Health

Springhill Medical Center

Dekalb Regional Medical Center

East Alabama Medical Center

Flowers Hospital

Gadsden Regional Medical Center

Jackson Hospital and Clinic

Northeast Alabama Regional Medical Center

South Baldwin Regional Medical Center

Thomas Hospital

Vaughan Regional Medical Center

Baptist Medical Center South

Cullman Regional Medical Center

Marshall Medical Center

Russell Medical Center

Shoals Hospital

University of South Alabama Cardiology Department

Walker Baptist Medical Center

ALASKA

Alaska Regional Hospital

Providence Alaska Medical Center

Mat-Su Regional Medical Center

Alaska Native Medical Center

Central Peninsula Hospital

Fairbanks Memorial Hospital

ARIZONIA

Chandler Regional Medical Center

Abrazo Arizona Heart Hospital

Mercy Gilbert Medical Center

Havasu Regional Medical Center

Saint Joseph’s Hospital and Medical Center

Tucson Medical Center

Abrazo Arrowhead Campus

Carondelet St. Mary’s Hospital

Northwest Medical Center

Yavapai Regional Medical Center

Abrazo Central Campus

HonorHealth

Mayo Clinic Arizona

Mountain Vista Medical Center

Valley View Medical Center

Western Arizona Reg Medical Center

Yuma Regional Medical Center

Abrazo Scottsdale Campus

Abrazo West Campus

Banner - University Medical Center Tucson

Banner Boswell Medical Center

Banner Desert Medical Center

Banner Heart Hospital

Banner Thunderbird Medical Center

Banner University Medical Center - Phoenix

Canyon Vista Medical Center

Carondelet St. Joseph’s

Flagstaff Medical Center

Honor Health - Deer Valley Medical Center

HonorHealth John C. Lincoln Medical

Kingman Regional Medical Center

Oro Valley Hospital

Phoenix Children’s Hospital

Santa Cruz Valley Regional Hospital

Tempe St. Luke’s Hospital

Verde Valley Medical Center

ARKANSAS

CHI St. Vincent Infirmary

Mercy Health System of Northwestern Arkansas

National Park Medical Center

University of Arkansas Medical Sciences Physician

Arkansas Heart Hospital

Baptist Health - Fort Smith

Baptist Health Medical Center - Little Rock

Northwest Medical Center - Bentonville

Saline Memorial Hospital

Washington Regional Medical Center

Baptist Health Medical Center - North Little Rock

Baxter Regional Medical Center

CHI St. Vincent Hospital

Mercy Hospital Fort Smith

NEA Baptist Memorial Hospital

St. Bernards Medical Center

St. Mary’s Regional Medical

Unity Health White County

Medical Center

Baptist Memorial Hospital - Jonesboro

CHI St. Vincent North

Conway Regional Medical Center

Jefferson Regional Medical Center

Medical Center of South Arkansas, LLC

Northwest Medical Center - Springdale

Arkansas Children’s Hospital

Baptist Health Medical Center - Conway

Saint Mary’s Regional Medical Center

White River Medical Center

CALIFORNIA

Adventist Health and

Rideout Hospital

Adventist Health

Bakersfield

Eisenhower Medical Center

University of California

Bakersfield Heart Hospital

California Pacific Medical Center

El Camino Health

French Hospital Medical Center

Palomar Medical Center

Sutter Medical Center

- Sacramento

Antelope Valley Hospital

Dignity Health St. Joseph’s Medical Center

Doctors Medical Center

Loma Linda University Medical Center

Memorial Medical Center

Modesto

NorthBay Medical Center

Pomona Valley Hospital Medical Center

Temecula Valley Hospital

UC San Diego Health System

Sulpizio CV Center

University Of California Davis Medical Center

Adventist Health

Alta Bates Summit Medical Center

Hoag Memorial Hospital

Presbyterian

Loma Linda University Medical Center -

Mercy General Hospital

Sacramento

Mills - Peninsula Medical Center

Riverside Community Hospital

Saint Agnes Medical Center

St. Bernardine Medical Center

Sutter Santa Rosa

Regional Hospital

Tri-City Medical Center

UC Irvine Health

University of California

San Francisco Medical Center

White Memorial Medical Center

Adventist Health St. Helena

Cedars - Sinai Health Systems

Community Memorial Hospital

Desert Regional Medical Center

Desert Valley Hospital

Emanate Health Medical Center

Fresno Heart and Surgical Hospital

Keck Medical Center of

Los Robles Hospital & Medical Center

Marian Regional Medical Center

MemorialCare Long Beach Medical Center

Salinas Valley Memorial Healthcare System

Sharp Memorial Hospital

St. John’s Regional Medical

Torrance Memorial Medical Center

Arrowhead Regional Medical Center

Bakersfield Memorial Hospital

Community Hospital of the Monterey Peninsula

Emanuel Medical Center

Enloe Medical Center

Fresno Community Hospital

Medical Center

Garfield Medical Center

Good Samaritan Hospital

Huntington Hospital

John Muir Medical Center

- Concord Campus

Kaiser Foundation Hospital

Kaiser Permanente Medical Center

- San Francisco

Kaiser Permanente Medical Center

- Santa Clara

Kaweah Delta Hospital District

Marin Health Medical Center

Memorialcare Saddleback Medical Center

Northridge Hospital Medical Center

PIH Health Good Samaritan Hospital

Providence Little Company of Mary Medical Center

Providence Mission Hospital

Providence Saint John’s Health Center

Providence St. Joseph Hospital

Santa Barbara Cottage Hospital

Santa Rosa Memorial Hospital

Scripps Memorial Hospital

Scripps Mercy Hospital -

Sequoia Hospital

Sharp Chula Vista Medical Center

Sharp Grossmont Hospital

Stanford Health Care

Stanford Health Care Valley Care

Sutter Delta Medical Center

Washington Hospital

West Hills Hospital & Medical Center

Children’s Hospital of Los Angeles

Community Medical Center -

Corona Regional Medical Center

Dignity Health Dominican Hospital

Glendale Memorial Hospital and Health Center

Henry Mayo Newhall Hospital

Kaiser Foundation Hospital

Kaiser Permanente Irvine Medical Center

Kaiser Permanente Oakland Medical Center

Lakewood Regional Medical Center

Lucile S. Packard Children’s Hospital at Stanford University

MemorialCare Orange Coast Medical Center

Palmdale Regional Medical Center

PIH Health Hospital - Whittier

Providence Saint Joseph Medical Center

Providence St. Jude Medical Center

Providence St. Mary Medical Center

Riverside University Health System Medical Center

San Antonio Regional Hospital

Shasta Regional Medical Center

Southern California Hospital at Culver City

Sutter Roseville Medical Center

University Of California - Santa Monica

Valley Presbyterian Hospital

West Anaheim Medical Center

Adventist Medical Center -

Adventist Health - Simi Valley

Adventist Health Simi Valley

Alameda Health System

Barstow Community Hospital

California Hospital Medical Center

Children’s Hospital of Orange County

Chino Valley Medical Center

Corona Regional Medical Center

Dameron Hospital Association

Dignity Health

Dignity Health Mercy Medical Center

El Centro Regional Medical Center

Fountain Valley Regional Hospital

Hollywood Presbyterian Hospital

John F. Kennedy Memorial Hospital

John Muir Medical Center - Walnut Creek Campus

Kaiser Foundation - Roseville Medical Center

Kaiser Foundation Hospital South Sacramento

Kaiser Permanente - Vallejo Medical Center

Kaiser Permanente Fremont Medical Center

Kaiser Permanente Medical Center Health Sciences

Kaiser Permanente Modesto Medical Center

Kaiser Permanente Orange County - Anaheim Medical Center

Kaiser Permanente Sacramento Medical Center

Kaiser Permanente San Rafael Medical Center

Kaiser Permanente Walnut Creek

Kaiser Redwood City Medical Center

Los Alamitos Medical Center

Marshall Medical Center

Mercy Medical Center Merced

Methodist Hospital of South CA

Oroville Hospital

PIH Health Hospital - Downey

Pioneers Memorial Healthcare District

Pioneers Memorial Hospital

Placentia Linda Hospital

Providence Holy Cross Medical Center

Providence Tarzana Medical Center

Queen of the Valley Medical Center

Rady Children’s Hospital - San Diego

Rancho Spring Medical Center

Regional Medical Center - San Jose

Ridgecrest Regional Hospital

San Joaquin General Hospital

San Ramon Regional Medical Center

Santa Clara Valley Health and Hospital System

Santa Teresa Community Hospital

Sherman Oaks Hospital

Sierra View District Hospital

St. Joseph Hospital

St. Mary Medical Center

St. Mary’s Medical Center

St. Rose Hospital

Sutter Amador Surgery Center

Sutter Solano Medical Center

UCSF Benioff Children’s Hospitals,

USC Verdugo Hills Hospital

Valley Children’s Hospital

COLORADO

Medical Center of Aurora

UCH - Memorial Hospital

Rose Medical Center

National Jewish/ SCL Saint Joseph Hospital

Medical Center of the Rockies

Porter Adventist Hospital

Saint Mary’s Hospital and Regional Medical Center

St. Anthony Hospital

University of Colorado Hospital Authority

Valley View Hospital

Lutheran Medical Center

North Colorado Medical Center

Parkview Medical Center

Penrose Hospital

Boulder Community Health

Parker Adventist Hospital

Platte Valley Medical Center

SCL Health Good Samaritan Medical Center

Swedish Medical Center

Castle Rock Adventist

Highlands Ranch Hospital

Littleton Adventist Hospital

Mercy Regional Medical Center

Sky Ridge Medical Center

St. Anthony North Health

St. Francis Medical Center

Avista Adventist Hospital

Community Hospital

Longmont United Hospital

McKee Medical Center

Poudre Valley Hospital

CONNECTICUT

Yale

DELAWARE

Christiana

Bayhealth

DISTRICT OF COLUMBIA

The George Washington

FLORIDA

AdventHealth

AdventHealth

Wesley

St. Joseph’s

AdventHealth

AdventHealth

Joseph’s

City..............

Baptist Hospital of Miami,

Bayfront Health

Saint Petersburg

HCA Florida Osceola Hospital..

Morton Plant Hospital...............

Mount Sinai Medical Center....

Physicians Regional HS

Pine Ridge..................................

Sarasota Memorial Hospital.....

UF Health

AdventHealth

AdventHealth

Ascension

Baptist

Broward

River

HCA Florida JFK Medical Hospital

HCA Florida Memorial

HCA Florida North Florida Hospital

HCA Florida West

Holy Cross Hospital........................

Jackson Memorial Hospital...........

Lakeland Regional Medical Center

Lee Health - HealthPark Medical Center

Naples Community Hospital

UF Health Shands

University of Miami Hospital and Clinics

Winter Haven Hospital...................

AdventHealth

AdventHealth

Ascension Sacred Heart

Ascension Sacred Heart

Cleveland Clinic

Cleveland Clinic

HCA

HCA

HCA

Orlando Health.....................................

ShorePoint

South Miami Hospital..........................

Tallahassee Memorial

Tampa General Hospital......................

Health

Wellington Regional

AdventHealth

Baptist Hospital..........................................

Bethesda Hospital,

Baptist Health South

Boca Raton Regional Hospital.................

Bravera

Delray Medical Center..............................

HCA Florida Bayonet Point Hospital......

HCA Florida Blake Hospital

HCA Florida Brandon Hospital................

HCA Florida Citrus Hospital.....................

HCA Florida Fawcett Hospital.................

HCA Florida Kendall Hospital..................

HCA Florida Lawnwood Hospital...........

HCA Florida Mercy Hospital....................

HCA Florida Ocala Hospital.....................

HCA Florida Westside Hospital..............

Holmes Regional Medical Center...........

Lakewood Ranch Medical Center............

Mayo Clinic..................................................

North Okaloosa Medical Center..............

Palm Beach Gardens Medical Center....

Palmetto General Hospital.......................

Rockledge Regional Medical Center.....

The Villages Regional Hospital................

Venice Regional Bayfront Health............

Advent Health New Smyrna Beach..............

AdventHealth Altamonte Springs...............

AdventHealth Apopka...................................

AdventHealth Deland.....................................

AdventHealth East Orlando..........................

AdventHealth Fish Memorial........................

AdventHealth Heart of Florida.....................

Ascension Sacred Heart on the Emerald Coast

Ascension St. Vincent’s Clay County...........

Ascension St.

HCA Florida Oak Hill

Jackson North

Jackson South

Lee Health

Lower Keys

Mease Countryside

Morton Plant

North Broward

Oviedo

Parrish

Physicians

Sebastian River

South Florida

South Miami

St.

St. Cloud

St.

St.

Wolfson

AdventHealth

Bayfront

Cape

Cleveland

Dr.

Good

HCA Florida Englewood

HCA Florida Highlands

HCA Florida Palms

HCA Florida Pasadena Hospital

HCA Florida Poinciana Hospital.........................

HCA Florida Putnam Hospital............................

HCA Florida Sarasota Doctors Hospital...........

HCA Florida South Shore Hospital....................

HCA Florida South Tampa Hospital..................

HCA Florida St. Lucie Hospital...........................

HCA Florida Trinity Hospital...............................

Heart and Rhythm

Jackson West Medical

Joe DiMaggio

Johns Hopkins

Children’s

Melbourne Regional Medical Center...............

Memorial Hospital

South Broward Hospital

Memorial Regional Hospital................................

Miami Children’s Health

Nemours Children’s Hospital.............................

North Shore Medical

Ocala

Palm Bay Hospital..................................................

Physicians Regional Medical Center

Santa

Sarasota

South Miami

GEORGIA

AU Medical

Piedmont

St. Joseph’s

Hamilton Medical

Medical Center

Memorial Health

Medical Center

Saint Francis - Emory

Piedmont Henry Hospital....................

Piedmont Hospital................................

Piedmont Newnan Hospital................

Wellstar Kennestone Regional Medical Center

Emory Saint Joseph’s Hospital

Atlanta

Emory University Hospital........................

Emory University Hospital Midtown......

Floyd Medical Center.................................

Northeast Georgia Health System

Northside Hospital - Gwinnett

Southern Regional Medical Center.........

Atlanta Medical Center..................................

Cartersville Medical Center...........................

Children’s Healthcare of Atlanta..................

Coliseum Medical Centers............................

East Georgia Regional Medical Center......

Eastside Medical Center................................

Grady Health System......................................

Houston Medical Center...............................

Memorial Satilla Health..................................

Piedmont Rockdale

Southeast Georgia Health

Spalding

Tanner Medical

Tanner Medical

Tift Regional Medical

Union General Hospital...................................

Wellstar Cobb Hospital..................................

WellStar North Fulton Hospital

Wellstar Paulding Hospital............................

WellStar West Georgia Medical Center.....

Adventist Health System

AdventHealth

Atlanta Medical Center

WEST

Coffee Regional Medical Center

Doctors Hospital - Augusta

East Georgia Regional Medical Center

Emory Decatur Hospital

Emory Johns Creek Hospital

Fairview Park Hospital

John D. Archbold Memorial Hospital

Meadows Regional Medical Center

Northeast Georgia Medical Center

Northside Hospital - Atlanta

Northside Hospital - Cherokee

Northside Hospital - Forsyth

Piedmont Columbus Regional

Piedmont Mountainside Hospital

Piedmont Walton Hospital

Polk Medical Center

Upson Regional Medical Center

Wellstar Douglas Hospital

HAWAII

Straub Medical Center

The Queen’s Medical Center

Pali Momi Medical Center

Hilo Medical Center

Kaiser Permanente

Medical Center

Maui Memorial Medical Center

North Hawaii Community Hospital

IDAHO

Saint Alphonsus Regional Medical Center

Portneuf Medical Center

St. Alphonsus Medical Center - Nampa

St. Luke’s

Eastern Idaho Regional Medical Center

Kootenai Health

St. Joseph Regional Medical Center

HCA - West Valley Medical

Idaho Falls Community Hospital

St. Luke’s Magic Valley Regional Medical Center

ILLINOIS

OSF HealthCare

Medical Center

Riverside Health Care

Loyola University Medical Center

Edward Hospital

Memorial Hospital Carbondale

OSF Saint Anthony Medical Center

Rush - Copley Hospital

AMITA Health Adventist

Medical Center Hinsdale

Northwestern Medicine McHenry Hospital

Springfield Memorial Hospital

Trinity Medical Center - Rock Island

University of Chicago Medical Center

AMITA Health Adventist Medical Center La Grange

AMITA Health Alexian Brothers Medical Center

AMITA Health Resurrection Medical Center Chicago

AMITA Health Saint Joseph Medical Center

Blessing Hospital

Carle BroMenn Medical Center

Highland Park Hospital

HSHS St. Elizabeth’s Hospital

NorthShore University Health System

Northwest

Hospital

OSF HealthCare Heart of Mary Medical Center

OSF Saint Joseph Medical Center

Protestant Memorial Medical Center

Rush University Medical Center

University of Illinois Medical Center at Chicago

Advocate Christ Medical Center

Advocate Good Samaritan Hospital

Advocate Illinois Masonic Medical Center

Advocate Lutheran General Hospital

Advocate Sherman Hospital

AMITA Health Adventist Medical Center GlenOaks

AMITA Health Mercy Medical Center

AMITA Health St. Mary’s Hospital

Carle Foundation Hospital

Elmhurst Memorial Healthcare

Good Samaritan Hospital

MacNeal Hospital

Memorial Hospital Shiloh

Northwestern Central DuPage Hospital

Northwestern Lake Forest Hospital

Northwestern Medicine Huntley Hospital

Northwestern Memorial Hospital

Palos Health

Prairie Heart Institute at St. John’s Hospital

Rush Oak Park Hospital

Silver Cross Hospital

UnityPoint Health Methodist

UnityPoint Health Methodist

West Suburban Medical Center

Advocate Condell Medical Center

Advocate Good Shepherd Hospital

AMITA Health Adventist Medical Center Bolingbrook

AMITA Health Saint Francis Hospital of Evanston

AMITA Health Saint Joseph Hospital

Chicago

AMITA Health Saint Joseph Hospital

AMITA Health Saints Mary and Elizabeth Medical Center

AMITA Health St. Alexius Medical Center

Anderson Hospital

Franciscan Health Olympia Fields

Genesis Medical Center, Silvis

Gottlieb Memorial Hospital

Heartland Regional Medical Center

Mercyhealth Javon Bea Hospital

Mount Sinai Hospital

Sarah Bush Lincoln Health Center

Advocate Children’s Hospital Oak

Advocate South Suburban Hospital

Advocate Trinity Hospital

Alton Memorial Hospital

FHN Memorial Hospital

Gateway Regional Medical Center

Glenbrook Hospital

Humboldt Park Health

Jersey Community Hospital District

John H. Stroger Jr Hospital of Cook County Hospital

Katherine Shaw Bethea Hospital

Lurie Children’s Hospital of Chicago

Northwestern Delnor Hospital

Northwestern Medicine Kishwaukee Hospital

Red Bud Regional Hospital

SSM Health Good Samaritan Hospital

- MT Vernon

St. Mary’s Hospital

Swedish Covenant Hospital

Vista Medical Center

INDIANA

Lutheran Hospital of Indiana

Indiana University Health Methodist Hospital

Parkview Heart Institute

Columbus Regional Hospital

Northwest Health

Deaconess Gateway Heart Hospital

Franciscan Health

Indiana University Health Arnett Hospital

Indiana University Health

Ball Memorial Hospital

Indiana University Health Bloomington

Ascension St. Vincent Evansville

Northwest Health

Saint Joseph Health System

Union Hospital

Ascension St. Vincent Heart Center

Ascension St. Vincent Hospital

Clark Memorial Hospital

Community Hospital

Deaconess Hospital

Elkhart General Hospital

Goshen Hospital

Indiana University Health North Hospital

Indiana University Health

Saxony Hospital

Indiana University Health West Hospital

Reid Health

Community Heart and Vascular Hospital

Dupont Hospital

Franciscan Health Crown

Franciscan Health Lafayette East

Kosciusko Community Hospital

Marion General Hospital

Memorial Hospital of South Bend

Methodist Hospital Southlake Campus

St. Mary Medical Center

Baptist Health Floyd

Franciscan Health Dyer

Franciscan Health Michigan City

Health and Hospital Corporation of Marion County

Hendricks Regional Health

Methodist Hospital Northlake Campus

Pinnacle Healthcare, LLC

St. Catherine Hospital

Community Hospital Anderson

Community Hospital East

Community Hospital South

Community Howard Regional Health

Franciscan Health - Hammond

Franciscan Health - Munster

Good Samaritan Heart Center

Hancock Memorial Hospital

Lutheran Downtown Hospital

Memorial Hospital and Health Care Center

Riley Hospital for Children

Indiana University Health

Riverview Health

Scott Memorial Hospital

St. Elizabeth

Terre Haute Regional Hospital

Union Hospital Clinton

Witham Health System

Woodlawn Hospital

IOWA

St. Luke’s Hospital

Allen Memorial Hospital

MercyOne North Iowa

MercyOne Siouxland Medical Center

Genesis Medical Center, Davenport

Iowa Methodist Medical Center

Mercy Iowa City

MercyOne Des Moines Medical Center

MercyOne Waterloo Medical Center

University of Iowa Hospitals and Clinics

The Finley Hospital

Trinity Medical Center - Bettendorf

Trinity Regional Medical Center

UnityPoint Health, St Luke’s Sioux City

Iowa Lutheran Hospital

MercyOne Dubuque Medical Center

Ottumwa Regional Health Center

CHI Health Mercy

Mercy Medical Center

MercyOne Clinton Medical Center

KANSAS

Advent Health

Shawnee Mission

Hays Medical Center

The University of Kansas Health System

Overland Park Regional Medical Center

Salina Regional Health Center

Stormont Vail Health

Olathe Medical Center

Providence Medical Center

University of KansasHealth System St. Francis Campus

Ascension Via Christi Hospitals in Wichita

Wesley Medical Center

Western Plains Medical Center

AdventHealth South Overland Park

Ascension Via Christi Hospital at Manhattan

Menorah Medical Center

Newman Regional Health

St. Catherine Hospital

St. Luke’s South Hospital

Via Christi Hospital -

Kansas Medical Center

Lawrence Memorial Hospital

Wesley Woodlawn Hospital

William Newton

KENTUCKY

Baptist Health Lexington

Baptist Health Paducah

Kings Daughters Medical Center

Jewish Hospital

Norton Audubon

Pikeville Medical Center

St. Joseph Hospital

Baptist Health Louisville

Saint Elizabeth Healthcare

Edgewood

and Awardees

Ephraim McDowell Regional

Medical Center

Medical Center at Bowling Green

Norton Hospital

Baptist Health Corbin

Mercy Health Lourdes Hospital

Saint Joseph East

Baptist Health Hardin

Harrison Memorial Hospital

Highlands ARH Regional Medical Center

Lake Cumberland Regional Hospital

Meadowview Regional Medical Center

Norton Brownsboro Hospital

Owensboro Health Regional Hospital

Saint Joseph London

St. Claire Regional Medical Center

T. J. Samson Community Hospital

Baptist Health Deaconess

Madisonville, Inc

Clark Regional Medical Center

Frankfort Regional Medical Center

Georgetown Community Hospital

Greenview Regional Hospital

Hazard ARH Regional Medical Center

Jackson Purchase Medical Center

Baptist Health Richmond

Bluegrass Community Hospital

Bourbon Community Hospital

CHI Saint Joseph Health System, St. Joseph Berea

Clark Regional Medical Center

Fleming County Hospital

Logan Memorial Hospital

Murray Calloway County Hospital

Norton Children’s Hospital

Norton Women’s & Children’s Hospital

Spring View Hospital

St. Mary & Elizabeth Hospital

Three Rivers Medical Center

University of Louisville Hospital

LOUISIANA

CHRISTUS St. Patrick Hospital

CHRISTUS St. Frances Cabrini Hospital

Ochsner Clinic Foundation

St. Tammany Health System

CHRISTUS Shreveport Bossier Health System

Ochsner - LSU Health Shreveport

Our Lady of The Lake Regional Medical Center

St. Francis Medical Center

Willis Knighton Medical Center

East Jefferson General Hospital

Ochsner Lafayette General Medical Center

Our Lady of Lourdes Heart Hospital

Terrebonne General Health System

Tulane University Hospital and

Lakeview Regional Medical Center, A Campus of Tulane

Ochsner - LSU Health

Shreveport Monroe Medical

Rapides Regional Medical Center

Baton Rouge General Medical

Glenwood Regional Medical Center

Lake Charles Memorial Hospital

North Oaks Medical Center

Our Lady of Lourdes Regional Medical Center

Touro Infirmary Medical Center

University Medical Center

Acadian Medical Center

Beauregard Memorial Hospital

Children’s Hospital of New Orleans

Cypress Pointe Surgical Hospital

Lane Regional Medical Center

Mercy Regional Medical Center

Minden Medical Center

Ochsner Baptist Medical Center

Ochsner Medical Center

Ochsner Medical Center

Ochsner Medical Center

Slidell Memorial Hospital and Medical Center

St. Bernard Parish Hospital

St. Charles Parish Hospital

West Calcasieu Cameron Hospital

West Jefferson Medical Center

Willis Knighton Bossier

Willis Knighton Pierremont

MAINE

Maine Medical Center

Central Maine Medical Center

Eastern Maine Medical Center

York Hospital

MARYLAND

Adventist Healthcare White Oak Medical Center

Johns Hopkins Hospital

Luminis Health Anne Arundel Medical Center

University of Maryland Medical Center Cardiology

UPMC Western Maryland

Adventist HealthCare Shady Grove Medical Center

MedStar Union Memorial Hospital

MedStar Southern Maryland Hospital Center

Sinai Hospital of Baltimore

Suburban Hospital

TidalHealth Peninsula Regional, Inc.

University of Maryland Saint Joseph Medical Center

Frederick Health Hospital

Holy Cross Hospital

Spring,

Howard County General Hospital

MedStar Franklin Square Medical Center

Carroll Hospital Center

Holy Cross Germantown Hospital

Johns Hopkins Bayview Medical Center

Meritus Medical Center

Saint Agnes Hospital

UM Baltimore Washington Medical Center

UM Upper Chesapeake Medical Center, Inc

University of Maryland Capital Region Medical Center

University of Maryland Shore

Regional Health

Walter Reed National Military Medical Center

MASSACHUSETTS

Lahey Hospital and Medical Center

Lawrence General Hospital

Baystate Medical Center

Brigham & Women’s Hospital

Cape Cod Hospital

Massachusetts General Hospital

Mount Auburn Hospital

Saint Vincent Hospital

Tufts Medical Center

UMASS Memorial Medical Center

Beth Israel Deaconess Medical Center

Boston Medical Center

Charlton Memorial Hospital

Lowell General Hospital

Mercy Hospital

St. Elizabeth’s Medical Center

Anna Jaques Hospital

Berkshire Medical Center, Inc

Milford Regional Medical Center

Beth Israel Deaconess Hospital Heart Plymouth, Inc.

Beverly Hospital

Boston Children’s Hospital

Caritas Holy Family Hospital

Cooley Dickinson Hospital

Good Samaritan Medical Center

Melrose - Wakefield Hospital

MetroWest Medical Center

North Shore Medical Center-

Saint Anne’s Hospital

Signature Healthcare Brockton Hospital

South Shore Health System

UMass Memorial Medical Center

MICHIGAN

Spectrum Health

UP Health System

Heart Marquette

Edward W. Sparrow

Hospital Assoc

Mercy Health

MidMichigan Medical Center

Heart Midland

St. Joseph Mercy Oakland

Trinity Health St. Joseph Mercy

Ann Arbor

Ascension Genesys Hospital

Ascension Health

Ascension Providence Hospital

Southfield

Ascension St. John Hospital

Borgess Medical Center

Henry Ford Macomb Hospital

Lakeland HealthCare

McLaren Bay Region

McLaren Flint

McLaren Greater Lansing

McLaren Macomb

McLaren Northern Michigan

Michigan Medicine

Spectrum Health

Butterworth Hospital

Beaumont Hospital, Dearborn

Beaumont Hospital, Royal Oak

Bronson Methodist Hospital

Covenant Healthcare

Harper University Hospital

Henry Ford Health

Henry Ford Jackson Hospital

Holland Hospital

McLaren Port Huron Hospital

Munson Medical Center

Ascension Macomb - Oakland Hospital

Ascension Providence Hospital Novi

Ascension Providence Rochester Hospital

Beaumont Hospital, Troy

Garden City Hospital

McLaren Oakland

Mercy Health Saint Mary’s

Saint Mary Mercy Hospital

Beaumont Hospital, Farmington Hills

Beaumont Hospital, Grosse Pointe

Beaumont Hospital, Trenton

Beaumont Hospital, Wayne

DMC Sinai - Grace Hospital

Henry Ford Health System West Bloomfield

Henry Ford Wyandotte Hospital

Hurley Medical Center

Huron Valley Sinai Hospital

Lake Huron Medical Center

McLaren Central Michigan

McLaren Thumb Region

Monroe Regional Hospital

Promedica Monroe Regional Hospital

University of Michigan Health - West

UP Health System - Bell Hospital

UP Health System - Portage

Wayne State University

Heart Children’s Hospital

MINNESOTA

CentraCare Heart & Vascular Center

Essentia Health - St. Mary’s Medical Center

University of Minnesota Health, Heart Care - Minneapolis

Allina Health Minneapolis

Heart Institute - Minneapolis

Allina Health Minneapolis

Heart Institute - Saint

Mayo Clinic Hospital

Saint Mary’s Campus

Mercy Hospital part

North Memorial Health

St. Joseph’s Hospital

St. Luke’s Hospital

University of Minnesota Health, Heart Care - Edina

Park Nicollet Methodist Hospital

Regions Hospital

Sanford Bemidji Medical Center

Essentia Health - St. Joseph’s

Hennepin County Medical Center

Children’s Minnesota

Mayo Clinic Health System

Ridgeview Medical Center

St. John’s Hospital

University of Minnesota Health, Heart Care - Burnsville

MISSISSIPPI

Baptist Memorial Hospital

- Desoto

Mississippi Baptist Medical Center

Baptist Memorial Hospital

- Golden Triangle

Merit Health Wesley Medical Center

Forrest General Hospital

Baptist Memorial Hospital

North Mississippi

North Mississippi Medical Center

Ocean Springs Hospital

St. Dominic - Jackson Memorial Hospital

University of Mississippi Medical Center

Magnolia Regional Health Center

Southwest MS Regional Medical Center

Anderson Regional Medical Center

Memorial Health System

Merit Health River Region

Methodist Healthcare

- Olive Branch Hospital

Pascagoula Hospital

Baptist Memorial Hospital

- North Mississippi

Delta Regional Medical Center

Merit Health System

River Oaks Hospital

Rush Foundation Hospital

Singing River Gulfport

Bolivar Medical Center

Merit Health - Biloxi

Merit Health Natchez

MISSOURI

Barnes Jewish Hospital/ Washington University

Heartland Regional Medical Center

Research Medical Center

North Kansas City Hospital

Saint Francis Medical Center

Centerpoint Medical Center

Freeman Health System

Liberty Hospital

Mercy Hospital Joplin

Mercy Hospital Springfield

Mercy Hospital St. Louis

Poplar Bluff Regional Medical Center

Saint Luke’s Hospital of Kansas City

Southeast Missouri Hospital

University of Missouri Hospital and Clinics

Boone Hospital Center

Christian Hospital BJC Healthcare

Cox Medical Center Branson

Cox Medical Center South

Mercy Hospital South

SSM Health Saint Louis University Hospital

St. Luke’s Hospital

Carondelet Heart Institute at St. Joseph Medical Center

Hannibal Regional Hospital

Lee’s Summit Medical Center

Missouri Baptist Medical Center

SSM Health DePaul Hospital - St. Louis

St. Mary’s Medical Center

Truman Medical Centers

Capital Region Medical Center

Children’s Mercy Kansas City

Citizens Memorial Hospital

Mercy Hospital Jefferson

Mercy Hospital Washington East Community

Northeast Regional Medical Center

Saint Luke’s East Hospital

Saint Luke’s Northland Hospital

SSM Health - St Marys Hospital Jefferson City

SSM Health St. Clare Hospital -

SSM Health St. Mary’s Hospital -

and Awardees

Moberly Regional Medical Center

Ozarks Healthcare

Phelps County Regional Medical Center

Progress West Healthcare

SSM Cardinal Glennon Children’s Medical

St. Louis Children’s Hospital

MONTANA

Billings Clinic

St. Vincent Healthcare

Logan Health

Community Medical Center

Providence St. Patrick Hospital

Bozeman Health

St. James Health Care

Benefis Hospitals

NEBRASKA

Bryan Medical Center

Nebraska Medicine

CHI Health CUMC - Bergan Mercy

CHI Health Nebraska Heart

Faith Regional Health Services

Kearney Regional Medical Center

Nebraska Methodist Hospital

Bellevue Medical Center

Great Plains Health

Mary Lanning Healthcare

CHI Health Good Samaritan

CHI Health Immanuel

CHI Health Lakeside

CHI Health St. Francis

Children’s Hospital and Medical Center

NEVADA

Saint Mary’s Regional Medical Center

Renown Regional Medical Center

University Medical Center of Southern Nevada

Dignity Health St. Rose Dominican Siena

MountainView Hospital

Dignity Health St. Rose Dominican

San Martin

North Vista Hospital

Northeastern Nevada

Regional Hospital

Sunrise Hospital and Medical Center

Desert Springs Hospital

Northern Nevada Medical Center

Spring Valley Hospital

Carson Tahoe Regional Medical Center

Centennial Hills Hospital Medical Center

Henderson Hospital

Renown South Meadows Medical Center

Southern Hills Hospital

Louis

SSM St. Joseph Hospital - St. Charles

SSM St. Joseph Hospital West

St. Luke’s

Peres Hospital

Barnes Jewish St. Peters Hospital

Belton Regional Medical Center

Bothwell Regional Health Center

Heart Care Center, LLC

Lake

System

Summerlin Hospital Medical Center

Valley Hospital Medical Center

NEW HAMPSHIRE

Catholic Medical Center

Portsmouth Regional Hospital

Concord Hospital

Dartmouth Hitchcock Medical Center

Exeter Hospital

Parkland Medical Center

Southern New Hampshire Medical

St. Joseph Hospital

Elliot Hospital

Wentworth - Douglass

NEW JERSEY

Jersey Shore University Medical Center

JFK Medical Center

Englewood Health

Hackensack Meridian Health Network

Ocean Medical Center

Riverview Medical Center

Cooper University Health System

Deborah Heart & Lung Center

Morristown Medical Center

Newark Beth Israel Medical Center

St. Francis Medical Center

The Valley Hospital

AtlantiCare Regional Medical Center

Bayshore Community Hospital

Cooperman Barnabas Medical Center, Inc.

Robert Wood Johnson University Hospital

Southern Ocean Medical Center

Virtua Our Lady of Lourdes

Capital Health Medical Center - Hopewell

St. Joseph’s Health

University Hospital

Clara Maass Medical Center

Inspira Medical Center -

Inspira Medical Center

Jersey City Medical Center

Raritan Bay Medical Center

St. Michael’s Medical Center

Bayonne Medical Center

Centrastate Medical Center

CentraState Medical Center

Chilton Medical Center

Christ Hospital

Community Medical Center

Hackettstown Medical Center

Holy Name Medical Center

Hunterdon Healthcare System

Jefferson Washington Township Hospital

Monmouth Medical Center

Mountainside Medical Center

Newton Medical Center

Overlook Medical Center

Princeton Medical Center

Robert Wood Johnson University Hospital

- Hamilton

Robert Wood Johnson University Hospital - Rahway

Robert Wood Johnson University Hospital - Somerset

Saint Clare’s Hospital

Saint Peter’s University Hospital

Shore Medical Center

St. Luke’s Warren Campus

St. Mary’s General Hospital

Trinitas Regional Medical Center

Virtua Health Inc.

Virtua Memorial Hospital

Virtua Our Lady of Lourdes

NEW MEXICO

Presbyterian Healthcare Services

San Juan Regional Medical Center

Lovelace Medical Center

Memorial Medical Center

Mountain View Regional Medical Center

University of New Mexico Hospital

Carlsbad Medical Center

Eastern New Mexico Medical Center

Gerald Champion Regional Medical

Christus St. Vincent Regional Medical

Los Alamos Medical Center

NEW YORK

UR Medicine Strong Memorial Hospital

St. Elizabeth Medical Center

The Mount Sinai Medical Center

Bellevue Hospital Center

Mount Sinai St. Luke’s

New York Presbyterian - Queens

St. Joseph’s Hospital

Stony Brook University Hospital

Westchester County Health Care Corp

New York Presbyterian - Weill Cornell Medical Center

St. Peter’s Hospital

Vassar Brothers Medical

Albany Medical Center Hospital

Bassett Medical Center

Good Samaritan Hospital

Good Samaritan Hospital Medical Center

Jamaica Hospital Medical

Mercy Hospital of Buffalo

Montefiore Medical Center

New York Presbyterian

- Brooklyn Methodist Hospital

New York Presbyterian

- Columbia University Irving

NYU Langone Health - Tisch Hospital

St. Francis Hospital and Heart Center

Upstate Medical University

Arnot Ogden Medical Center

Bronx Care Health System

Cayuga Medical Center at Ithaca

Ellis Hospital

Gates Vascular Institute

Maimonides Medical Center Division of Cardiology

New York Presbyterian

- Lawrence Hospital

Northwell Health Lenox Hill Hospital

Northwell Health North Shore

University Hospital

Northwell Health Southside Hospital

Northwell Health Staten Island Hospital

NYU Langone Hospital - Long Island

Richmond University Medical Center

Rochester Regional Health System

UPMC Chautauqua

Wyckoff Heights Medical Center

Cohen Children’s Medical Center

Garnet Health

Glens Falls Hospital

Montefiore St Lukes’s Cornwall

Mount Sinai Beth Israel

Mount Sinai South Nassau Hospital

New York Presbyterian - Hudson Valley Hospital

Northwell Health Long Island

Jewish Hospital

Olean General Hospital

Stony Brook Southampton Hospital

The Brooklyn Hospital Center

United Health Services Hospitals/ Wilson Regional

Brookdale Hospital & Medical Center

Crouse Hospital

HealthAlliance Hospital - Broadway Campus

Jacobi Medical Center

John T. Mather Hospital

Long Island Community Hospital

Montefiore Nyack Hospital

New York Presbyterian

- Morgan Stanley Children’s

Niagara Falls Memorial Medical Center

Northern Westchester Hospital

Northwell Health Huntington Hospital

NYU Langone Hospital - Brooklyn

Peconic Bay Medical Center

Rochester Regional Health

Samaritan Hospital

Saratoga Hospital

SBH Health System

St. Catherine of Siena

UVM Health Network

White Plains Hospital

NORTH CAROLINA

CarolinaEast

Medical Center

New Hanover Regional Medical Center

UNC Medical Center

Frye Regional Medical Center

Duke University Hospital

Atrium Health’s Carolinas Medical Center

Cape Fear Valley Health System

Moses H. Cone

Memorial Hospital

Novant Health Forsyth Medical Center

Novant Health Presbyterian Medical Center

Rex Hospital

Wake Forest Baptist Health

WakeMed Raleigh Campus

Atrium Health Cabarrus

CaroMont Regional Medical Center

UNC Health Southeastern

Vidant Medical Center

Alamance Regional Medical Center

Atrium Health Wake Forest Baptist High Point

Duke Raleigh Hospital

Duke Regional Hospital

Haywood Regional Medical Center

Nash UNC Healthcare

Sentara Albemarle Medical Center

WakeMed Cary Hospital

Atrium Health Pineville

Catawba Valley Medical Center

Central Carolina LifePoint Health

FirstHealth Moore Regional Hospital

Johnston UNC Health Care

Mission Hospital, Inc.

Novant Health Huntersville Medical Center

Novant Health Matthews Medical Center

Pardee Hospital

Watauga Medical Center

Wayne UNC Healthcare

Wilson Medical Center

Davis Regional Medical Center

Harris Regional Hospital

Iredell Memorial Hospital

Lake Norman Regional Medical

Margaret R. Pardee Memorial Hospital

Maria Parham Health

Novant Health Rowan Medical Center

Atrium Health Union

Betsy Johnson Hospital

Caldwell Memorial Hospital

Carteret Health Care

Central Harnett Hospital

DLP Cardiac Partners LLC/BRC

Halifax Regional Medical Center

Johnston Health Clayton

Person Memorial Hospital

Rutherford Regional Health System

Scotland Healthcare System

Swain County Hospital

NORTH DAKOTA

Sanford Medical Center

Bismarck

Sanford Medical Center

Altru Health System

Essentia Health -

Trinity Hospitals

OHIO

Health

Summa Health System

- Akron Campus

Hillcrest Hospital

ProMedica Toledo Hospital

Southwest General Health Center

Aultman Hospital

Fairview Hospital

University Hospitals Cleveland Medical Center

Adena Regional Medical Center

Bethesda Hospital

Cleveland Clinic

Cleveland Clinic Mercy Hospital

Firelands Regional Medical Center

Kettering Health Hamilton

Kettering Health Main Campus

The MetroHealth System

The University of Toledo Medical Center

Trinity Medical Center West

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While the wellness of all health care providers has always been a primary focus of the American College of Cardiology (ACC), the unprecedented challenges over the last several years have underscored the importance of the well-being of all clinicians.

Find resources and tools to incorporate wellness into your professional and personal lives on ACC’s Clinician Well-Being Portal.

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THE HEART OF QUALITY PATIENT CARE

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Lander

culating eGFR in patients, opting to adopt the algorithm en dorsed by the National Kidney Foundation. She notes there also has been a broader push among clinicians in recent years to consider the impact of social drivers like income, housing status, and access to food and transportation on patients of color when making clinical assessments.

“I think a lot of times when we’re measuring race we’re actually measuring racism, both structurally and interper sonally,” Saunders says.

Much of the recent attention to ward removing race in clinical as sessments began with the publica tion of that 2020 article in the New England Journal of Medicine, which listed about a dozen tools providers use when assessing everything from lung function to a patient’s risk of dying in the hospital from heart fail ure. Such tools could lead to issues such as nonwhite patients experienc ing delays in care that white patients don’t face, the article notes.

“Many of these race-adjusted algo rithms guide decisions in ways that may direct more attention or resourc es to white patients than to members of racial and ethnic minorities,” wrote the authors, from Massachusetts General Hospital, Harvard Medical School and NYU Langone Health. “If doctors and clinical educators rigor ously analyze algorithms that include race correction, they can judge, with fresh eyes, whether the use of race or ethnicity is appropriate.”

No simple solution. A study pub lished in May 2021 by the American Journal of Obstetrics and Gynecol ogy introduced an updated model that does not factor in race when es timating whether women will have a successful vaginal birth after cesarean section, or VBAC. By lowering the estimated chance of success for women of color, a previous version of the VBAC calculator – a tool singled out in the NEJM piece – could push them toward a C-section, which is a major surgical procedure many maternal health experts believe is performed too often.

says Dr. Malika Fair, senior director of equity and social accountability for the Association of American Medical Colleges. “Their intent when they were being used sometimes was to identify health inequities.”

Fair says unilaterally removing race from every algorithm is a feasible approach, but fails to answer whether doing so would make things better or worse for patients. “We have to take the time to figure that out so that we don’t end up inadvertently creating more racial health inequities when we remove race from the equation,” Fair says.

Notably, a 2021 study published in The Lancet Oncology found that re moving race from an eGFR equation could undercut cancer treatment in Black patients.

We’re at a pivotal time to create change.

Spurring change. Dr. Megan Mahoney, chief of staff for Stanford Health Care and a professor of medi cine at Stanford University, says pro fessional medical societies can play a huge part in providing and promot ing guidance on alternatives that cli nicians can use to assess disease risk without factoring in race. Yet much of the action taken thus far has been led by individual hospitals and health systems, which have made policy deci sions after deliberation and consider ation by their own experts.

Mahoney says medical societies can streamline the decision process for hospitals by serving as a trusted arbiter to review the evidence and pro vide guidance that most will accept.

“A particular health care system can do it, it’s just that it’s going to be harder to get buy-in from those who are actually implementing the change – the physicians on the front line – without the professional societies backing them,” Mahoney says.

On the other hand, adjusting for race in some cases may have benefits if it results in minority groups potentially receiving more consideration. For example, race adjustment within an atherosclerotic cardiovascular disease risk estimator – which gauges the risk of having an event like a stroke and helps clini cians determine when to start patients on cholesterol-lowering medication – can automatically classify patients who identify as Black as being at higher risk than white patients, making earlier detection and intervention more likely for Black patients.

“Using race in these clinical algorithms hasn’t been all bad,”

She agrees it’s important to identify the root causes of health disparities that have led to differences in risk outcomes. But Mahoney fears leaving race-based algorithms in place could reinforce concepts that tie race to biology, and could have long-term social and clinical ramifications.

“The perpetuation of race as a biological factor both in medical education and in medicine in gen eral: The risk of that far outweighs that minor benefit some racial groups might be getting from the current state,” Mahoney says. “We are really putting our medi cal students and a whole generation of trainees at a disadvantage when the concept of biological race is reinforced in their training.”

A

Safe

Consider

by Lisa Esposito

WHEN YOU’RE preg nant, deciding where to have your baby is a practical and per sonal matter, an edu cated and emotional choice. Asking ques tions and doing your own research in ad vance helps you make an informed decision – one you feel comfortable with – about where you want to give birth.

Where you deliver your baby is closely tied to your maternity care provider, of course. “People are usually going to make that decision based on their first finding a physician or midwife they feel that they connect with,” says Dr. Jennifer Frink, an OB-GYN and medical director of the women’s health service line at Ascension Michigan, who practices out of Ascension Borgess Hospital in Kalamazoo.

Shared decision-making is an impor tant health care approach, Frink says. “You want your providers – physician or midwife – and the hospital to embrace this philosophy,” she says. “Your concerns, your fears, your wants and hopes about how the labor experience goes – you want all those components to be heard and val ued by the care team that’s working with you. By the same token, you want to have a team of professionals that, once they listen to those things, are going to give you some options that are medically ap propriate for you.”

Checking each hospital’s quality data can help ensure the best outcomes for you and your baby. Knowing what you want in terms of labor and delivery options helps you and your doctor shape an individual birth plan. Strong support – from breastfeeding guidance to having your partner at your side – makes a huge difference in this unique, unforgettable experience.

Key quality metrics

Public data on maternal and fetal outcomes is increasingly available from indi vidual maternity hospitals and statewide websites. If you can’t find it, ask. The U.S. News ratings of Best Hospitals for Maternity Care can help; see Page 83 for high-performing hospitals and usnews.com/bestmaternityhospitals for more information. The following indicators can help you compare facilities: C-section rate. Vaginal deliveries, when possible, are associated with fewer risks and better outcomes than cesarean sections. To gauge hospital quality in general, ask or search online for C-section rates. Data shows that a facility, not just individual physicians, drives C-section rates, says Dr. Holly Loudon, an

OB-GYN and chair of the department of obstetrics, gynecology and reproductive science at Mount Sinai West and Mount Sinai Morningside in New York City. “It’s really important to look at that C-section rate and compare it with other hospitals in the region when you’re choosing where you want to deliver,” Loudon says. High-risk academic centers often have a higher Csection rate because they have more highrisk deliveries and multiple births.

VBAC rate. In the past, it was almost as sumed that women who delivered their first babies by C-section would deliver any subse quent babies by C-section, as well. However, a vaginal birth is possible in many cases. Two similar terms are used for this option. TOLAC, or “trial of labor after cesarean,” and VBAC, which means “vaginal birth after cesarean,” and implies success.

An uncommon but possible complica tion is when the scar on the uterus from the previous C-section separates during the vaginal birth attempt, known as uter ine rupture, which is a medical emergency. Women interested in VBAC receive coun seling from their doctors to weigh the risks and benefits.

NTSV C-section rate. This is the C-sec tion rate for first time mothers with lowrisk pregnancies; it stands for “nulliparous, term, singleton, vertex.” In other words, these women aren’t having a multiple birth like twins or triplets, aren’t delivering pre maturely and their baby is not in a breech or other higher-risk position during birth – yet they’re undergoing cesarean sections.

Early elective delivery rate. When C-sections are scheduled (or labor is in duced) before 39 weeks of gestation – with out medical necessity – it’s known as early elective delivery. A high rate is considered a red flag in terms of maternity hospital quality. “We know that babies that are born before 39 weeks ‘just because’ don’t do as well as babies that are allowed to deliver when their moms go into labor naturally,” Frink says. “We also know that people who have inductions before 39 weeks ‘just be cause’ tend to have a higher risk of ending up with a C-section.”

Early deliveries aren’t always avoidable,

she notes. But there are pretty strict criteria about when that’s the case.

Episiotomy rate. An episiotomy is a surgical cut made to the vagina during childbirth. Routine use of episiotomy is not recommended, except when indicated in certain clinical situations. “Episiotomies have become something that used to be done routinely and now are very rarely needed,” Loudon says.

Questions for your team

Items to address about your maternity care include:

l Does the facility have maternal-fetal medicine spe

labor positions involving leaning or sitting on the ball. Birthing tubs can make movement more comfortable during labor and may enable water births for low-risk, single, full-term pregnancies.

l Can you have at least one support person with you? If you’re hav ing a doula at your birth, make sure that person doesn’t “count” as the single support person.

l Will you have induced labor? What goes into that decision? Cer tain pregnancy complications or medical conditions may make inducing labor safer, rather than waiting for contractions to start.

l Does your facility offer VBAC/TOLAC? If you’re interested in VBAC, ask if the facility allows it. Because trying to have a VBAC comes with the remote risk of uterine rupture, a hospital must be equipped to quickly respond. “The risk is less than 1% for an average patient undergoing a trial of labor,” Cormano says. “But it can be a very dangerous outcome. It requires an emer gency C-section. It requires being in a setting where people can respond within seconds.”

l Do you offer gentle C-section? “We’re doing more with what some people are calling ‘gen tle cesareans’ or ‘family-centered cesareans,’ where we use clear drapes so you can see your baby right after they’re born through a clear drape,” Loudon says. “And then have imme diate skin-to-skin contact and even breastfeeding right away.”

l Is delayed cord clamping available? That al lows extra time for nutrient-rich blood in the placenta and cord to flow to the baby.

If your pregnancy is considered high risk, you might also want to know if the hospital

Your concerns, fears and wants should be valued by your care team.

cialists or perinatologists? For women in a high-risk category, this is pertinent information.

l Is there the option for laboring with a midwife or doula? When hospitals have these support components, C-section rates are reduced, notes Dr. Julia Cormano, an OB-GYN and assistant professor of obstetrics, gynecolo gy and reproductive sciences with UC San Diego Health.

l Is group prenatal care an option? Programs like Cen teringPregnancy allow expectant mothers at similar pregnancy stages to receive prenatal education and social support in a group setting. Emerging research suggests that group prenatal care is associated with a lower risk of having a preterm birth or a baby with a low birth weight.

l What pain-control options are offered, including and beyond epidurals? What labor positions can you deliver in? Can you walk around? Are birthing balls or birth ing tubs available? Birthing balls can enable alternative

has a neonatal intensive care unit and if an anesthesiologist and pediatrician are available around the clock. How often can you see your baby in the NICU? Some hospitals offer parents tech options like real-time video access to their newborns. If your baby unex pectedly is in need of NICU care, and the hospital does not have a NICU, where does the baby get transferred to?

Breastfeeding support

Breastfeeding is shown to be optimal for babies, but it’s definitely a learning experience for new mothers. Ask about international board-certified lactation consultants on staff.

You can also look for Baby-Friendly facilities. Baby-Friendly hospitals and birthing centers are designated as such for their high standards in supporting and enabling breastfeeding as soon as possible after birth. Rooming-in for healthy babies and mothers, and maternity staff that’s fully trained in breastfeeding care and problem-solving for feeding difficulties, make continued breast feeding more likely when families go home. l

Best Hospitals for Maternity Care

by Ben Harder and Min Hee Seo

HILDBIRTH is often a joyous event. And the hospital where a pregnant patient delivers can play a big role in mak ing it a positive experience. When it comes to ma ternity care for uncomplicated pregnancies, the best hospitals achieve safe outcomes, offer sound care without performing unnecessary inter ventions and support patients who choose to breastfeed. The hospitals listed here excel in these respects. To identify them, we surveyed maternity centers across the nation and obtained detailed data from nearly 600. For example, we collected stats on each hospital’s rate of cesarean section.

Reducing risks. C-section, one of the oldest medical pro cedures known to humanity, can be lifesaving. But like all surgeries, it has risks, including potentially dangerous blood loss, and it’s costlier and has a longer recovery time than vaginal delivery. C-section also is linked with long-term problems in the newborn, such as higher rates of asthma and allergies. There are long-term risks for the mother, too – and for any future children. Internal scarring from the operation can, in subsequent preg nancies, lead to placenta accreta, a dangerous condition. For these rea sons, experts discourage unnecessary C-sections. Our methodology rewards hospitals for achieving low C-section rates; this measure counted for 30% of each hospital’s overall score.

Experts also advise against induc ing labor or performing a C-section

if a patient is more than a week away from her due date, unless there’s a compelling medi cal reason for initiating an early elective delivery. Our methodology checks whether a hospital has a reasonable early elective delivery rate of 5% or less. This measure counted for one-tenth of each hospital’s over all score.

While labor and delivery usually end well, com plications can occur. Most have no lasting consequences. But no parent wants to see their helpless newborn whisked away to a neonatal intensive care unit. We collected data on each hospital’s rate of newborn complications, both moderate and severe, and weighed it at 25%.

Breastfeeding has benefits for a baby, including a stronger immune system. That’s why experts encourage new parents to feed breast milk if possible. But hospitals don’t always re inforce that message – or give patients the support they need to lactate and nurse. Each hospital’s success in encouraging and supporting breastfeeding counted for 25%.

The last 10% of the methodology rewarded hospitals that routinely offer vaginal birth after cesarean, or VBAC, to women who have had a previous C-section and want to avoid having another one.

The tables that follow also display the availability of several features that may interest you but that don’t factor into the methodology, such as whether a hospital welcomes partners to stay overnight. For more, check out usnews.com/bestmaternityhospitals.

ALABAMA

Thomas Hospital, Fairhope 18.4% 2% 4.1% 58.3% Yes No No - Yes Yes

ARIZONA

Banner Casa Grande Medical Center, Casa Grande 21.8% 0% 1.8% 14.4% Yes No No No Yes Yes

Banner Del E. Webb Medical Center, Sun City West 15.9% 0% 2.1% 55.6% Yes Yes Yes No Yes Yes

Banner Desert Medical Center, Mesa 18.5% 0% 1.7% 51.6% Yes Yes Yes Yes Yes Yes

Banner Estrella Medical Center, Phoenix 16.7% 1% 2.2% 43.9% Yes Yes Yes Yes Yes Yes

Banner Gateway Medical Center, Gilbert 19.9% 3% 1.5% 40.6% Yes No Yes Yes Yes Yes

Banner Ironwood Medical Center, San Tan Valley 11.2% 0% 2.1% 52.0% Yes Yes Yes No Yes Yes

Banner Thunderbird Medical Center, Glendale 24.1% 1% 1.2% 43.1% Yes No Yes Yes Yes Yes

Banner-University Medical Center Phoenix 17.8% 0% 2.7% 39.2% Yes Yes Yes Yes Yes Yes

TMC Healthcare-Tucson 20.5% 4% 1.8% 44.9% Yes Yes Yes Yes Yes Yes

CALIFORNIA

Emanate Health Queen of The Valley Hospital, West Covina 21.6% 1% 2.4% 35.9% Yes No No Yes Yes Yes

Hoag Memorial Hospital Presbyterian, Newport Beach 25.9% 3% 1.6% 57.2% Yes Yes Yes Yes Yes Yes Huntington Hospital, Pasadena 22.2% 0% 2.3% 42.2% Yes No No Yes Yes Yes

Kaiser Permanente Anaheim and Irvine Med. Centers, Anaheim 22.7% 0% 1.5% 67.1% Yes Yes No Yes Yes Yes

Kaiser Permanente Baldwin Park Medical Center, Baldwin Park 22.3% 1% 1.0% 71.1% Yes - - Yes - Kaiser Permanente Downey Medical Center, Downey 21.5% 0% 2.7% 60.8% Yes Yes No Yes Yes Yes

Kaiser Permanente Fontana and Ontario Med. Centers, Fontana 20.0% 0% 2.1% 58.0% Yes Yes No Yes Yes Yes

Kaiser Permanente Los Angeles Medical Center 22.3% 0% 2.2% 53.1% Yes Yes Yes Yes Yes Yes

Kaiser Permanente Moreno Valley Medical Ctr., Moreno Valley 22.0% 0% 4.2% 70.3% Yes Yes No Yes Yes Yes

Kaiser Permanente Panorama City Medical Ctr., Panorama City 16.6% 0% 2.3% 58.1% Yes Yes No Yes Yes Yes

Kaiser Permanente Riverside Medical Center, Riverside 21.6% 1% 1.8% 68.9% Yes Yes No Yes Yes Yes

Kaiser Permanente San Diego Zion and San Diego Med. Ctr. 22.5% 0% 2.9% 60.9% Yes Yes No Yes Yes Yes

Kaiser Permanente South Bay Medical Center, Harbor City 20.6% 1% 2.5% 65.1% Yes Yes No Yes Yes Yes

Kaiser Permanente Woodland Hills Med. Ctr., Woodland Hills 25.0% 0% 2.0% 65.9% Yes Yes - No Yes Yes

Kaweah Health Medical Center, Visalia 24.7% 1% 1.4% 50.9% Yes Yes No No Yes Yes

Loma Linda University Children’s Hospital, Loma Linda 18.5% 0% 4.0% 58.1% Yes No No Yes Yes Yes

Loma Linda University Medical Center-Murrieta 20.7% 0% 4.3% 70.4% Yes Yes No Yes Yes Yes

Lucile Packard Children’s Hospital Stanford, Palo Alto 21.9% 0% 2.9% 65.5% Yes Yes No Yes Yes Yes

MemorialCare Miller Children’s & Women’s Hosp. Long Beach 23.7% 0% 2.8% 51.3% Yes No No Yes Yes Yes MemorialCare Orange Coast Medical Center, Fountain Valley 24.8% 4% 1.8% 56.4% Yes - - Yes - MemorialCare Saddleback Medical Center, Laguna Hills 23.2% 10% 1.3% 54.4% Yes - - Yes - NorthBay Medical Center, Fairfield 24.2% 0% 0.9% 75.5% Yes No No Yes Yes Yes Palomar Medical Center Escondido 17.8% 0% 3.5% 59.8% Yes No No No Yes Yes

Palomar Medical Center Poway 20.1% 0% 1.2% 78.9% Yes No Yes Yes Yes Yes Providence St. Jude Medical Center, Fullerton 20.9% 0% 2.0% 49.5% Yes No Yes Yes Yes Yes Redlands Community Hospital, Redlands 20.5% 3% 2.6% 75.1% Yes No No Yes Yes Yes

Salinas Valley Memorial Healthcare System, Salinas 23.6% 0% 1.3% 61.0% Yes No No Yes Yes Yes

Santa Clara Valley Medical Center, San Jose

Sharp Chula Vista Medical Center, Chula Vista

Stanford Health Care-ValleyCare, Pleasanton

COLORADO continued

SCL Health Saint Joseph Hospital,

SCL Health St. Mary’s Medical Center, Grand Junction

UCHealth Longs Peak Hospital, Longmont

UCHealth Medical Center of the Rockies, Loveland

UCHealth Memorial Hospital, Colorado Springs

UCHealth Poudre Valley Hospital, Fort Collins

UCHealth University of Colorado Hospital, Aurora

UCHealth Yampa Valley Medical Center, Steamboat Springs

CONNECTICUT

Hospital of Central Connecticut, New Britain

William W. Backus Hospital, Norwich

FLORIDA

Ascension Sacred Heart Pensacola Hospital, Pensacola

Ascension St. Vincent’s Clay County, Middleburg 15.9%

Ascension St. Vincent’s Southside Hospital, Jacksonville 16.1%

Baptist Medical Center Beaches, Jacksonville Beach 18.3%

Lakeland Regional Health Medical Center, Lakeland 22.5%

NCH Baker Hospital, Naples 19.9%

Sarasota Memorial Hospital, Sarasota 23.5%

UF Health Shands Hospital, Gainesville 24.7%

IDAHO

2.1%

1.1% 46.5%

2.3% 32.3%

1.6% 69.3%

St. Alphonsus Regional Medical Center, Boise 19.8% 0% 3.2% 62.7%

St. Luke’s Magic Valley Medical Center, Twin Falls 26.5% 1% 1.9% 55.7%

St. Luke’s Nampa Hospital, Nampa 20.7% 1% 2.3% 72.6%

St. Luke’s Regional Medical Center, Boise 24.1% 3% 2.4% 72.1%

ILLINOIS

Advocate Christ Medical Center, Oak Lawn 26.2% 0% 1.7% 35.8% Yes Yes No Yes Yes Yes

Advocate Condell Medical Center, Libertyville 26.0% 0% 2.3% 64.4% Yes No Yes No Yes Yes

Advocate Good Samaritan Hospital, Downers Grove 26.2% 0% 1.9% 39.9% Yes No No Yes Yes Yes

Advocate Good Shepherd Hospital, Barrington 23.8% 0% 1.4% 70.8% Yes No No No Yes Yes

Advocate Illinois Masonic Medical Center, Chicago 23.2% 3% 2.4% 65.0%

Advocate Lutheran General Hospital, Park Ridge 25.6% 0% 1.6% 48.0%

Advocate Sherman Hospital, Elgin 19.9% 0% 2.6% 57.9%

Advocate Trinity Hospital, Chicago 19.0% 0% 2.3% 23.8%

Alton Memorial Hospital, Alton 16.2%

Edward Hospital, Naperville 24.9%

Elmhurst Hospital, Elmhurst

Northwestern Medicine Kishwaukee Hospital, DeKalb

Northwestern Medicine Lake Forest Hospital, Lake Forest

Northwestern Memorial Hospital, Chicago

Rush Copley Medical Center,

IOWA

2.2% 57.6%

1.9%

MARYLAND

Hospital,

Hospital of Baltimore

of Maryland Upper Chesapeake Medical Center,

of Maryland Shore Medical Center

MASSACHUSETTS

Easton

Beth Israel Deaconess Medical Center, Boston 20.7% 0% 3.3% 43.9% Yes No Yes Yes Yes Yes

Boston Medical Center 20.3% 0% 3.3% 42.3% Yes Yes Yes Yes Yes Yes Southcoast Hospitals-Fall River, New Bedford & Wareham 17.1% 0% 2.7% 43.8% Yes Yes Yes No Yes Yes

Tufts Medical Center, Boston 21.1% 7% 2.0% 48.1% Yes - - Yes - UMass Memorial Medical Center, Worcester 21.3% 2% 3.0% 41.1% Yes Yes Yes Yes Yes Yes

MICHIGAN

Beaumont Hospital-Farmington Hills 21.4% 0% 2.5% 26.2% Yes No Yes No Yes Yes Beaumont Hospital-Grosse Pointe 25.7% 3% 1.7% 58.4% Yes Yes Yes No Yes Yes

Beaumont Hospital-Royal Oak 25.9% 0% 1.8% 60.5% Yes Yes Yes Yes Yes Yes

Beaumont Hospital-Troy 24.0% 0% 1.8% 52.7% Yes Yes Yes Yes Yes Yes

Beaumont Hospital-Wayne 22.9% 0% 2.0% 36.6% Yes No Yes No Yes Yes

McLaren Greater Lansing Hospital, Lansing 19.6% 3% 2.0% 41.2% Yes No Yes - Yes Yes

Spectrum Health Big Rapids Hospital, Big Rapids 20.0% 0% 1.4% 55.3% No No Yes No Yes Yes

Spectrum Health Gerber Memorial, Fremont 20.6% 0% 2.8% 63.6% No Yes Yes No Yes Yes

Spectrum Health Pennock, Hastings 4.8% 0% 2.8% 58.9% No Yes Yes No Yes Yes

Spectrum Health Zeeland Community Hospital, Zeeland 17.0% 0% 2.3% 64.0% No No Yes No Yes Yes

Spectrum Health-Butterworth & Blodgett Campuses, Grand Rapids 24.3% 5% 2.2% 58.6% Yes Yes Yes Yes Yes Yes U. of Michigan Health Von Voigtlander

HAMPSHIRE

NEW JERSEY

Health Medical Center-Hopewell, Pennington

Medical Center, Pompton Plains

Englewood Hospital, Englewood

Medical Center-Elmer

Jefferson Health-Stratford, Cherry Hill & Washington Township

Jersey Shore U. Med. Ctr. at Hackensack Meridian Hlth., Neptune 23.2% 0% 3.2% 51.4% Yes Yes Yes Yes Yes Yes Morristown Medical Center, Morristown 22.7% 0% 1.8% 59.0% Yes Yes Yes Yes Yes Yes Newton Medical Center-New Jersey, Newton 21.8% 0% 2.5% 62.2% No Yes Yes No Yes Yes Ocean U. Med. Ctr. at Hackensack Meridian Hlth., Brick Township 23.8% 1% 1.6% 43.1% Yes Yes No No Yes Yes

Overlook Medical Center, Summit 24.3% 0% 1.6% 55.7% Yes Yes Yes Yes Yes Yes Pascack Valley Med. Ctr. at Hackensack Meridian Hlth., Westwood 23.1% 2% 2.9% 54.1% Yes Yes Yes No Yes Yes

NEW YORK

Cayuga Medical Center

Ithaca

Thompson Hospital, Canandaigua

Island

Med.

Sinai Morningside & Mount Sinai West Hospitals

H. Noyes Memorial Hospital, Dansville

Joseph’s Health Hospital, Syracuse

Peter’s Hospital-Albany

NORTH CAROLINA

Atrium Health-Cabarrus, Concord

Atrium Health-Pineville, Charlotte 20.7% 2% 1.6% 49.6% Yes Yes No No Yes Yes Atrium Health-Union, Monroe 19.6% 3% 3.2% 35.4% Yes Yes No Yes Yes Yes

Duke Regional Hospital, Durham 16.8% 0% 2.8% 70.1% Yes Yes Yes No Yes Yes Duke University Hospital, Durham 25.7% 0% 2.4% 53.4% Yes Yes Yes Yes Yes Yes

FirstHealth Moore Regional Hospital, Pinehurst 25.5% 0% 1.4% 46.4% Yes Yes No Yes Yes Yes

Harris Regional Hospital, Sylva 13.8% 0% 3.5% 82.1% No Yes Yes - Yes Yes

Moses H. Cone Memorial Hospital, Greensboro 23.2% 0% 3.3% 44.5% Yes Yes Yes Yes Yes Yes

Sentara Albemarle Medical Center, Elizabeth City 17.9% 0% 2.5% 49.3% Yes - Yes No Yes Yes UNC Rex Hospital, Raleigh 23.0% 0% 1.6% 51.0% Yes Yes Yes Yes Yes Yes

University of North Carolina Hospitals, Chapel Hill 17.9% 0% 2.1% 57.2% Yes Yes Yes Yes Yes Yes

NORTH DAKOTA

Sanford Medical Center Bismarck 14.4% 2% 2.2% 62.9% Yes - - Yes - Sanford Medical Center Fargo 23.6% 3% 3.1% 52.2% Yes - - Yes - OHIO

Atrium Medical Center-Middletown 14.3% 0% 3.3% 59.4% Yes Yes Yes No Yes Yes Bethesda North Hospital, Cincinnati 26.5% 2% 1.8% 47.4% Yes Yes Yes No Yes Yes Cleveland Clinic Fairview Hospital 21.6% 4% 3.1% 66.0% Yes Yes Yes Yes Yes Yes Cleveland Clinic Hillcrest Hospital 25.5% 3% 2.4% 55.8% Yes Yes Yes Yes Yes Yes Cleveland Clinic Mercy Hospital, Canton 15.3% 0% 0.9% 44.5% Yes Yes Yes Yes Yes Yes Kettering Health Main Campus, Kettering 22.0% 0% 2.3% 62.7% Yes No No Yes Yes Yes Soin Medical Center, Beavercreek 16.5% 1% 2.2% 48.1% Yes Yes No No Yes Yes University Hospitals Portage Medical Center, Ravenna 20.0% 0% 3.8% 56.4% Yes Yes Yes No Yes Yes

County Memorial Hospital, Lawton

Medical Center,

PENNSYLVANIA

CAROLINA

Carilion Roanoke Memorial Hospital, Roanoke

Inova Fair Oaks Hospital, Fairfax 26.0% 0% 2.0% 62.5% Yes Yes Yes Yes Yes Yes Sentara Martha Jefferson Hospital, Charlottesville

Sentara Northern Virginia Medical Center, Woodbridge 22.1% 0% 2.8% 42.9% Yes No Yes Yes Yes Yes Sentara RMH Medical Center, Harrisonburg 25.1% 1% 2.6% 59.8% Yes Yes Yes No Yes Yes Sentara Williamsburg Regional Medical Center, Williamsburg 16.0% 0% 3.0% 70.6% Yes Yes Yes No Yes Yes

Health Community Memorial Hospital, South Hill

Medical Center, Richmond

Medical Center,

11 Signs You Should Fire Your Doctor

If you’re noticing these red flags, it could be time to move on

by Ruben Castaneda and Angela Haupt ©

STAYING W ITH A DOCTOR or other provider you’re not happy with is as harmful as staying in a relationship you know is bad because it’s easier than making a change. But parting ways may be the healthiest move. “If you’re not happy with your doctor, you’re not going to have a good relationship. That trust won’t be there, so you might hesitate to see them,” says Michael Urban, senior lecturer and director of the doctorate of occupational therapy program at the University of New Haven in Connecticut. “And you won’t tell them everything about your health when you do go, which could put your health at risk.”

Changing doctors can be a challenging process, however. Before you embark on that path, analyze whether a change is necessary. Here are 11 signs it’s time to fire your doctor:

1. You don’t mesh. You don’t need to see eye to eye on everything, but it’s helpful if you work well together. If you want a partnership, for example, a doctor who spouts commands is not the best fit; if you value a warm bedside manner, consider ditching a formal, distant physician.

“Some patients like doctors who are very direct and blunt,” says Dr. Kenny Lin, a family physician based in Washington, D.C. “And some patients can’t stand that type of doctor because they think he or she isn’t empathetic enough or doesn’t provide enough options.” When there’s a mismatch, neither person is at fault – but it could be grounds for termination.

2. Your time isn’t respected.

Do you routinely wait an hour to see your physician, only to feel like you’re being rushed through the visit? If your doctor doesn’t take the time to answer your questions or address your concerns, there’s a problem. “If your doctor’s not giving you the time you need, they’re not listening to you fully,” Urban says. “They’re not giving you the full care that you need.”

The medical community is becoming in-

creasingly sensitive to patients’ precious time. If your doctor’s chronic lateness makes you grind your teeth, why not have a look elsewhere?

3. You’re kept in the dark. A doctor should be open and thorough about why he recommends a certain treatment or orders a specific test, plus share all results with you. If he doesn’t explain a decision, or “not to your satisfaction, at that point a doctor is bad,” Lin says.

It’s also important that information is shared using terms you understand, rather than complicated medical jargon; otherwise, explanations are meaningless. Your health is too important for you to be left feeling confused or uninformed.

4. You’re not being heard.

Listening is one of the most important skills a physician can have, says Dr. Neel Anand, professor of orthopedic surgery and medical director of the Cedars-Sinai Spine Center in Los Angeles.

A good doctor listens to a patient’s description of pain and

other symptoms. “As physicians, we’re a busy bunch,” he says. “But our most important time spent in a day is with our patients. If we don’t allow them to give us a complete picture of their overall health, we can’t help them effectively maximize it. It’s best to go with the doctor who puts down the chart and actively listens to what’s going on with you.”

5. You find the office staff unprofessional. The receptionists are the link between you and the doctor. If they blow you off – or neglect to give a message to the physician about side effects you’re experiencing due to a new medication, for example – your health could be at risk. Even if you like your doctor, a bad experience with office staff could be grounds for your exit.

6. You don’t feel comfortable.

Doctors need to know intimate details you may not even share with friends or family members. If you’re unable to disclose such facts, you and your doctor may not be the right match.

A sense of unease about her decisions and recommendations, even if you can’t put your finger on exactly why you feel uncomfortable, is also a perfectly legitimate reason for cutting the cord, says Don Powell, president and CEO of the American Institute

for Preventive Medicine, which promotes healthy behavior through well ness programs and publications.

Beware of sloppy medical mistakes, too: If your doctor prescribes a drug you’re allergic to – and you know that information is in your medical history – a separation may be needed.

7. Your care isn’t coordinated.

Your primary care physician should be the quarterback of your health care team, managing each step of the medical process. That means keeping track of any reports and instructions from the specialists you see and talking with you about their recommendations. If that’s not happening, important aspects of your health care could slip through the cracks.

8. You can’t get access.

A good doctor is available for follow-up questions and concerns. Pa tient advocate Trisha Torrey, founder of the Alliance of Professional Health Advocates and author of “You Bet Your Life! The 10 Mistakes

Every Patient Makes,” recalls the time her husband developed severe tooth pain on a weekend. His dentist’s voicemail included a cell phone

A good doctor actively listens to you.

number and the promise of a quick response. But her husband never heard back. An emergency clinic visit and root canal later, he told his dentist she was fired.

A growing number of doctors are making themselves available to patients via email, text message and virtual platforms. At the very least, you need to know that in an emergency, you won’t be left hanging.

9. Your care isn’t holistic.

While most physicians can capably prescribe medication and order tests, it’s important to understand if your physician considers how a new drug or protocol will impact your lifestyle, says Dr. Joseph Giaimo, a pulmonologist in Palm Beach Gardens, Florida, and immediate pastpresident of the American Osteopathic Association.

If your doctor isn’t addressing your medical issue from a “mind, body, spirit” perspective, she might not be for you. The best health outcomes will happen when you are able to talk to your physician about lifestyle issues like eating habits, how much exercise you should get and whether you’re interacting with other people enough to avoid social isolation.

10. Your doctor is a reluctant learner.

Whether your doctor went to medical school three or 30 years ago, make sure you have access to his curriculum vitae. The CV, or résumé, can offer a great picture of how in touch your doctor is with medical advances, Anand says.

For example, techniques to treat back pain have advanced in the last 30 years. “You want to make sure (your doctor) is keeping pace,”

Anand says. The CV will tell you what conferences the physician has attended, what continuing education he is receiv ing and whether he is training other medical professionals in the field. A doctor could provide such education by speaking at conferences, conducting research studies, or authoring journal articles or textbook chapters in a given specialty, be it cardiovascular health or spinal conditions.

11. You’re not treated with respect.

If your physician has you wondering why doctors are so rude, it’s time to split up. Same goes if she trivializes your concerns. One of the clearest signs you should move on is if she walks out of the room while you’re still talking.

There are online tools patients can use to see how other people have rated particular doctors.

For example, ProPublica’s Vital Signs API database provides in formation on 1.3 million doctors and other health care profes sionals throughout the country.

The database includes details on the provider’s specialty, location and contact information; standing with federal health programs; office visits and costs; relationships with drug and medical device companies; prescribing patterns and habits; and surgical per formance. Healthgrades, another online tool, has more than 10 million patient ratings and reviews across a wide range of specialties.

Urban suggests not making judg ments based on patient reviews alone. “When people are happy, they don’t always leave comments. I’ve seen some doctors who are great who’ve had many negative comments,” he says. Ask for recommendations from friends and other people in your area, which you can do in online forums.

When considering a new doctor, ask if you can schedule a quick meet and greet. If he is willing to take a few minutes to speak with you, that shows he is invested in listening to you down the road. You could even just drop by the office to get a sense of the environment. If the office is clean and the staff is calm and profes sional, those are signs of a good fit. l

The Path to What’s Possible Starts Here

Nationwide Children’s Hospital is a national and global destination for pediatric health care--designed to manage the most complex of diseases and treat the sickest patients.

We build research programs to assure tomorrow’s breakthroughs help children everywhere.

We support the needs of the whole family--whether they come to us from around the corner or around the globe.

We are one of the country’s largest not-for-profit freestanding pediatric health care networks. Our nearly 14,000 hospital staff and 1,600 medical staff have been providing the best possible care since 1892.

The word impossible isn’t spoken here.

NationwideChildrens.org

Your Ticket to a Long and Healthy Life

Successful aging hinges on at least six factors you can control

by Ruben Castaneda

IF YOU WANT to see what successful aging looks like, take a look at how Larry Gondelman and Pamela Roddy are doing.

At age 70, Gondelman, a lawyer in Washington, D.C., at tends dozens of concerts a year, from hip-hop to rock and every genre in between. He teaches class es on topics such as the history of rock and roll and tales of songwriters and their works through an organization that offers continuing education classes for seniors. He’s also the “supreme com missioner” of a rigorous weekly pickup full-court basketball game that’s well into its fourth decade. Gondelman competes with law school friends he’s known for more than 40 years as well as some of their sons.

While still active at the law firm, Gondelman’s no longer in the daily grind. He works on bigpicture issues, helping with strategy and ethical questions. “It’s the best,” Gondelman says of this stage of his life. “Every day there’s something ex citing to do.”

Roddy, of Bethesda, Maryland, feels equally en thusiastic. Now 82, she stopped working at age 75, after a long career that started in academia, moved to private scientific research and ended with the federal government, where she worked as an ad ministrator. Now, she plays tennis up to three times a week, takes online Zumba classes, lifts weights at home and is learning to play pickleball. She’s in several book clubs and takes three to four 90-minute continuing education classes a week, on literature, history and economics. Roddy also volunteers at Maryland Responds, helping manage distribution of COVID-19 vaccines and testing programs.

“I’m very happy,” Roddy says. “Retirement has enabled me to more fully enjoy my husband, Jim, my children and grandchildren and many friends. I continue to experience the mental and physical toll from taking care of sick and dying loved ones. However, this toll is partially offset by the knowledge that I am doing the best I can – and the luck of continued good health.”

Increased life expectancy. Gondelman and Roddy are examples of what gerontology experts would call successful aging. Thanks to investments over time in public health, medical care and education, life spans in the developed world have increased dramatically in the past 12 decades, says Dr. Linda Fried, dean of the Columbia University Mailman School of Public Health. She’s also the director of the Robert N. Butler Columbia Aging Center.

In 1900, the average life expectancy for men and women in the U.S. was 47 years, she says. As of the first half of 2020, average life expectancy was nearly 78 years, according to the Centers for Disease Control and Prevention. Life expectancy was 80.5 years for women and 75 years for men.

The idea that living longer necessarily means enduring significant de clines in health has changed in the last two decades, Fried says. “In the last

©

20 years, public health scientists have shown it’s possible to live a long life with health,” she says. “It’s possible to increase your health span as long as your life span. Some decline in health and function is inevitable. But the image that older life is about decrepitude turns out not to be right.”

While some physical and mental slowdown is to be expected with advancing age, research suggests such degradation isn’t as severe as previously thought, says Jennifer Ailshire, an associate professor of gerontology with the Leonard Davis School of Gerontology at the University of Southern California. The expec tation used to be that the course of a person’s life would resemble a graphic in which a person climbs up a set of stairs, gaining in abilities, then hits a peak somewhere before or around middle age. That would be followed by a steady downward spiral in physiological and physical abilities. That belief is outdated. “It’s a para digm shift that’s happened maybe in the last 10 years,” she says. Many baby boomers – people born between 1946 and 1964 – are maintaining good fitness and high levels of cognitive health as they are aging, she says.

This change in expectations about what older life looks like is occurring as the popula tion is rapidly aging. There are about 74 million baby boomers in the U.S. By 2030, all baby boomers will be 65 years or older, according to the U.S. Census Bureau. That year, for the first time, seniors will outnumber children in the U.S., bureau demographers project.

Defining success. In their 1998 book “Suc cessful Aging,” Dr. John W. Rowe and Robert L. Kahn provide a definition of what that en tails, which many experts in gerontology still refer to as a benchmark. Rowe and Kahn define successful aging as: being free of disease or dis ability, maintaining high physical and cognitive abilities, and interacting with others in mean ingful ways.

That doesn’t mean that people who are disabled, homebound, have cognitive deficits or are suffering from chronic and potentially terminal illnesses like cancer or diabetes are “failures,” says Harry “Rick” Moody, a visiting faculty member at Fielding Graduate Univer sity in Santa Barbara, California. Moody has spent decades working in the field of gerontol ogy, and wrote a textbook on the topic.

“No matter what your situation, there are op

portunities for living a meaningful and positive life,” he says. “We should avoid putting people in categories that make it sound like their lives are a ‘failure.’ ” It’s important to keep in mind that aging successfully doesn’t mean you start jumping out of airplanes or bungee jumping in your later years, Moody says. “It doesn’t mean you have all the skills and abilities you had when you were younger,” he explains. “As you get older your memory and hearing will likely get worse. Declinations will happen, but you can compensate. For example, I wear hearing aids.” Moody is 77. “If you compensate, you’ll age successfully. If you don’t, you won’t age successfully.”

Here are six strategies for aging successfully:

1. Don’t feel limited by age. If you’ve enjoyed certain ac tivities throughout your life, continue them, Ailshire says. De pending on your physical abilities, you may have to make some adaptations. For example, if you love singles tennis but have a hard time covering the court by yourself now, switch to doubles. If you’ve always had fun dancing, don’t stop the music. “My grandmother would go out dancing into her 80s,” she says.

2. Keep learning and growing. Adopting new skills and hobbies or developing “encore careers” can help people age successfully, Ailshire says. In particular, learning a new language or how to play a musical instrument can help you maintain your cognitive abilities, research suggests.

If you need to work for financial reasons, you might look for jobs that are challenging in new ways. For example, you might train for a post in a different department at your company, she says. Or, people who have worked a desk job might look for a caregiving role or something in the service industry. Some people develop an encore career in which they hope to use their skills to help make the world better, in fields like education, the environment, social services and the nonprofit arena.

a day or not, make sure you get plenty of walking in each week. Introduce some forms of aerobic exercise, to the point of getting a rapid heartbeat and being out of breath.”

It may be helpful to consult with a personal trainer who can tailor your exercise routine to your physi cal requirements and limits. It’s also important to pay attention to the risks of advancing age, like the possibility of falling.

5. Cultivate social connections. “As we grow older, it’s inevitable that old ties will fray,” Moody says. “People die, move away, get remarried, go in different directions. Adapting is what we need to do.”

Besides staying in contact with the people already in your orbit, that means making new friends. “In particular, cultivate ties with other generations,” he says. “It’s not always easy, but essential. Move on from grieving the loss of what cannot be re stored. Feed the opportunities for connection and look for unexpected opportunities.” They can present themselves through volunteering, mentoring younger colleagues or playing sports.

The idea that aging equals decrepitude is obsolete.

Gondelman, for example, main tains friendships with younger asso ciates at his law firm, some of whom he met when he ran the firm’s sum mer associates program. He’d some times talk about music with them and introduce them to bands they hadn’t heard of. He’s also friendly with players in his weekly basketball game who are decades younger.

3. Eat a healthy diet. As you get older, your metabolism naturally slows down. Moody recommends consuming more fruits and vegetables and fewer processed foods to maintain your physical and cognitive health. The Mediterranean diet (see Page 99), which emphasizes fresh fruits and vegetables and whole grains, is an eating regimen that fits Moody’s rec ommendations, and is highly touted by many registered di etitians as a healthy and sustainable eating plan.

“Modestly reducing calories can make a difference because belly fat tends to increase with age,” Moody says. Keep an eye on your consumption of sugar, which can lead to weight gain and diabetes, and of salt, which is associated with high blood pressure.

4. Get some exercise. If you’re playing tennis, pickleball or even pickup hoops into your older years, great. If not, try walk ing and some weight training. “Dramatic and heroic exercise is not needed,” Moody says. “Whether you reach 10,000 steps

6. Adapt to losses. Remember, experiencing some cognitive defi cits and physical limitations are to be expected as you age, Moody says. There are lots of practical ways to compensate. For example, if your short-term memory isn’t as sharp as it once was, carry a notebook and write everything down. If your joints aren’t up to full-court basket ball anymore, try half-court games. And always, get enough sleep, so you can be at your best cognitively and physically.

“Adapting to losses doesn’t mean ducking your head or hiding out,” he says. “Creative strategies help. The great pianist Arthur Rubinstein, when he got old, used to deliberately slow down before a fast segment, in order to create the impression of playing faster.” l

This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The John A. Hartford Foundation. Castaneda was one of 17 distinguished reporters across the country selected to participate in the Journalists in Aging Fellows Program in 2021.

Mediterranean Moves

An expert’s view of the pleasures of a U.S. News top diet

by Kelly LeBlanc

OU DON’T HAVE to hop on an airplane to enjoy the numerous documented health benefits of a Mediter ranean diet, consistently a standout in the annual U.S. News Best Diets rank ings. (For a wealth of information on the eating plans featured, visit usnews.com/diets.) In fact, you’ll be working with many familiar ingredients, such as pasta. The difference lies in how these ingredients are served – and what they’re partnered with on the plate. Here are a few tips to help you get started:

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1. Put flavor first.

One of the best things about the Mediterranean diet is that it really isn’t a “diet” at all. Flavor is front and center in this style of eating, which is steeped in a rich culinary and cultural heritage. Medi terranean vegetables in particular steal the show in dishes like Pantescan salad with capers (a flavorful tomato and po tato salad), orecchiette con cime di rapa (pasta with broccoli rabe and chile peppers) or fattoush (a vegetable and pita bread salad).

To give ordinary foods a Medi terranean flair, brighten them with a squeeze of fresh lemon or orange juice, add a drizzle of extra virgin olive oil and season them with a generous handful of fresh herbs. Not only do these ingredients add acidity, richness and inviting aromas, but also they’re a healthy way to season dishes without relying too heavily on salt.

2. Opt for olive oil.

Olive oil is your go to fat. It’s just as appropriate drizzled over vegetable salads as it is as the base of sauteed onions and to matoes. Olive oil is a source of heart healthy monounsaturated fats and polyphenols.

Having a little bit of fat with your meals can help you better absorb the fat soluble vitamins (A, D, E and K) in foods; can reduce the glycemic response of a meal, meaning your blood

sugar won’t spike as much; and can also contribute to sa tiety, so you aren’t immediately hungry again. In one study of more than 90,000 people, those eating more than ½ tablespoon of olive oil per day had a 14% to 17% lower risk of heart disease compared with people who didn’t eat olive oil. The scientists also found that replacing 5 grams per day of butter, margarine, mayonnaise or dairy fat with the equivalent amount of olive oil was linked with a 5% to 7% lower risk of heart disease.

A product labeled “extra virgin olive oil” was naturally extracted (cold processed) with no heat or chemicals and has more of its original flavors and nutrients intact. Extra virgin is the highest-quality virgin olive oil, meeting both chemical (acidity) and sensory (taste and smell) standards set by the International Olive Council.

For the best health benefits, it’s important to store olive oil without exposure to light, heat and oxygen, and to use it before the best-by date on the bottle.

3. Feast on fish.

While most Americans gener ally eat enough protein, we tend to over-sample from the meat and poultry categories and fall short on seafood and plant-based proteins like legumes. One easy way to embrace the Mediterranean diet is to have seafood-based meals a few times per week.

Not all fish are created equal in the flavor and texture department. Grilled shrimp and grilled octopus have a pleasant, meaty texture, while salmon can be buttery and almost steak-like in its richness. Pan-fried sardine or salmon patties are also a delicious choice. For an affordable and easy weeknight option, turn to canned or pouched tuna or salmon.

4. Bring on the beans.

There are plenty of plant-based Mediterranean dishes that provide protein. Many popular reci pes feature this combination of protein and fiber, among them pasta e fagioli (an Italian pasta and bean soup) and espinacas con garbanzos (a Span ish dish made of stewed chickpeas and spinach).

Try using lentils in a casserole or vegetarian Bolognese sauce, mixing chickpeas or cannel lini beans into pasta or grain bowls, or choosing hummus or a nut-based trail mix as a snack. Ad ditionally, walnuts and flaxseed offer plant-based sources of omega-3 fatty acids and are important to eat if fish is not frequently on your menu.

5. Find fermented dairy foods.

In the traditional Mediterranean diet, milk spoiled quickly, so it was often enjoyed in small amounts in its fermented form – as yogurt or artisan cheese. Fermented foods are linked with healthy changes to the gut microbiome.

Although dairy is important in a Mediterranean diet, the focus is on quality over quantity. A small amount of a flavorful cheese can be the perfect finishing touch to a mixed green and tomato salad or a warm bowl of wholewheat pasta. Creamy, protein-filled Greek yogurt is de lightful in a breakfast bowl with fresh fruit, mixed nuts and a drizzle of honey. To explore the savory side of yogurt,

make a tzatziki sauce with Greek yogurt, gar lic and fresh herbs and serve it as a dip for fresh or roasted vegetables.

6. Embrace the rest of the lifestyle, too. The base of the Mediterranean diet pyramid we use at Oldways depicts images of people eating together, cooking together and being active to illustrate that these practices are an important part of an overall Mediterranean lifestyle that can help us manage stress and maintain our health. Traditionally, Mediterranean meals were not rushed eat ing occasions in a cubicle or drive-through, but rather were a time for socializing with loved ones. And in places like Italy, Spain and Greece, dinner is often followed by an evening walk. While many people have sacrificed mindful meals in managing their busy lifestyles, the tide may be turning. For some families, the COVID-19 pandemic cre ated space to reclaim mealtime and savor home-cooked recipes with loved ones. No matter where you are, you can take a Mediterranean staycation by embracing the key ele ments of the diet and lifestyle – and be well on your way to better health and well-being. l

Kelly LeBlanc is a registered dietitian and director of nutrition at Oldways, a nonprofit organization that inspires people to rediscover the joys of the old ways of eating.

Engage with patients

Custom FeaturesWhy

Show Your Strength

The benefits of strength training go far beyond muscle size

by K. Aleisha Fetters, MS, CSCS

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F YOU WANT to build bigger biceps or get an elusive six-pack, strength training is an essential component for making it happen. But even if maxing out your muscle size isn’t your objec tive, strength training might still be the best way to hit your health goals.

“A lot of people believe that if they don’t want to look like a bodybuilder, they shouldn’t perform resistance training,” says Michael Rebold, an associate professor who heads up the integrative exercise science program at Hiram College in Ohio. “So the only form of exercise they do is aerobic –and then they wonder why they’re having trouble making significant improvements in their (overall) health.”

Before your next workout, consider 11 additional science-backed benefits of strength training:

1

Lower abdominal fat

In a 2014 study published in the journal Obesity, Harvard researchers followed 10,500 men for 12 years and found that strength training is more effective at preventing increases in abdominal fat than cardio vascular exercise.

“When people incorporate strength training into their exercise routine, they not only burn calories, but increase lean muscle mass, which stimulates the metabolism,” Re bold says. Muscle mass is a major factor in determining basal metabolic rate, or the number of calories the body burns per day to keep you alive.

2Better cardiovascular health

Abdominal fat (aka visceral fat) is located in and around the vital organs and is linked to a higher risk of cardiovascular disease. That’s because visceral fat appears to trigger the release of certain proteins and hormones that cause inflammation, which has been shown to damage blood vessels, boost blood pressure and lead to other cardiac problems. Curbing any excess abdominal fat through strength training can certainly improve heart health.

For example, 2013 research published in the Journal of Applied Physiology demonstrated that young men who regularly strength train have better-functioning HDL, or good cholesterol, compared with those who never pump iron. Rebold explains that strength training improves blood pressure and triglyceride levels similarly to car diovascular exercise, but it has an even stronger beneficial effect on HDL.

3

Controlled blood sugar levels

Rebold says anyone with Type 2 diabetes should incorporate resistance training. Research has shown that, in addition to building muscle, strength training also improves the muscle’s ability to take in and use glucose, or blood sugar.

“In your muscle cells, you have these transporters that pick up glucose from the blood and deliver it to the mus cle cells,” Rebold says. This “improves their functioning to pick up a lot more glucose from the blood and (deposit it) into muscle, thereby decreasing blood sugar levels.”

4

Reduced cancer risk

Visceral fat not only increases the risk of heart disease and diabetes, but it’s also linked to an increased risk of cancer. Research from the journal On cogene published in 2017 showed that visceral fat cells produce high levels of a cancer-triggering protein called fibroblast growth factor-2, or FGF2.

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Muscle strength may be a better gauge of health than BMI.|

5Lowered injury risk

“Having a good muscle base is important for all movement, balance, coordination and injury prevention,” explains Dr. Adam Rivadeneyra, a sports medicine physician with Hoag Orthopedic Institute in Irvine, California. “If a muscle is too weak, it puts more stress on its connecting tendon and (over time) can result in tendinitis.”

Strength training also increases the number and diameter of collagen fibrils in tendons to increase their strength and help prevent injury, according to a 2015 review published in the International Journal of Sports Physical Therapy, a publication of the International Federation of Sports Physical Therapy.

6Strengthened mental health

Runner’s high gets a lot of hype, but strength training also improves symptoms of clinical depression and anxiety. Exercise-triggered endorphins may play a role, but strength training also provides an opportunity to overcome obstacles in a controlled, predictable environment, increasing mental resilience, according to findings from Harvard Medical School.

For the greatest anti-anxiety effects, a 2014 review published in the journal Frontiers in Psychology showed that using low to moderately heavy weights that you can lift for at least 10 to 12 reps works best.

7

Improved flexibility and mobility

It’s time to rethink your stretching routine. By taking your joints through their full range of motion during strength exercises, you can increase that range of motion over time. Results from a 2017 study in the journal Isokinetics and Exercise Science show that strength training improves flexibility in both men and women.

A previous North American Journal of Sports Physical Therapy study from 2006 suggested that eccentric strength exercises may provide the biggest benefit, improving hamstring flexibility twice as well as static stretching. Eccentric exercises are any that emphasize muscle lengthening, rather than shortening. Examples might include the lowering phase of a squat or raising the bar during a lat pull-down, Rivadeneyra says.

8Better body image

Sure, exercise impacts body composition and physique. But research, including a 2013 Journal of Extension study of middle-aged and older women, shows that consistent strength training improves body image and perceived

physical appearance – no matter what the actual aesthetic results.

Improvements in mental health and energy levels, as well as feelings of accomplishment, are the likely catalysts for improved overall body image, according to researchers.

9

Osteoporosis prevention and management

Strong bodies have strong bones, with strength training significantly increasing bone mineral density, Rivadeneyra says. He explains that any weight-bearing exercise in which you’re standing and gravity is pulling down on your body lightly stresses and strengthens the bones and muscles.

Plus, every time a muscle contracts, it pulls on the bones it’s attached to, which stimulates the cells within the bone to produce structural proteins and move minerals into the bone, he says.

For the greatest results, prioritize standing weightbearing, strength-training moves such as squats and lunges. In a 2014 Journal of Family and Community Medicine study, just 12 weeks of strength training with squats increased lower spine and femur (thigh) bone mineral density by 2.9% and 4.9%, respectively.

10

Boosted brain health Strength training can improve brain power across a person’s lifespan, but the effects are perhaps the strongest in older adults suffering from cognitive decline. In one 2016 study in the Journal of the American Geriatrics Society, when men and women ages 55 through 86 with mild impairment performed twiceweekly weight training for six months, subjects significantly improved their scores on cognitive tests. However, when participants spent their workouts stretching, their cognitive test scores declined.

The key might be getting the blood flowing, Rebold says, noting that high-intensity strength training increases the flow of blood, oxygen and other nutrients throughout the body, including the brain. In the study, adults lifted 80% of their 1RM, or the maximum amount of weight they could lift for one rep. That roughly equates to the amount of weight they could lift for eight reps without breaking form.

11A longer lifespan

One of strength training’s many benefits is a longer life. A 2015 study in The Lancet found that grip strength accurately predicts death from any cause. A 2017 report in Current Opinion in Clinical Nutrition and Metabolic Care suggested that muscle strength and lean muscle mass may serve as better measures of a person’s overall health than body mass index or BMI. l

Best Hospitals

These 20 medical centers excel in treating patients with complex diagnoses and those with relatively routine needs. Each is nationally ranked in 9 or more of the 15 Best Hospitals specialties and is rated “high performing” in most or all of 20 common procedures and conditions (see Page 190 and usnews.com/best-hospitals). Honor Roll standing is based on points. A hospital that was ranked No. 1 in all specialties and rated high performing in all procedures and conditions would have received 531 points. The 20 highest scorers qualified for the Honor Roll.

Mayo Clinic Rochester, Minnesota

points

Cedars-Sinai Medical Center Los Angeles, California

points

Langone Hospitals New York, New York 425 points

Cleveland Clinic Cleveland, Ohio

points

Johns Hopkins Hospital Baltimore, Maryland

points

UCLA Medical Center

Angeles, California

points

New York-Presbyterian Hospital-Columbia and Cornell New York, New York

points

General Hospital Boston, Massachusetts

points

Memorial Hospital Chicago, Illinois

points

Stanford Health CareStanford Hospital Stanford, California

points

Barnes-Jewish Hospital St. Louis, Missouri

points

UCSF Health-UCSF Medical Center San Francisco, California

points

Hospitals of the University of PennsylvaniaPenn Presbyterian Philadelphia, Pennsylvania 322 points

Brigham and Women’s Hospital Boston, Massachusetts 317 points

Houston Methodist Hospital Houston, Texas 306 points

Mount Sinai Hospital New York, New York 300 points

University of Michigan Health-Ann Arbor Ann Arbor, Michigan

points

Clinic-Phoenix Phoenix, Arizona

points

University Medical Center Nashville, Tennessee

points

Rush University Medical Center Chicago, Illinois

points

by Ben Harder

OR MORE THAN three decades, the mis sion of the Best Hospitals rankings has been to help guide patients, in consultation with their doctors, to the right place when they need a high level of specialty care. These are patients whose surgery or condition is complex. Or whose advanced age, physical infirmity or exist ing medical condition limits their options.

Such people account for a small fraction of hospital patients, but they add up to millions of individuals, and many hospitals may not be able to meet their needs. A hospital ranked by U.S. News in cancer, say, is likely to have the expertise and capability to enroll an elderly patient with a metastatic tumor into a clinical trial for an unproven but innovative treatment.

Some community hospitals also can provide access to such experimental therapies. But not all.

The following pages offer hospital rankings in 15 special ties, from cancer to urology. Of more than 4,500 hospitals evaluated by U.S. News this year, only 164 performed well enough to be ranked in any specialty. In 12 of 15 specialties, analysis of objective data from the federal government and other sources generated the main factors determining whether a hospital was ranked. Some kinds of data, such as death rates, are intimately related to quality. Numbers of patients and the balance of nurses to patients are examples of data that are also important, although the quality connection may seem less evident. To capture medical experts’ opinions, we also factored in results from annual surveys of specialist physi

No hospital is best for every patient.

cians who were asked to name hospitals they consider best in their specialty at handling difficult cases. Hospitals in the other three specialties (ophthalmology, psychiatry and rheumatology) were ranked solely on the basis of the annual physician surveys. That’s because reliable objective data aren’t available for those areas of care.

Based on input from experts and medical studies, we have revised the ranking methodologies over time to make the rankings even more useful to consumers. This year, for example, the obstetrics and gynecology ranking factored in whether each hospital had

completed a U.S. News survey designed to provide the public with more transpar ent information about its maternity care.

Beyond the specialty rankings, we ex panded a set of hospital ratings that give patients information about which hospi tals excel in specific procedures or in caring for patients with certain conditions. New this year are ratings in ovarian cancer sur gery, prostate cancer surgery and uterine cancer surgery. Hospital performance in these areas can be found in the Best Regional Hospitals rankings (Page 190), which combine data from the specialty rankings and the procedures and condi tions ratings to help consumers identify hospitals with expertise in numerous areas of care. More detail is available at usnews.com/best-hospitals.

To be considered for ranking in 11 of the data-driven specialties, a hospital had to meet any of four criteria: It had to be a teaching hospital, or be affiliated with a medical school, or have at least 200 beds, or have at least 100 beds and offer at least four out of eight advanced medical technologies.

The hospitals next had to meet a vol ume requirement in each specialty – a minimum number of Medicare inpatients from 2018 to 2020 who received certain procedures and treatment for specific conditions. A hospital that fell short was still eligible if nominated in the specialty by at least 1% of physicians responding to the expert opinion survey.

At the end of the process, 2,203 hospitals remained candidates for ranking in at least one spe cialty. Each received a U.S. News score of 0 to 100 based on four elements, de scribed below. The top 50 hospitals in each specialty were ranked. Scores and data for the rest are at usnews.com. The four elements and their weights in most specialties are:

Patient outcomes (37.5%). Success at keeping patients alive and getting them home was judged by the proportion of Medicare inpatients with certain condi tions in 2018, 2019 and 2020 who died within 30 days of admission or were dis charged to another health care facility. Both rates were adjusted to account for the severity of patients’ illnesses, the com plexity of their care, and risk-elevating factors such as advanced age, obesity, high

blood pressure and poverty (as reflected by whether they received Medicaid).

A widely used approach to so-called risk adjustment was employed to adjust each patient’s risk in calculating odds of a good outcome. To avoid penalizing in stitutions receiving the sickest patients, we excluded from our analysis patients transferred in from another hospital. A score of 5 indicates the best chance of survival or discharge to home (and 1 the worst) relative to other hospitals.

Patient experience (5%). Most hos pitals are required to assess patients’ satisfaction with their experience using a survey known as the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS. The score reflects how many patients had a positive overall experience during hospitalization.

Other care-related indicators (30%). The balance of patients per nurse and the hospital’s number of patients – an indica tor of its degree of experience in a spe cialty – are examples of these factors.

Expert opinion (27.5%). Specialists were asked to name up to five hospitals that they consider best in their area of expertise for patients with the most dif ficult medical problems. In the 2022 survey alone, responses were tallied from more than 32,000 physicians. The figures shown under “% of specialists recommend ing hospital” in the tables are the average percentages of specialists in 2020, 2021 and 2022 who recommended a hospital. In rehabilitation, expert opinion carried a weight of 50%. In the three specialties based entirely on expert opinion, a hospital had to be cited by at least 5% of responding physicians in the latest three years of U.S. News surveys to be ranked. That created lists of 12 hospitals in ophthalmology, 11 in psychiatry and 11 in rheumatology.

If you’ve consulted past editions of Best Hospitals, you may notice that a hospital you’re considering has risen or fallen in the rankings. A decline shouldn’t auto matically be interpreted as a decline in performance; rather, it may be because of changes to the methodology or because other hospitals improved.

No hospital, no matter how excellent, is best for every patient. You’ll want to add your own fact-gathering to ours and consult with your doctor or other health professional as you weigh your options. l

A Glossary of Terms

CARF: accredited by the Commission on Accreditation of Rehabilitation Facilities International as of April 30, 2022.

Completion of care rate: how often a hospital avoids needing to transfer patients to an acute-care hospital during their rehabilitation.

Discharge to home score: reflects proportion of patients who, at discharge, went home rather than to a nursing home or other facility.

FACT accreditation level: hospital meets Foundation for the Accreditation of Cellular Therapy standards as of March 1, 2022, for harvesting and transplanting stem cells from a patient’s own bone marrow and tissue (level 1) and from a donor (level 2) to treat cancer.

Flu vaccination rate: percentage of hospital’s staff who received a seasonal flu vaccine.

NAEC epilepsy center: designated by the National Association of Epilepsy Centers as of March 1, 2022, as a regional or na tional referral facility (level 4) for staffing, technology and training in epilepsy care.

NCI cancer center: designated by the National Cancer Institute as of March 29, 2022, as a clinical or comprehensive cancer hospital.

NIA Alzheimer’s center: designated by the National Institute on Aging as of Feb. 7, 2022, as an Alzheimer’s Disease Center, indicating high quality of research and clinical care.

Number of patients: except in rehabilita tion, estimated number of Medicare inpatients in 2018, 2019 and 2020 who received certain high-level care as defined by U.S. News. (In some cases, data from 2017 were used to adjust for the pan demic’s impact on 2020 data.) Based on an adjustment to the number of such pa tients with traditional Medicare insurance. In geriatrics, only patients ages 75 and older are included. In rehabilitation, only patients treated in 2020 are included.

A Nurse Magnet hospital: recognized by the American Nurses Credentialing Center as of Jan. 4, 2022, for nursing excellence.

Nurse staffing score: relative balance of nonsupervisory registered nurses (inpatient and outpatient) to average daily number of all patients. Inpatient staffing receives greater weight. Agency and temporary nurses are not counted.

Patient experience: percentage of patients who responded positively to a survey about the overall quality of their stay.

Patient services score: number of services offered out of the number considered important to quality (such as genetic testing in cancer and an Alzheimer’s center in geriatrics).

% of specialists recommending hospital: percentage of physicians responding to U.S. News surveys in 2020, 2021 and 2022 who named the hospital as among the best in their specialty for especially challenging cases and procedures, setting aside location and cost.

Public transparency: indicates whether hospital publicly reports its performance through the American College of Cardiology, the American Heart Association and the Society of Thoracic Surgeons (in cardiology & heart surgery) or the American Heart Association (in neurology & neurosurgery), and whether hospital completed a U.S. News survey about maternity care (in obstetrics & gynecology).

Rank: based on U.S. News score except in ophthalmology, psychiatry and rheumatology, where specialist recommendations determined rank.

Readmission prevention rate: how often hospital keeps patients from being readmitted to an acute-care hospital within the 30 days following discharge.

Successful discharge rate: how often patients go directly home from this hospital and remain at home, rather than requiring further institutional care. Survival score: reflects patient survival rate in the specialty within 30 days of admission.

Technology score: reflects availability of technologies considered important to a high quality of care, such as PET/CT scanner in pulmonology and diagnostic radioisotope services in urology.

Trauma center: indicates Level 1 or 2 trauma center certification. Such a center can care properly for the most severe injuries.

U.S. News score: summary of quality of hospital inpatient care. In most special ties, survival is worth 30%, discharge to home 7.5%, operational quality data such as nurse staffing and patient vol ume 30%, specialists’ recommendations 27.5%, and patient experience 5%.

Proud to rank among the nation’s Top 10 ‘Best Hospitals’ for Cancer.

We bring the cures of tomorrow to the people who need them today.

Lee

Cancer Center

Southwestern Medical Center,

Hutchinson Cancer Center/U. of Washington Med. Ctr.,

Mount Sinai Hospital, New York

Houston Methodist Hospital

Orlando

Beth Israel Deaconess Medical Center, Boston

Rush University Medical Center, Chicago

Huntsman Cancer Institute at the U. of Utah, Salt Lake City

U. of Kentucky Albert B. Chandler Hospital, Lexington

Duncan Comp. Cancer Ctr. at Baylor St. Luke’s Med. Ctr., Houston

Montefiore Medical Center, Bronx, N.Y.

OHSU Hospital-Knight Cancer Institute, Portland, Ore. 57.2

Vanderbilt University Medical Center, Nashville, Tenn. 57.0

UC Davis Medical Center, Sacramento, Calif. 56.8

University of Michigan Health Rogel Cancer Center, Ann Arbor

North Shore University Hosp. at Northwell Health, Manhasset, N.Y. 55.5

Thos. Jefferson U. Hosps.-Sidney Kimmel Cancer Ctr., Philadelphia 55.5

University Hospital, Atlanta

Georgetown University Hospital, Washington, D.C.

Health Fairview U. of Minnesota Medical Center,

Medical Center, Orange, Calif.

University of Kansas Hospital, Kansas City

Medical Center,

Cancer Ctr.-U. of Miami Hosp.

Hill Hospital at Northwell Health,

4,131 1.9

2,108 1.5

6.2%

1.3%

2 8 7.0%

8 1.4%

8 0.3%

2 8 0.2%

2 8 0.5%

1,645 2.1 No 2 8 0.6%

1,443 2.2

2 8 1.3%

1,452 1.8 Yes 2 8 1.0%

866 2.0 Yes 0 8 0.5%

2,716 2.5 Yes 2 8 0.6%

91% 1,780 2.2 Yes 2 8 0.9%

91% 2,379 2.3 Yes 2 8 3.0%

89% 1,621 2.7

2,865 2.7

90% 2,043 2.4

90% 1,933 2.1

2,376 2.2

1,615 2.0

1,055 2.0

2,283

1,633

2 8 0.9%

2 8 3.6%

2 8 0.5%

2 8 1.0%

1.5%

2 8 0.9%

2 8 0.6%

2 8 1.3%

0.5%

0.0%

1.8%

0.6%

Cancer won’t be my last dance.

When City Ballet of San Diego’s Chiara Valle continued to have agonizing leg pain after a previous hospital misdiagnosed an aggressive bone cancer, she knew she needed a second opinion if she ever wanted to dance again. Chiara turned to Montefiore Einstein to get back to The Washington Ballet, and is now with City Ballet of San Diego. Everyday Montefiore Einstein is helping passionate people keep doing what they love.

See Chiara’s story at montefiore.org/chiara

A new heart was Joseph’s winning save.

Thanks to Montefiore Einstein, he’s victorious.

Joseph didn’t just need a new heart right away, he needed a hospital that could perform a bloodless transplant. He was referred to Montefiore Einstein, the only hospital within 800 miles that could save his life.

See Joseph’s story at: montefiore.org/joseph

Celebrating Great Achievements

The American College of Cardiology (ACC) applauds those hospitals and health care facilities that have achieved the HeartCARE Center designation and the work of the HeartCARE Center champions who provide leadership in earning this national distinction.

Each of the institutions demonstrates a commitment to world-class cardiovascular care through community engagement coupled with quality improvement in care delivery as well as implementation of disease and procedure-specific accreditation programs. Additionally, the constant support of many qualified and dedicated physicians and cardiovascular care team members, including credentialed Fellows and Associates of the ACC, is essential to each hospital and facility’s ongoing HeartCARE Center achievement.

We recognize their collaborative efforts, purposeful focus, and passion for excellence in working to deliver exceptional care and optimal outcomes for cardiovascular patients.

Please visit CVQuality.acc.org/HCC to learn how hospitals can achieve ACC’s HeartCARE Center recognition.

NORTHEAST

Albert Einstein Medical Center

Philadelphia, PA

Yolanda Huertas Nixon, ACNP-BC, CRNP, MSN, AACC

Sumeet Mainigi, MD, FACC

Chester County Hospital

West Chester, PA

Ralph G. Smith, IV, RN, AACC

Timothy Boyek, MD, FACC

Conemaugh Memorial Medical Center

Johnstown, PA

Shannon Boyer, RN, AACC

Cyril Nathaniel, MD, FACC

Hackensack University Medical Center

Hackensack, NJ

Tammy Russo, ACNP, AACC

Michael Lim, MD, FACC

Jersey Shore University Medical Center

Neptune, NJ

Jennifer Heck-Kanellidis, DNP, AACC

Brett Sealove, MD, FACC

JFK University Medical Center

Edison, NJ

Jodelle Gold, ACNP-BC, AACC

Raj Ballal, MD, FACC

Lahey Hospital and Medical Center

Burlington, MA

Shauna Holden, NP-C, AACC

Frederic Resnic, MD, FACC

Lawrence General Hospital Lawrence, MA

Kathy Caredeo, RN, AACC

Sunit Mukherjee, MD, FACC

Ocean University Medical Center Brick, NJ

Jennifer Heck-Kanellidis, DNP, AACC

Ali R. Moosvi, MBBS, FACC

Regional Hospital of Scranton Scranton, PA

Debra Jadick, NP, AACC

Sridhar Sampath-Kumar, MD, FACC

Riverview Medical Center Red Bank, NJ

Jennifer Heck-Kanellidis, DNP, AACC

Shaddy K. Younan, MD, FACC

St. Elizabeth Medical Center

Utica, NY

Stephanie Mathias, CCRN, AACC

Michael W. Kelberman, MD, FACC

MIDWEST

Bryan Medical Center

Lincoln, NE

Sarah Schroeder, NP, AACC

John Steuter, MD, FACC

Indiana University Health Methodist Hospital Indianapolis, IN

Andrea Price, CPHQ, RCIS, AACC

Richard Kovacs, MD, MACC

Lutheran Hospital Fort Wayne, IN

Amanda Lutter, AGPCNP-BC, AACC

Vijay Chilakamarri, MD, FACC

Parkview Heart Institute Fort Wayne, IN

Angela Starkey, NP, AACC

Patrick B. Gregory, MD, FACC

Spectrum Health Butterworth Hospital

Grand Rapids, MI

John Mulder, IV, MPAS, AACC

David H. W. Wohns, MD, FACC

SOUTH

AdventHealth Carrollwood

Tampa, FL

Joy Viars, ARNP, AACC

Humberto Coto, MD, FACC

AdventHealth Dade City Dade City, FL

Christy N. Burkhart, BSN, CCRN, RN, AACC

Tun Aung, MBBS, FACC

AdventHealth Ocala

Ocala, FL

Lynn Smith, RN, AACC

Robert Feldman, MD, FACC

AdventHealth Sebring Sebring, FL

James E. Leicht, RCIS, AACC

Deepti Bhandare, MD, FACC

AdventHealth Tampa Tampa, FL

Richard N. Dance, PharmD, AACC

Charles Lambert, MD, PhD, MBA, FACC

AdventHealth Wesley Chapel Wesley Chapel, FL

Allison K. Sutton, APRN, FNP-C, AACC

Asad Sawar, MBBS, FACC

AdventHealth Zephyrhills Zephyrhills, FL

Christy N. Burkhart, BSN, CCRN, RN, AACC

Tun Aung, MBBS, FACC Baptist Health Lexington Lexington, KY

Megan C. Switzer, NP, AACC

Azhar Aslam, MBBS, FACC Baptist Health Paducah Paducah, KY

Blair Lane Brockman, NP, AACC Craig Beavers, PharmD, FACC Bayhealth Medical Center Kent Campus Dover, DE

Benjamin Louis Collins, MBA, BSN, AACC John Shuck, MD, FACC

Baylor St. Luke's Medical Center Houston, TX

Lisa Wall, AGPCNP-BC, NP-C, AACC Emerson Perin, MD, FACC CarolinaEast Medical Center New Bern, NC

Laura Nicole Peters, BS, RT, AACC Alex Kirby, MD, FACC

CHI St. Luke's Health Memorial Lufkin Lufkin, TX

Jamie Huckabee, FNP-C, AACC Ravinder Bachireddy, MBBS, FACC Christiana Care Health Services Newark, DE Jennifer Oldham, MSN, RN, AACC Neil Wimmer, MD, FACC

CHRISTUS Mother Frances Hospital - Tyler Tyler, TX

Jamie Moore, RN, AACC James Hoff, MD, FACC

CHRISTUS Ochsner St. Patrick Hospital Lake Charles, LA

Anna Landry, NP, AACC Michael Turner, MD, FACC

To find a hospital or facility that participates in ACC’s quality improvement

or to find the right hospital to meet

Christus St. Frances Cabrini Hospital

Alexandria, LA

Erika McCormick, BSN, CCRN, AACC

Reymond Meadaa, MD, FACC

Frye Regional Medical Center

Hickory, NC

Seth Call, PA-C, AACC

Vincent Patrone, MD, FACC

Jackson-Madison County General Hospital Jackson, TN

Dylan Wilson, BCPS, PharmD, AACC

John Baker, MD, FACC

King's Daughters Medical Center

Ashland, KY

Kristie Turkey, APRN, AACC

Sandeep Krishnan, MD, FACC Lexington Medical Center West Columbia, SC

Dawn Crumpton, BSN, RN, AACC

Robert Malanuk, MD, FACC

Methodist Texsan Hospital San Antonio, TX

Michael Hendricks, MBA, RN, AACC

Obinna Isiguzo, MBBS, FACC

Mon Health Medical Center Morgantown, WV Denise Palmer, RN, AACC

Bradford E. Warden, MD, FACC

Norton Audubon Hospital Louisville, KY

Robert Rogers, APRN, AACC

Ibrahim Fahsah, MD, FACC

Spartanburg Medical Center Spartanburg, SC

Jennifer Smith, MSN, RN, AACC

Nalin K. Srivastava, MD, FACC

The Hospitals of Providence Sierra Campus El Paso, TX

Laura Wilson, AGACNP-BC, AACC

Edward R. Assi, DO, FACC

WVU Medicine Camden Clark Medical Center Parkersburg, WV Kristina Brooks, DNP, AACC

David A. Gnegy, MD, FACC

WEST

Adventist Health and Rideout Marysville, CA

Eric Cooper, BSN, MPA, NE-BC, RN-BC, AACC

Rajinder Singh, MBBS, FACC Rose Medical Center Denver, CO

Lauren Meehan, MSN, AACC

Michael R. Wahl, MD, FACC

Saint Joseph Hospital Denver, CO

Jennifer Lynch, APRN, AACC

Jake Michael Chanin, MD, MS, FACC

Saint Mary's Regional Medical Center Reno, NV

Rachael Coe, RN-BC, AACC

Devang M. Desai, MBBS, FACC

The Medical Center of Aurora Aurora, CO

Linda Pilon, CCRN, MSN, NE-BC, AACC

Nelson A. Prager, MD, FACC

UCHealth Memorial Hospital Colorado Springs, CO

Dawn Lovejoy, RN, AACC

Christopher Manhart, DO, FACC

Cardiology  &  Heart Surgery

Clinic-Phoenix

Oak,

University Medical Center,

of Michigan Health Frankel

Jolla Hospitals, La Jolla,

Heart & Vascular Inst.

MedStar

Francis Hospital & Heart Center, Roslyn, N.Y.

CentraCare-St. Cloud Hospital, St. Cloud, Minn.

University of Alabama at Birmingham Hospital

Davis Medical Center, Sacramento, Calif.

Montefiore Medical Center, Bronx, N.Y.

Hosp.

Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio

Duke University Hospital, Durham, N.C.

Ohio State University Wexner Medical Center, Columbus

UCSF Health-UCSF Medical Center, San Francisco 59.9

University Hosps. Harrington Heart & Vascular Institute, Cleveland 59.8

Barnes-Jewish Hospital, Saint Louis

UPMC Presbyterian Shadyside, Pittsburgh

Mount Sinai Morningside & Mount Sinai West Hospitals, New York 58.8

Advocate Christ Medical Center, Oak Lawn, Ill. 58.2

Hackensack U. Med. Ctr. at Hackensack Meridian Hlth., N.J. 58.0

Mayo Clinic-Jacksonville, Fla. 57.8

University of Chicago Medical Center

Morristown Medical Center, Morristown, N.J.

University of Kansas Hospital, Kansas City

VCU Medical Center, Richmond, Va.

New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn

Baylor Scott and White The Heart Hospital, Plano, Texas

88%

12,682 2.1

13,575 2.0

2.0

7,432 2.3

4,075 2.7

15,349 2.5

5,918 1.6

1.1%

8 3.0%

8 0.9%

8 3.4%

8 1.2%

8 1.8%

8 1.0%

8 0.0%

8 1.7%

5 8 0.6%

6 8 0.8%

5 8 0.6%

9,269 2.1 Yes 6 8 6.8%

8,918 2.2 Yes 6 8 1.7%

3,143 2.6 Yes 6 8 2.1%

6,309 2.6 Yes 6 8 1.2%

8,677 2.5 Yes 6 8 3.4%

10,044 2.3 Yes 6 8 2.2%

5,422 2.0 No 5 8 0.5%

9,809 2.7 Yes 6 8 0.2%

86% Yes 7,215 2.8 Yes 5 8 0.6%

95%

93%

3,168 2.8 Yes 6 8 2.5%

4,584 2.3 Yes 6 8 1.4%

12,325 2.1 Yes 5 8 1.0%

6,688 2.1 Yes 6 8 0.5%

4,637 1.9 Yes 6 8 0.8%

5,800 1.4 No 5 8 0.2%

7,253 2.7 Yes 5 8 1.7%

Clinic, Rochester, Minn.

General Hospital,

Langone Hospitals,

York-Presbyterian Hospital-Columbia

Medical Center, Los

Health-UCSF Medical Center,

Medicine-University of Washington Medical

Barnes-Jewish Hospital, Saint Louis

Houston Methodist Hospital

Northwestern Memorial Hospital, Chicago

Cleveland Clinic

Cedars-Sinai Medical Center, Los Angeles

University of Texas MD Anderson Cancer Center, Houston

Mount Sinai Hospital, New York

Montefiore Medical Center, Bronx, N.Y.

Johns Hopkins Hospital, Baltimore

University of Chicago Medical Center

NorthShore University Health System-Metro Chicago 69.5

18 UT Southwestern Medical Center, Dallas 69.5

20 Vanderbilt University Medical Center, Nashville, Tenn. 68.8

Memorial Sloan Kettering Cancer Center, New York 67.8

Brigham and Women’s Hospital, Boston 67.1

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 66.7

Beaumont Hospital-Royal Oak, Mich. 66.2

UPMC Presbyterian Shadyside, Pittsburgh 65.7

UC Davis Medical Center, Sacramento, Calif. 65.4

Tampa General Hospital 65.2

Mayo Clinic-Phoenix 64.5

AdventHealth Orlando 64.4

Mayo Clinic-Jacksonville, Fla. 64.3

Stanford Health Care-Stanford Hospital, Stanford, Calif. 64.3

Yale New Haven Hospital, New Haven, Conn.

Hoag Memorial Hospital Presbyterian, Newport Beach, Calif.

UCHealth University of Colorado Hospital, Aurora

Mount Sinai Beth Israel, New York

State University

of Michigan Health-Ann

Shore University Hosp.

Memorial Medical Center,

29.3%

20.7%

5.2%

7.6%

6.1%

4 8 7.0%

4 8 5.7%

4

6.4%

1.4%

2.4%

8 8.2%

4 8 2.2%

1.9 Yes 4 8 1.7%

1,022 2.3 Yes 4 8 3.9%

85% 2,474 2.5 No 4 8 1.4%

92% 525 2.4 Yes 4 8 9.7%

90% 691 2.3 Yes 4 8 2.2%

90% 1,300 1.6 Yes 4 8 0.4%

93% 637 2.2 Yes 4 8 2.2%

91% 754 2.3 Yes 4 8 4.1%

95% 354 2.4 Yes 4 8 0.6%

92% 781 2.4 Yes 4 8 8.1%

91% 861 2.5 Yes 4 8 5.5%

87% 1,445 2.0 Yes 4 8 0.3%

92% 1,063 2.3 Yes 4 8 2.6%

89% 414 2.7 Yes 4 8 0.2%

89% 1,448 2.6 Yes 4 8 0.5%

96% 417 3.2 Yes 4 8 1.7%

89% 3,132 1.9 No 4 8 0.3%

95% 507 2.8 Yes 4 8 1.9%

2.7 Yes 4 8 1.4%

2.0 Yes 4 8 4.2%

2.5 Yes 4 8 0.4%

2.1 Yes 4 8 6.9%

1.4 No 4

Ear, Nose &

Health Care-Stanford

Medical Center,

Medical Center, Los

Eye and Ear, Massachusetts General Hospital,

Hopkins Hospital, Baltimore

Clinic, Rochester, Minn.

Health-UCSF Medical Center,

Memorial Sloan Kettering Cancer Center, New

University of Michigan Health-Ann Arbor

Vanderbilt University Medical Center, Nashville, Tenn.

Hosps. of the U. of Pennsylvania-Penn Presby.,

OHSU Hospital, Portland, Ore.

New York-Presbyterian Hospital-Columbia and Cornell

Barnes-Jewish Hospital, Saint Louis

MUSC Health-University Medical Center, Charleston, S.C.

Tampa General Hospital

University Hospitals Cleveland Medical Center

Mayo Clinic-Phoenix 78.9

Ohio State University Wexner Medical Center, Columbus 77.2

University of Texas MD Anderson Cancer Center, Houston 76.8

UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego 75.1

University of Alabama at Birmingham Hospital 74.0

Cleveland Clinic 73.6

UW Medicine-University of Washington Medical Center, Seattle 72.9

UPMC Presbyterian Shadyside, Pittsburgh 72.5

NYU Langone Hospitals, New York 71.4

Brigham and Women’s Hospital, Boston

University of Kansas Hospital, Kansas City

University Hospital, Durham, N.C.

Emory University Hospital Midtown, Atlanta

University of Iowa Hospitals and Clinics, Iowa City

New Haven Hospital, New Haven, Conn.

Hosp. and the Medical College of Wis.,

University Medical Center, Chicago

Medical Center of USC, Los Angeles

2.0

8.4%

7.0%

1.9%

12.7%

14.5%

10.2%

5.3%

No 1.5%

Yes 8.7%

Yes 8.3%

Yes 8.2%

8 Yes 1.9%

8 Yes 3.6%

8 Yes 5.3%

8 Yes 4.8%

219 2.6 Yes 8 Yes 0.7%

471 2.6 Yes 8 Yes 1.3%

285 3.2 Yes 8 No 2.0%

632 2.2 Yes 8 Yes 6.5%

854 1.9 Yes 8 No 6.7%

91% 196 2.1 Yes 8 Yes 2.3%

90% 671 2.3 Yes 8 Yes 2.5%

92% 490 2.4 Yes 8 No 7.3%

91% 321 2.3 Yes 8 No 5.9%

92% 581 2.3 Yes 8 Yes 6.7%

89% 254 2.4 Yes 8 Yes 3.0%

2.4 Yes 8 Yes 2.5%

2.1 Yes 8 Yes 2.7%

211 2.1 Yes 8 Yes 2.5%

696 1.7 No 8 No 2.6%

8 Yes 8.2%

8 Yes 1.1%

8 Yes 0.8%

8 Yes 1.0%

8 Yes

Clinic, Rochester, Minn.

Medical Center,

Medical Center, Los Angeles

Clinic

Langone Hospitals,

Keck Medical Center of USC, Los Angeles

Northwestern Memorial Hospital, Chicago

Houston Methodist Hospital

Clinic-Phoenix

Hopkins Hospital,

San Diego Health-La Jolla

New York-Presbyterian Hospital-Columbia

Mount Sinai Hospital, New York

University of Chicago Medical Center

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 73.9

15 Stanford Health Care-Stanford Hospital, Stanford, Calif. 73.9

17 UPMC Presbyterian Shadyside, Pittsburgh 73.2

18 Massachusetts General Hospital, Boston 72.8

19 Memorial Sloan Kettering Cancer Center, New York 72.4

20 Barnes-Jewish Hospital, Saint Louis 72.2

8

6.6%

8

6.9%

No 16.8%

6.2%

8 Yes 2.5%

8 Yes 5.4%

7 8 No 2.1%

5.1%

2.9%

Yes 5.5%

88% 5,379 2.3 Yes 7 8 Yes 6.1%

90% 3,010 2.3 Yes 7 8 Yes 3.9%

91% 4,510 2.5 Yes 7 8 Yes 5.8%

94% 3,643 2.7 Yes 7 8 Yes 2.7%

5 92% 7,006 2.3 Yes 7 8 Yes 4.2%

5 94% 5,950 2.6 Yes 7 8 Yes 8.3%

5 95% 5,106 2.4 Yes 6 8 No 2.8%

5 90% 6,112 2.5 Yes 7 8 Yes 4.0%

21 Mayo Clinic-Jacksonville, Fla. 72.1 5 5 95% 2,979 2.8 Yes 7 8 No 5.4%

22 UCSF Health-UCSF Medical Center, San Francisco 71.6 5 5 91% 2,890 2.6 Yes 7 8 Yes 5.2%

23 OHSU Hospital, Portland, Ore. 71.5 5 5 91% 2,557 2.2 Yes 7 8 Yes 0.9%

24 Beaumont Hospital-Royal Oak, Mich. 71.3

Jefferson Health-Thomas Jefferson U. Hospitals, Philadelphia 70.8

University of Michigan Health-Ann Arbor 70.8

Brigham and Women’s Hospital, Boston 70.1

St. Francis Hospital & Heart Center, Roslyn, N.Y. 70.1

Duke University Hospital, Durham, N.C.

North Shore University Hosp. at Northwell Health, Manhasset, N.Y.

Baylor St. Luke’s Medical Center, Houston 69.5

University of Texas MD Anderson Cancer Center, Houston 68.7

Israel Deaconess Medical Center,

Baylor University Medical Center,

Queen’s Medical Center,

General Hospital

5 87% 6,372 2.0 Yes 7 8 Yes 0.3%

90% 4,388 2.1 Yes 7 8 Yes 1.8%

92% 4,699 2.7 Yes 7 8 Yes 5.7%

92% 5,029 2.4 Yes 6 8 Yes 4.2%

94% 3,168 2.0 Yes 6 8 No 0.3%

4,303 2.1 Yes 7 8 Yes 4.1%

5,859 2.4 Yes 6 8 Yes 1.1%

3,279 2.0 Yes 7 8 No 1.8%

2.6%

2.0%

1.5%

0.1%

Sinai Hospital, New York

Clinic

Langone Hospitals, New York

Mayo Clinic, Rochester, Minn.

UCLA Medical Center, Los Angeles

New York-Presbyterian Hospital-Columbia

Johns Hopkins Hospital, Baltimore

Northwestern Memorial Hospital, Chicago

Health-UCSF Medical Center, San Francisco

Cedars-Sinai Medical Center, Los Angeles

UC San Diego Health-La Jolla and Hillcrest Hospitals, San

Keck Medical Center of USC, Los Angeles

Mayo Clinic-Phoenix 87.2

Rush University Medical Center, Chicago

Stanford Health Care-Stanford Hospital, Stanford, Calif. 86.6

Massachusetts General Hospital, Boston 86.2

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 85.6

18 Barnes-Jewish Hospital, Saint Louis 84.7

19 Brigham and Women’s Hospital, Boston 84.3

20 UPMC Presbyterian Shadyside, Pittsburgh 83.4

21 University of Michigan Health-Ann Arbor 83.0

22 Houston Methodist Hospital 82.8

23 UC Davis Medical Center, Sacramento, Calif. 81.3

24 North Shore University Hosp. at Northwell Health, Manhasset, N.Y. 80.9

25 Lenox Hill Hospital at Northwell Health, New York 80.6

Mayo Clinic-Jacksonville, Fla. 80.5

UT Southwestern Medical Center, Dallas 80.5

Vanderbilt University Medical Center, Nashville, Tenn. 79.9

29 Yale New Haven Hospital, New Haven, Conn. 79.7

Duke University Hospital, Durham, N.C.

University of Kansas Hospital, Kansas City

OHSU Hospital, Portland, Ore.

Beaumont Hospital-Grosse Pointe, Mich.

Hospital, Oroville, Calif.

Health University Hospital, Madison, Wis.

St. Francis Hospital & Heart Center, Roslyn, N.Y.

University of Alabama at Birmingham Hospital

11,097

16,740

11,055 2.1

5,666 2.5

9 17.9%

9 6.9%

9 3.2%

9 8.8%

9 18.8%

Yes 9 4.0%

Yes 9 10.9%

9 2.3%

9 10.3%

No 7 1.0%

9 4.1%

Yes 9 1.0%

96% 11,756 3.2 Yes Yes 8 2.4%

91% 11,067 2.1 Yes Yes 9 1.7%

94% 14,784 2.7 Yes Yes 9 1.4%

94% 29,068 2.6 Yes Yes 9 5.8%

91% 20,319 2.5 Yes Yes 9 2.6%

90% 21,053 2.5 Yes Yes 9 2.5%

92% 20,817 2.4 Yes Yes 9 1.6%

92% 27,417 2.3 Yes Yes 9 5.0%

92% 16,398 2.7 Yes Yes 9 3.6%

92% 24,767 2.1 Yes No 9 1.3%

89% 11,024 2.7 Yes Yes 9 0.5%

90% 42,128 2.4 Yes No 9 2.2%

89% 18,456 2.9 Yes No 9 0.9%

95% 9,737 2.8 Yes Yes 8 1.5%

93% 11,878 2.2 Yes No 9 0.8%

91% 16,224 2.3 Yes Yes 9 1.2%

86% 39,267 2.0 Yes Yes 9 3.7%

18,031 2.1 Yes Yes 9 5.7%

93% 14,672 2.1 Yes Yes 8 0.6%

91% 7,964 2.2 Yes Yes 9 0.5%

10,177

0.0%

0.0%

2.3%

8 0.0%

15,604

Brigham and Women’s Hospital,

Clinic, Rochester, Minn.

Barnes-Jewish Hospital, Saint Louis

Clinic

University of Alabama at Birmingham Hospital

Johns Hopkins Hospital, Baltimore

Long Island Jewish Med. Ctr. at Northwell, New Hyde Park,

UCLA Medical Center, Los Angeles

Stanford Health Care-Stanford Hospital, Stanford, Calif.

Inova Fairfax Hospital, Falls Church, Va.

NYU Langone Hospitals, New York

New York-Presbyterian Hospital-Columbia and Cornell

Rush University Medical Center, Chicago

UW Health University Hospital, Madison, Wis.

Cedars-Sinai Medical Center, Los Angeles

MUSC Health-University Medical Center, Charleston, S.C.

University of Chicago Medical Center

Lenox Hill Hospital at Northwell Health, New York 77.2

Northwestern Memorial Hospital, Chicago 77.2

20 Vanderbilt University Medical Center, Nashville, Tenn. 76.7

UC Davis Medical Center, Sacramento, Calif. 76.6

21 U. of Michigan Health Von Voigtlander Women’s Hospital, Ann Arbor 76.6

Yale New Haven Hospital, New Haven, Conn. 76.3

UCI Medical Center, Orange, Calif. 75.6

Houston Methodist Hospital 75.1

Beaumont Hospital-Royal Oak, Mich. 74.6

UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego 74.6

Morristown Medical Center, Morristown, N.J.

Advocate Christ Medical Center, Oak Lawn, Ill.

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 71.3

West Penn Hospital, Pittsburgh

Scripps La Jolla Hospitals, La Jolla, Calif.

University Hospital, Durham, N.C.

Montefiore Medical Center, Bronx, N.Y.

92%

91%

6.8%

10.0%

3.7%

9.6%

1.6%

7.3%

5 9 3.1%

5 9 2.7%

5 9 2.2%

5 9 0.9%

5 9 5.3%

5 9 7.0%

Yes 5 9 1.2%

2.4 No 5 9 0.6%

2.7 Yes 5 9 1.8%

2.0 Yes 5 9 1.3%

90% 270 2.3 Yes 5 9 1.2%

89% 180 2.9 Yes 5 9 4.6%

92% 159 2.0 Yes 5 9 4.9%

91% 173 2.3 Yes 5 9 3.9%

89% 187 2.7 Yes 5 9 1.0%

92% 303 2.7 Yes 5 9 3.7%

86% 467 2.0 Yes 5 9 2.7%

90% 188 2.0 Yes 5 9 1.9%

92% 165 2.1 Yes 5 8 1.0%

87% 275 2.0 Yes 5 9 0.6%

91% 208 2.1 Yes 5 9 2.1%

91% 388 2.1 Yes 5 9 0.2%

88% 446 2.7 Yes 5 9 0.1%

91% 251

5 9 2.4%

5 9 0.1%

5 9 0.7%

5 8 5.3%

5 9 0.5%

Langone Hospitals,

Health-UCSF Medical Center, San

New York-Presbyterian Hospital-Columbia and Cornell

Rush University Medical Center, Chicago

Johns Hopkins Hospital, Baltimore

Mayo Clinic, Rochester, Minn.

Cedars-Sinai Medical Center, Los Angeles

Cleveland Clinic

Mount Sinai Hospital, New York

Northwestern Memorial Hospital, Chicago

Massachusetts General Hospital, Boston

UCLA Medical Center, Los Angeles

Barnes-Jewish Hospital, Saint Louis 81.5

Stanford Health Care-Stanford Hospital, Stanford, Calif. 79.6

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 78.1

15 Houston Methodist Hospital 78.1

17 Long Island Jewish Med. Ctr. at Northwell, New Hyde Park, N.Y. 76.5

5 9 6.4%

5 9 18.1%

5 9 10.7%

5 9 3.4%

5 9 18.3%

Yes 5 9 22.9%

Yes 5 8 1.6%

2.4 Yes Yes 5 9 10.0%

Yes 5 9 2.7%

3,129 2.0 Yes Yes 5 9 4.1%

5,254 2.6 Yes Yes 5 9 16.1%

2,975 3.2 Yes Yes 5 9 6.6%

90% 5,361 2.5 Yes Yes 5 9 5.9%

94% 2,683 2.7 Yes Yes 5 9 4.1%

91% 4,043 2.5 Yes Yes 5 9 5.6%

92% 4,480 2.1 Yes Yes 5 9 1.1%

5 87% 4,848 1.8 Yes Yes 5 9 0.9%

18 Mayo Clinic-Jacksonville, Fla. 75.2 5 5 95% 2,278 2.8 Yes Yes 5 9 4.7%

19 Brigham and Women’s Hospital, Boston 75.1 5 5 92% 4,597 2.4 Yes Yes 5 9 5.5%

20 University of Michigan Health-Ann Arbor 74.2 5 5 92% 2,917 2.7 Yes Yes 5 9 3.3%

21 UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego 74.0 5 5 91% 2,074 2.1 Yes Yes 5 9 2.3%

22 Lenox Hill Hospital at Northwell Health, New York 73.0 5 5 89% 1,957 2.9 Yes Yes 5 9 1.1%

23 Duke University Hospital, Durham, N.C. 71.6 4 5 91% 4,029 2.1 Yes Yes 5 9 5.6%

24 Emory University Hospital, Atlanta 71.0

University of Miami Hospital and Clinics-UHealth Tower 70.2

5 91% 3,054 2.2 Yes Yes 5 9 3.2%

5 87% 1,097 1.3 Yes Yes 5 9 2.1%

Mayo Clinic-Phoenix 69.8 5 5 96% 1,754 3.2 Yes Yes 5 9 4.2%

Baylor St. Luke’s Medical Center, Houston 69.6

University of Kansas Hospital, Kansas City 69.5

Ohio State University Wexner Medical Center, Columbus 69.3

St. Francis Hospital & Heart Center, Roslyn, N.Y. 69.0

UT Southwestern Medical Center, Dallas 69.0

OHSU Hospital, Portland, Ore. 68.2

Presbyterian Shadyside,

Permanente

Angeles Medical Center

Hospital-Grosse Pointe, Mich.

Orlando

5 87% 3,009 2.0 Yes Yes 5 8 0.6%

5 93% 3,638 2.1 Yes Yes 5 9 0.9%

89% 5,410 2.2 Yes Yes 5 9 2.2%

94% 1,867 2.0 Yes No 5 8 0.2%

93% 2,717 2.2 Yes Yes 5 9 1.8%

0.8%

2.3%

0.4%

No

0.0%

Beat 3 brain tumors.

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I had 3 brain tumors. Yet, I believed I could rise. I had a team all around me who moved mountains so I could rise.

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We’re #1 at helping you move better.

Celebrating 13 years of being the best Orthopedic Hospital in the nation.

Our great outcomes—the lowest rates of complication, infection, and readmission in the nation—start with putting our patients first. At Hospital for Special Surgery, it’s not just about being #1 in Orthopedics. It’s all the moments that our specialized doctors, dedicated staff, and state-of-the-art facilities can enable for our patients.

Learn more at HSS.edu

Orthopedics

Health-UCSF Medical Center,

Health Shands Hospital, Gainesville, Fla.

Hospital-Troy, Mich.

Orthopedic Institute, Irvine, Calif.

University Health System-Metro Chicago

Keck Medical Center of USC, Los Angeles

Lancaster General Hospital, Lancaster, Pa.

North Shore University Hosp. at Northwell Health, Manhasset, N.Y.

Florida Orthopaedic Institute at Tampa General Hospital

Providence Mission Hospital, Mission Viejo & Laguna Beach, Calif.

John Muir Health-Walnut Creek Med. Ctr., Walnut Creek, Calif.

Providence Holy Cross Medical Center, Mission Hills, Calif. 57.0

Johns Hopkins Hospital, Baltimore 56.9

St. Francis Hospital & Heart Center, Roslyn, N.Y. 56.8

Queen’s Medical Center, Honolulu 56.4

UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego 56.4

Brigham and Women’s Hospital, Boston 56.2

UW Health University Hospital, Madison, Wis. 55.9

Advocate Good Samaritan Hospital, Downers Grove, Ill. 55.6

Hackensack U. Med. Ctr. at Hackensack Meridian Hlth., N.J. 55.6

AdventHealth Orlando 55.4

Penn State Health Milton S. Hershey Medical Center, Hershey, Pa. 55.3

UW Medicine-University of Washington Medical Center, Seattle 55.1

Mayo Clinic-Phoenix

Mount Sinai Beth Israel, New York

UC Davis Medical Center, Sacramento, Calif.

4,158

4,588

1,500 2.5

4,052 1.6

3,891 2.4

2,670 2.6

2 7 2.8%

2 7 0.5%

2 7 0.2%

2 7 1.5%

2 7 0.3%

2 7 2.5%

2 7 0.1%

2 7 0.8%

2 7 2.1%

2,406 2.2 Yes 2 7 0.4%

2,274 2.3 Yes 2 6 0.1%

885 2.3 Yes 2 6 0.0%

92% 1,881 2.4 Yes 2 7 3.7%

94% 1,539 2.0 Yes 2 7 0.2%

92% 2,159 1.5 Yes 1 6 0.0%

91% 1,765 2.1 Yes 2 7 2.2%

92% 3,113 2.4 Yes 2 7 2.9%

92% 2,694 2.4 Yes 2 7 0.8%

89% 1,669 2.2 Yes 2 7 0.1%

86% 2,414 2.8 Yes 2 7 0.7%

89% 9,378 1.9 No 2 7 1.1%

91% 2,093 2.3 Yes 2 7 0.7%

91% 2,228 2.3 Yes 2 7 1.7%

96% 1,919 3.2 Yes 2 7 2.3%

83% 1,063 1.4 No 2 7 0.1%

89% 1,940 2.7 Yes 2 7 1.5%

are explained on Page 113.

The American Orthopaedic

OWN

AND

BONE

*

STAR PERFORMERS

AdventHealth Orthopedic Institute, Central Florida Division - Winter Park, FL

Allegheny Health Network (AHN)Jefferson Hospital - Pittsburgh, PA

* Androscoggin Valley Hospital Orthopaedics & Sports Medicine - Berlin, NH

Anne Arundel Medical Group Orthopedics/ Luminis Health - Annapolis, MD

* Atlantic General Hospital - Berlin, MD

AtlantiCare Regional Medical Center - Pomona, NJ

Atrium Health MSKI Fracture Prevention ProgramCharlotte, NC

Atrium Health Wake Forest Baptist Medical Center - Winston Salem, NC

Baptist Orthopedic Hospital at Mission TrailSan Antonio, TX

Berkshire Medical Center - Pittsfield, MA

Bryan Medical Center - Lincoln, NE

Cedars-Sinai Medical Center - Los Angeles, CA

* Central Carolina Orthopaedic AssociatesSanford, NC

CHRISTUS Mother Frances Hospital - Tyler - Tyler, TX

Concord Hospital - Concord, NH

Cooper Health System - Camden, NJ

Crystal Clinic Orthopaedic Center - Akron, OH

* Firelands Physician Group - Sandusky Orthopedics and Pain Management - Sandusky, OH

Froedtert & the Medical College of WisconsinMilwaukee, WI

* Goshen Physicians Orthopedics and Sports Medicine - Goshen, IN

Greater Baltimore Medical Center - Baltimore, MD

Hartford HealthCare Bone and Joint InstituteHartford, CT

Henry Ford Hospital - Detroit, MI

Hoag Orthopedic Institute - Irvine, CA

Huntington Hospital - Northwell HealthHuntington, NY

JPS Health Network - Fort Worth, TX

^

*

Institutions are recognized for at least 75% compliance on at least 5 of the 10 recommended secondary fracture prevention measures over the last year.

KCU/HCA Research Medical CenterKansas City, MO

Lahey Hospital and Medical Center - Burlington, MA

Lexington Medical Center - West Columbia, SC

MaineGeneral Orthopaedics - Augusta, ME

Marshfield Clinic Health System - Marshfield, WI

Medical University of South Carolina - Charleston, SC

Memorial Regional Hospital - Hollywood, FL

Mendelson Kornblum Orthopedic & Spine Specialists - Warren, MI

Michigan Neurosurgical Institute, PCGrand Blanc, MI

Mount Sinai South Nassau - Oceanside, NY

NMC Health - Newton, KS

North Central Baptist Hospital - San Antonio, TX

Northern Light Eastern Maine Medical CenterBangor, ME

* Norton Audubon Hospital - Louisville, KY

* Norton Brownsboro Hospital - Louisville, KY

* Norton Cancer Institute - Louisville, KY

* Norton Hospital - Louisville, KY

Norton Women's and Children's HospitalLouisville, KY

NYU Langone Orthopedic Hospital - New York, NY

NYU Winthrop Hospital - Mineola, NY

OHSU Department of Orthopaedics & Rehabilitation - Portland, OR

Orthopaedic Associates of MichiganGrand Rapids, MI

^Orthopedic Associates of SW Ohio - Dayton, OH

Overlake Medical Center & Clinics - Bellevue, WA Paramount Care, Inc. - Maumee, OH

^Park Nicollet Methodist Hospital/TRIA Orthopaedic Center - Minneapolis, MN

^Prisma Health-Upstate - Greenville, SC

ProMedica Toledo Hospital - Toledo, OH Regions Hospital - St. Paul, MN

Resolute Health Hospital - New Braunfels, TX

^Sanford Medical Center - Fargo - Fargo, ND

*

Sonoran Orthopedics - Scottsdale, AZ

South Texas Fracture Prevention ClinicSan Antonio, TX

Southern Illinois Healthcare Herrin HospitalHerrin, IL

St. Luke's Health System Osteoporosis and Bone Health Program - Boise, ID

Tahoe Forest Health System - Truckee, CA

Tallahassee Memorial HealthCare - Tallahassee, FL

The Bone and Joint Center at AdventHealth Zephyrhills - Zephyrhills, FL

The Bone and Joint Center- Capital Region Orthopaedic Associates - Albany, NY

The Methodist Hospitals, Ortho Spine CenterMerrillville, IN

* University of Cincinnati - Cincinnati, OH

* The University of Texas at Austin -

UT Health Austin - Austin, TX

* TSAOG Orthopaedics and Spine - San Antonio, TX

UnityPoint Health Endocrinology and Midwest Orthopedics - Peoria, IL

University Hospital - San Antonio, TX

* University of Connecticut - Farmington, CT

University of Iowa Hospitals & Clinics - Iowa City, IA

* University of Texas Southwestern Medical Center Dallas, TX

University of Wisconsin Hospitals and ClinicsMadison, WI

UT Health East Texas Orthopedic and Sports Medicine Institute - Tyler, TX

VCU Health - Richmond, VA

West Coast Bone Health & Wellness CenterCamarillo, CA

Wooster Community Hospital Health SystemWooster, OH

^WVU Medicine Department of OrthopaedicsMorgantown, WV

^Yale New Haven Hospital Fragility Hip Fracture Program - New Haven, CT

Mayo Clinic, Rochester, Minn.

National Jewish Health, Denver-U. of Colorado Hosp.,

Cedars-Sinai Medical Center, Los Angeles

NYU Langone Hospitals, New York

UCLA Medical Center, Los Angeles

Cleveland Clinic

Johns Hopkins Hospital, Baltimore

Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia

UCSF Health-UCSF Medical Center, San Francisco

UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego

New York-Presbyterian Hospital-Columbia and Cornell

Stanford Health Care-Stanford Hospital, Stanford, Calif. 85.6

Northwestern Memorial Hospital, Chicago 84.5

14 Mayo Clinic-Phoenix 82.2

14 North Shore University Hosp. at Northwell Health, Manhasset, N.Y. 82.2

16 Massachusetts General Hospital, Boston 81.4

17 Mount Sinai Hospital, New York 80.0

18 Houston Methodist Hospital 79.6

18 Vanderbilt University Medical Center, Nashville, Tenn. 79.6

20 Rush University Medical Center, Chicago 79.5

21 UT Southwestern Medical Center, Dallas 79.3

22 Memorial Sloan Kettering Cancer Center, New York 78.5

22 University of Michigan Health-Ann Arbor 78.5

24 Brigham and Women’s Hospital, Boston 77.2

Barnes-Jewish Hospital, Saint Louis 76.2

Keck Medical Center of USC, Los Angeles 76.2

UC Davis Medical Center, Sacramento, Calif. 76.1

Northwestern Lake Forest Hospital, Lake Forest, Ill. 76.0

UPMC Presbyterian Shadyside, Pittsburgh

Yale New Haven Hospital, New Haven, Conn.

Duke University Hospital, Durham, N.C.

University of Kansas Hospital, Kansas City

Beaumont Hospital-Royal Oak, Mich.

Hill Hospital at Northwell Health, New

State University

Medical Center,

Muir Health-Walnut Creek Med. Ctr., Walnut Creek,

4,170

9,764

7,099

5,977 2.4

3,189 2.4

6,758

4,291 2.1

18,065 3.1

6 8 19.5%

6 8 25.3%

6 8 2.8%

6 8 5.1%

6 8 4.9%

6 8 12.6%

6 8 14.4%

6 8 9.0%

6 8 10.5%

6 8 4.6%

6 8 6.9%

4,315 2.7 Yes 6 8 3.1%

92% 4,966 2.0 Yes 6 8 2.3%

96% 4,216 3.2 Yes 5 8 2.8%

90% 11,185 2.4 Yes 5 8 1.6%

94% 7,877 2.6 Yes 6 8 8.4%

88% 8,310 2.3 Yes 5 8 3.9%

92% 7,453 2.1 Yes 6 8 0.7%

91% 4,979 2.3 Yes 6 8 6.0%

91% 3,085 2.1 Yes 5 8 1.0%

93% 4,523 2.2 Yes 6 8 1.7%

95% 4,771 2.4 Yes 5 8 1.2%

92% 5,189 2.7 Yes 6 8 4.8%

92% 5,977 2.4 Yes 6 8 6.5%

90% 6,306 2.5 Yes 6 8 4.2%

92% 1,127 2.5 Yes 6 8 1.4%

89% 4,079 2.7 Yes 5 8 0.7%

91% 1,887 1.9 Yes 5 8 0.1%

7,788 2.3 Yes 6 8 5.3%

13,085 2.0 Yes 5 8 3.3%

5,844 2.1 Yes 6 8 7.7%

5,024 2.1 Yes 5 8 1.0%

1.5%

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Rehabilitation

Rank Hospital

services score (16=best)

by CARF

of specialists recommending hospital

1 Shirley Ryan AbilityLab, Chicago 100.0 94% 95% 60% 90% Very High 7 16 No 27.7%

2 TIRR Memorial Hermann, Houston 89.7 94% 96% 61% 93% Very High 7 16 Yes 16.5%

3 Spaulding Rehabilitation Hospital, Charlestown, Mass. 84.1 94% 95% 51% 98% Very High 7 16 Yes 19.0%

4 Kessler Institute for Rehabilitation, West Orange, N.J. 80.8 94% 94% 61% 93% Very High 6 12 Yes 14.0%

5 UW Medicine-University of Washington Medical Center, Seattle 75.7 93% 96% 65% 95% Very Low 7 16 Yes 13.4%

6 Mayo Clinic, Rochester, Minn. 71.1 93% 96% 64% 88% Low 7 16 Yes 11.7%

7 Rusk Rehabilitation at NYU Langone Hospitals, New York 70.8 93% 96% 60% 100% High 7 16 Yes 9.9%

8 Shepherd Center, Atlanta* 69.9 NA NA NA NA NA 7 16 Yes 7.6%

9 MossRehab, Elkins Park, Pa. 68.7 93% 95% 62% 99% Very High 6 16 Yes 6.7%

10 UPMC Mercy, Pittsburgh 67.2 94% 95% 60% 99% Very High 7 16 No 5.9%

11 Santa Clara Valley Medical Center, San Jose, Calif. 65.6 94% 96% 71% 90% Very High 7 15 Yes 3.8%

12 New York-Presbyterian Hospital-Columbia and Cornell 64.6 94% 96% 63% 95% Average 6 16 Yes 8.2%

13 Mount Sinai Hospital, New York 62.5 94% 96% 57% 97% Very High 7 16 Yes 4.9%

14 Baylor Scott and White Institute for Rehabilitation-Dallas 62.3 94% 96% 65% 99% Very High 7 15 Yes 1.7%

15 Craig Hospital, Englewood, Colo.* 61.9 NA NA NA NA NA 6 14 No 6.2%

16 Carolinas Rehabilitation, Charlotte, N.C. 61.3 93% 96% 65% 94% Very High 7 16 Yes 3.5%

17 Mary Free Bed Rehabilitation Hospital, Grand Rapids, Mich. 60.9 94% 96% 69% 100% Very High 7 16 Yes 1.7%

18 MedStar National Rehabilitation Hospital, Washington, D.C. 60.5 94% 96% 56% NR Very High 7 16 Yes 3.5%

19 Rancho Los Amigos National Rehab. Ctr., Downey, Calif. 58.0 93% 96% 66% 86% Very High 7 16 Yes 0.9%

20 University of Alabama at Birmingham Hospital 57.7 94% 96% 69% 98% Very High 7 16 No 1.3%

21 WakeMed Health and Hospitals, Raleigh Campus, N.C. 57.2 94% 97% 71% 99% Very High 6 15 Yes 0.6%

22 UW Medicine/Harborview Medical Center, Seattle 56.6 93% 96% 58% 93% Very High 7 16 Yes 3.2%

23 Johns Hopkins Hospital, Baltimore* 55.4 NA NA NA NA NA 7 16 Yes 3.3%

24 MetroHealth Medical Center, Cleveland 54.4 94% 96% 57% 100% Very High 7 16 Yes 1.5%

25 Kaiser Permanente Vallejo Medical Center, Vallejo, Calif. 54.3 93% 96% 77% 78% Very High 6 15 Yes 1.5%

26 Emory Rehabilitation Hospital, Atlanta 54.1 94% 96% 67% 100% Very High 7 16 Yes 2.0%

27 UT Southwestern Medical Center, Dallas 54.0 NR NR NR NR High 7 15 Yes 2.7%

28 Legacy Good Samaritan Medical Center, Portland, Ore. 53.1 94% 96% 73% 93% Very High 6 15 Yes 0.0%

29 Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 52.6 94% 95% 63% 100% Very High 7 16 Yes 2.0%

29 Sunnyview Rehabilitation Hospital, Schenectady, N.Y. 52.6 94% 96% 64% 91% Very High 7 16 Yes 0.3%

31 OhioHealth Rehabilitation Hospital, Columbus, Ohio 51.6 94% 96% 63% 97% Very High 7 15 Yes 0.2%

32 WellStar Kennestone Hospital, Marietta, Ga. 51.5 93% 97% 79% NR Average 6 15 Yes 0.0%

33 Ohio State University Wexner Medical Center, Columbus 51.4 93% 92% 58% 96% Very High 7 16 Yes 5.7%

University of Michigan Health-Ann Arbor

Sarasota Memorial Hospital, Fla.

Brooks Rehabilitation Hospital, Jacksonville, Fla.

St. David’s Medical Center, Austin

94% 95% 59% 100% Average 7 15 No 4.0%

94% 96% 66% 95% Very High 7 15 Yes 0.0%

94% 95% 57% 90% Very High 6 16 Yes 0.9%

94% 97% 69% 86% Very High 7 15 No 0.0%

Mayo Clinic, Rochester, Minn.

Clinic

Cedars-Sinai Medical Center, Los Angeles

Memorial Sloan Kettering Cancer Center, New York

New York-Presbyterian Hospital-Columbia and Cornell

University of Texas MD Anderson Cancer Center, Houston

Johns Hopkins Hospital, Baltimore

Keck Medical Center of USC, Los Angeles

University of Michigan Health-Ann Arbor

NYU Langone Hospitals, New York

UT Southwestern Medical Center, Dallas

Northwestern Memorial Hospital, Chicago

Vanderbilt University Medical Center, Nashville, Tenn.

Mount Sinai Hospital, New York

Rush University Medical Center, Chicago

UC San Diego Health-La Jolla and Hillcrest Hospitals, San Diego 76.0

17 UCSF Health-UCSF Medical Center, San Francisco 75.9

18 Barnes-Jewish Hospital, Saint Louis 75.4

19 Mayo Clinic-Phoenix 73.9

20 Long Island Jewish Med. Ctr. at Northwell, New Hyde Park, N.Y. 73.1

21 Hosps. of the U. of Pennsylvania-Penn Presby., Philadelphia 72.5

21 Houston Methodist Hospital 72.5

21 UCLA Medical Center, Los Angeles 72.5

24 New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn 72.1

25 North Shore University Hosp. at Northwell Health, Manhasset, N.Y. 71.7

Duke University Hospital, Durham, N.C. 71.2

UW Medicine-University of Washington Medical Center, Seattle 71.2

Brigham and Women’s Hospital, Boston 70.6

University of North Carolina Hospitals, Chapel Hill 70.5

30 Stanford Health Care-Stanford Hospital, Stanford, Calif.

Hackensack U. Med. Ctr. at Hackensack Meridian Hlth., N.J.

Oroville Hospital, Oroville, Calif.

University of Chicago Medical Center

UPMC Presbyterian Shadyside, Pittsburgh

Memorial Hospital, Fla.

Jefferson Health-Thomas Jefferson U. Hospitals,

University Hospital, Atlanta

St. Luke’s Medical Center,

1,756 1.9

1,059 2.4

1,039 2.5

1,214 2.2

6 9 20.8%

6 9 23.6%

6 9 1.4%

6 8 8.0%

6 9 6.3%

6 9 7.5%

6 9 15.2%

6 9 5.9%

6 9 7.5%

6 9 5.5%

6 9 4.1%

1,435 2.0 Yes 6 9 3.3%

91% 1,111 2.3 Yes 6 9 6.9%

1,414 2.3 Yes 6 9 4.5%

91% 363 2.1 Yes 6 9 1.3%

91% 655 2.1 Yes 6 9 2.2%

91% 746 2.6 Yes 6 9 9.4%

90% 783 2.5 Yes 6 9 2.1%

96% 722 3.2 Yes 6 8 3.7%

87% 1,665 1.8 Yes 6 9 1.5%

91% 1,080 2.5 Yes 6 9 3.0%

92% 980 2.1 Yes 6 8 1.5%

93% 793 3.2 Yes 6 9 10.9%

88% 505 1.4 No 6 9 0.1%

90% 871 2.4 Yes 6 9 1.2%

91% 988 2.1 Yes 6 8 5.3%

91% 910 2.3 Yes 6 9 3.3%

92% 902 2.4 Yes 6 9 2.5%

91% 827 1.7 Yes 6 9 2.4%

674 2.7 Yes 6 9 3.3%

86% 947 2.8 Yes 6 9 2.8%

78% 388 1.3 No 6 9 0.2%

866 2.3 Yes 6 9 1.9%

1.7%

0.0%

1.8%

1.3%

These hospitals

the best in their specialty

particularly challenging patients, in the view of at least 5% of medical specialists surveyed by U.S. News over the past three years.

Ophthalmology

RankHospital

Psychiatry

% of specialists recommending hospital

1 Bascom Palmer Eye Institute-U. of Miami Hosp. and Clinics, Miami 39.7%

2 Wills Eye Hospital, Thomas Jefferson U. Hospitals, Philadelphia 36.6%

3 Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore 26.6%

4 Mass Eye and Ear, Massachusetts General Hospital, Boston 22.9%

5 Stein and Doheny Eye Institutes, UCLA Med. Ctr., Los Angeles 17.8%

6 Duke University Hospital, Durham, N.C. 11.7%

7 University of Iowa Hospitals and Clinics, Iowa City 11.0%

8 University of Michigan Health Kellogg Eye Center, Ann Arbor 8.1%

9 UCSF Health-UCSF Medical Center, San Francisco 6.2%

10 John A. Moran Eye Ctr., U. of Utah Hosps. & Clinics, Salt Lake City 5.9%

11 Cole Eye Institute, Cleveland Clinic 5.7%

12 New York Eye and Ear Infirmary of Mount Sinai 5.3%

RankHospital

% of specialists recommending hospital

1 McLean Hospital, Belmont, Mass. 18.9%

2 Johns Hopkins Hospital, Baltimore 17.6%

3 Massachusetts General Hospital, Boston 17.0%

4 New York-Presbyterian Hospital-Columbia and Cornell 13.1%

5 UCSF Health-UCSF Medical Center, San Francisco 9.3%

Resnick Neuropsychiatric Hospital at UCLA, Los Angeles 8.5%

Mayo Clinic, Rochester, Minn. 6.2%

Yale New Haven Hospital, New Haven, Conn. 6.1%

Sheppard Pratt Hospital, Baltimore 5.3%

Menninger Clinic, Houston 5.2%

NYU Langone Hospitals, New York 5.2%

Rheumatology

RankHospital

% of specialists recommending hospital

Johns Hopkins Hospital, Baltimore 34.9%

Cleveland Clinic 24.6%

Hosp. for Special Surgery, NY-Presby. U. Hosp.-Columbia & Cornell 21.9%

Mayo Clinic, Rochester, Minn. 21.0%

Brigham and Women’s Hospital, Boston 15.5%

Massachusetts General Hospital, Boston 12.9%

NYU Langone Hospitals, New York

UCSF Health-UCSF Medical Center, San Francisco 10.5%

UCLA Medical Center, Los Angeles 9.4%

University of Alabama at Birmingham Hospital

UCHealth University of Colorado Hospital, Aurora 5.2%

Once Again, Ranked

Premier Eye Hospital In America.

Jose Pulido, MD, MS, MBA, MPH - Larry Donoso Endowed Chair and Director, Henry and Corrine Bower Memorial Laboratories for Translational Medicine

For the third consecutive year, ranked as a top 10 children’s hospital in the nation

Once again, we’re honored to be named one of just 10 children’s hospitals nationwide on the 2022–23 U.S. News & World Report Best Children’s Hospitals Honor Roll. Stanford Children’s Health is also ranked the No. 2 children’s hospital in the Pacific region and top-ranked in Northern California. This distinction demonstrates the enduring pursuit of excellence and exceptional quality that our faculty, physicians, and staff commit to patients and families. With our network of 65+ Bay Area locations, our patients can access this same great care close to home.

Children’s

The Long Road to Recovery

For kids and teens with chronic COVID, comprehensive clinic care can be tough to find

by Chelsea Cirruzzo  ©

MORGAN RANDALL’S family thought they’d dodged a bullet. The then15-year-old’s symptoms were mild when she got COVID-19 in Decem ber 2020 – no fever, but the Massa chusetts teen lost her sense of smell and taste and had a sore throat. The family went into quarantine, and five days later, Morgan felt better, passing time by joining her dance team over Zoom from her bedroom.

“I was completely fine,” she says. “I felt, like, normal.”

Winter break rolled around and Morgan took a breather from school and dancing. When she returned, something had changed. During more intense dance sessions, she was short of breath and her legs, strong from years of tap dancing and pirouettes, were tired and weak. Both Morgan and her mom, Jessica, figured she was still recover ing from COVID-19, but by mid-February 2021, the symptoms weren’t letting up. Morgan could no longer make it through her usual solo. Scared, they turned to a pe diatrician who quickly pulled Morgan from dance – an activity she’d done since she was 3 – out of fear that her heart was inflamed.

“I was just confused because I was like, ‘Why is my body giving up on me?’ ” says Morgan, now 17.

Morgan is among an unknown number of children and teens who have signs of long COVID, which is often characterized by fatigue, malaise, shortness of breath and other symptoms that persist or surface anew after an initial bout with COVID-19. In 2021, the National Institutes of Health launched an initiative to study long COVID, and the Centers for Disease Control and Prevention unveiled guidance for treating patients with post-COVID conditions.

But with much still to be learned about long COVID in adults – who are more likely to die or develop severe illness from COVID-19 – researchers also know very little about long COVID in chil dren, particularly when it comes to who is getting it and how best to treat them. While a number of long COVID clinics have cropped up around the country to treat adults through a system of coordinated, multidisciplinary care, pediatric clinics remain relatively limited, meaning plenty of children and their guardians must navi gate a patchy treatment landscape and long wait times.

Limited information

Research on pediatric long COVID is still in its infancy, but experts stress that more studies are sorely needed.

MORGAN RANDALL, 17, COMPLETES

A SOLO ON THE COMPETITION STAGE IN MAY 2022

A FEAT SINCE BECOMING ILL WITH LONG COVID.

Dr. Dan Cooper, a pediatric pulmonologist and professor of pediatrics at the University of California-Irvine, says that while children don’t tend to get as severely ill from COVID19 as adults, they’re still getting sick, and some are developing long-term symptoms, such as fatigue and shortness of breath. What’s more, he says the “relatively slow rate” of COVID vaccination among younger kids renders them more vulnerable to infection – and thus, long COVID.

Although long COVID doesn’t appear to be as common in kids as it is in adults, the science on pediatric long COVID is steps behind where it is in adults, explains Dr. Sean O’Leary, vice chair of the American Academy of Pediatrics Committee on Infectious Diseases.

Cooper says studies on pediatric long COVID need to focus on

several groups in particular: kids who had asymp tomatic or mild cases of COVID-19, those who were hospitalized and those who experienced multisystem inflammatory syndrome, or MIS-C – an uncommon but serious condition in which parts of the body like the brain, heart, lungs or eyes become inflamed. More than 8,600 patients in the U.S. as of late June 2022 had met the criteria for MIS-C, which can lead to post-COVID conditions, according to the CDC. At least 70 patients have died of MIS-C.

O’Leary says treatment for pediatric long COVID should focus on the specific needs of children, par ticularly on keeping them active through approaches such as physical therapy.

“One of our goals is to try to keep kids from get ting into sort of this vicious cycle of deconditioning” in which they’re so fatigued, they “don’t want to do anything,” O’Leary says. Research must explore the

PROVENQUALITY PROGRAMS AMERICANCOLLEGE of CARDIOLOGY

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Tenet Health System

Baylor Health Care System

Sentara Healthcare

Ballad Health System

Banner Health

Baptist Memorial Healthcare Corporation

BJC HealthCare

Christus Health System

Hendrick Health

Legacy Health

University of California Health System

Kaiser Permanente

Orlando Health

Lehigh Valley Health Network

Memorial Health System of California

Methodist Healthcare

MultiCare Health System

Northside Hospital System

Northwell Health

PeaceHealth

Yale New Haven Health

Mayo Foundation for Medical Education and Research

ProMedica Health System, Inc.

Quorum Health Corporation

Singing River Health System

SSM Health Care

St. Luke’s University Health Network

University of Colorado Health

University of Louisville Health, Inc.

Wellstar Health System

Ca rdiovascula r Institute

commonality of symptoms among kids with long COVID to help tailor future treatments, he adds.

For Breanna “Bree” Saligumba, an 11-year-old from California who loves soccer and track, ongoing symptoms since getting COVID-19 in March 2020 have caused her to miss school several times a month, says her mom, Marci. Bree is dealing with every thing from nerve pain, body tremors and difficulty breathing to inflammatory arthritis and fainting spells.

On a good day, Bree is the fastest girl on her soccer team, and has clocked running speeds on par with high school track athletes. But when her long COVID symptoms flare up, Bree struggles to play and tires easily. “I can’t stand anymore and it feels like I can’t move anymore and it hurts really bad,” she says.

Bree has been to the emergency room and urgent care so many times the family has lost count. In March 2022, Bree was rushed to the hospital by ambulance after she was found unresponsive on the school’s blacktop.

To manage her symptoms, Bree gets physical therapy, acu puncture and chiropractic care. She also uses several inhalers and painkillers. Although she is vaccinated, Bree contracted COVID-19 for a second time in May 2022.

Marci says Bree’s pediatrician helped coordinate much of her daughter’s care, sending the pair to multiple hospitals where Bree is seeing a rheumatologist, cardiologist, allergist and pain specialist.

“Her doctors are doing everything they can, but this virus is so new, there’s still things they need to learn,” Marci says.

A lag in clinics

One model for helping kids with long COVID takes a multi disciplinary approach to care, using a clinic as a hub that can connect patients to specialists all working together. But the availability of such clinics is lacking for youth.

That could be because the doctors running programs like these may simply have more experience working with adults, O’Leary says.

“It depends where you are, and it depends on the comfort level of the clinicians running the clinic,” he says.

It’s a challenge Jessica Ran dall, in Massachusetts, says she faced early in seeking out care for Morgan.

the idea came after he began seeing a pattern in early 2021: Kids who pri marily had mild COVID-19 infections in 2020 were coming back for care. Given the prevalence of long COVID in adults and the fact that more than 4 million children had tested positive for COVID-19 at that time, he began to wonder: Could there be thousands of kids with long COVID out there? (At least 14 million children have tested positive for COVID-19 since the pan demic began.)

Michigan Medicine wanted to be prepared, so the health system began building a model involving experts in areas such as pulmonology, cardiol ogy, physical rehabilitation and psy chology, he says.

Of the more than 100 kids who’ve been seen by the clinic, many are over age 10, most are in their teens and sev eral have had persistent symptoms for over a year. Very few had severe COVID19 symptoms initially, though a good number of patients lost their sense of smell and taste, Lumeng says. The clinic currently requires a referral from a pri mary care physician or a pediatric sub specialist for an appointment.

“I’d say the most prominent feature that we see is shortness of breath, chest pain – which again I think mirrors what is seen in adults,” Lumeng says. Many of the clinic’s patients are also active in sports and discovered their lingering conditions once they tried to take part again. These patients, Lumeng

14 million kids have developed COVID-19.

“When we first started look ing, I contacted a couple of hos pitals in Boston and they said, ‘We’re so sorry but we can’t see her because we’re not licensed to see pediatric cases,’ ” she says. Jessica recalls being on the phone daily with Morgan’s pediatrician trying to find options.

“I was doing my own research and legwork and our pediatri cian was kind of sending the referrals,” she says. “There really wasn’t a place to collectively be seen.”

There are exceptions. Michigan Medicine, for example, opened a pediatric clinic in 2021 at C.S. Mott Children’s Hos pital in Ann Arbor. Clinic leader Dr. Carey Lumeng, a pediatric pulmonologist and professor at the University of Michigan, says

says, have been responding to asthma treatment, even if they’ve never previously had asthma.

Meanwhile, many kids with chest pain show no evidence of a lung or heart problem, he adds. That’s not unlike Bree, who says the inhalers she’s received have helped her play again. “I can run a little bit lon ger,” she says, “and actually get some goals.”

Lumeng estimates there may be just 10 or so pe diatric long COVID clinics in the U.S., though an international consortium “is trying to get a handle” on the condition while developing key measures to

help make research across centers possible, he says. Still, it’s hard to find pediatric doctors with experi ence managing fatigue, loss of smell or even chest pain, he adds.

“So, you have to make sure you have a multi disciplinary team and have somebody to take the reins to at least triage,” Lumeng says. Otherwise, patients are seeing multiple disconnected special ists who don’t know all that’s going on, he adds.

At the Kennedy Krieger Institute in Baltimore, which also launched a long COVID clinic for kids, that multidisciplinary approach is key. The clinic features a team that includes experts in physical therapy and behavioral health, as well as an edu cation specialist, since several patients are having difficulties in school.

Because long COVID is often a constellation of symptoms, patients and families find it helpful to have an interdisciplinary team, says Dr. Laura Malone, a pediatric neurologist and clinic co-direc tor. The task of tackling each symptom individually can be daunting and frustrating otherwise.

Working together allows team members to bring different perspectives to the table, enabling the development of a cohesive treatment plan for the patient at the end of the visit, she says.

For Morgan, seeing specialists who get her needs has been huge. She saw a physical therapist virtually,

who helped her with breathing exercises. Morgan’s also seen a pulmonary specialist who diagnosed her with exercise-induced asthma. After a heart screen ing came back normal, she was gradually able to return to dance. In early 2022, when Morgan was finally well enough to finish a solo on the competi tion stage – a first since becoming chronically ill – she cried tears of relief, her mom recalls.

While she’s not 100%, Morgan, now vaccinated, is feeling much better, despite a second bout of COVID-19 in 2022. The only lingering symptoms she has are fatigue and brain fog, particularly if she overdoes it. Even so, she worries about her future. “I’m very competitive,” she says. “Will I ever be able to dance the same again? It’s kind of scary.”

For Jessica Randall, Morgan’s mom, the entire process has been frustrating. She says it took eight weeks to first get Morgan into various specialists’ of fices. She’s aware of a post-COVID clinic with Boston Children’s Hospital, and has an appointment on the books to dig deeper into Morgan’s persistent fatigue.

Meantime, she wants to see more pediatric clinic options come online to better treat kids during what can be a scary period of limbo.

“To some people, eight weeks doesn’t seem like a long time,” she says. “But when it’s your child and you’re not sure what’s wrong, and you don’t know if her heart is inflamed, it’s a long time to wait.” l

BREANNA SALIGUMBA, 11, AN ANIME FAN, LIVES WITH DEBILITATING LONG-COVID SYMPTOMS, INCLUDING FAINTING.

A National Crisis Deepens

The pandemic has dealt a major blow to youth mental health

by Steven Ross Johnson

©

OVERNMENT analyses are provid ing a troubling look at how Ameri ca’s youth have suffered during the COVID-19 pandemic.

One examination of data from a nationally representative survey of high school students taken during the first half of 2021 found that 37% of students said they experienced poor mental health either most of the time or always during

the pandemic, with more than 31% of students saying they’d struggled in the past 30 days.

At least 44% of students reported feeling persistently sad or hopeless over the past year, with nearly 20% say ing they’d seriously considered suicide; 9% reported at tempting suicide during that time period.

The analysis was one of several research studies pub lished in April 2022 by the Centers for Disease Control and Prevention.

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Nearly 20% of students said they’d seriously considered suicide.

tent feelings of sadness and hope lessness compared with 37% of students who identified as hetero sexual. More than a quarter of gay, lesbian and bisexual students said they attempted suicide in the past 12 months, compared with just 5% of heterosexual students.

A companion analysis also found that more than half of students reported experiencing emotional abuse by a parent or other adult in the home during the pandemic –such as being insulted or sworn at –while 11% said they were physically abused. Roughly 29% experienced a parent or adult in their home los ing a job amid the pandemic.

“These data echo a cry for help,” Dr. Debra Houry, the CDC’s acting principal deputy director, said in a state ment. “The COVID-19 pandemic has created traumatic stressors that have the potential to further erode students’ mental well-being. Our research shows that surrounding youth with the proper support can reverse these trends and help our youth now and in the future.”

Notably, feeling connected to others at school influ enced whether students reported experiencing poor mental health. Stronger social ties seemed to help shield kids from suicidal thoughts or attempts. Even a virtual sense of social connectedness to family and friends through phones or computers offered a buffer, the researchers found.

“Comprehensive strategies that improve connections with others at home, in the community, and at school might foster improved mental health among youths dur ing and after the pandemic,” the researchers wrote.

Unequal toll. A particularly large disparity in men tal health status was observed between heterosexual students and those who identified as lesbian, gay or bisexual. More than three-quarters of lesbian, gay and bisexual high school students reported having persis

Extreme stress. Additional find ings showed that about 1 in 3 stu dents reported using illicit drugs and alcohol more than they had before the pandemic, and that ap proximately one-third of students reported being treated badly or unfairly in school due to their race or ethnicity in their lifetime. About two-thirds of Asian students and more than half of both Black and multi racial students said they experienced what researchers called “perceived racism.”

The findings offer additional evidence pointing to a worsening mental health crisis among America’s youth. Data predating the pandemic, for example, found that persistent feelings of sadness and hopelessness among high school students increased by approximately 40% from 2009 to 2019.

“Young people and their families have been under in credible levels of stress during the pandemic,” Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, said in a spring 2022 call with reporters. “Our data exposes cracks and uncovers an important layer of insight into the extreme disruptions that some youth have encountered.”

Dr. Jonathan Mermin, director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said the pandemic’s impact on youth mental health will be felt well after the outbreak itself is over. “Together,” he said, “we can mitigate its negative effects, increase health equity and create a healthier future for all youth.” l

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Boosting Your Baby’s Bugs

As in adults, the microbiomes of children are important for their good health

by Arlene Weintraub

©

LYNZIE SMITH, A 34-YEAR-OLD mother of three, breast fed her newborns for more than six months and stuck to a low-fat diet high in fruits and vegetables during all of her pregnancies. Now she’s passing on her healthy eating habits to her 7-year-old son and two daughters, ages 5 and 2. She and her husband regularly serve their children plant-based protein smoothies made with fruits and vegetables, and then they get creative to persuade the children to drink the healthy shake.

“We tell them if they drink it, they’ll get big muscles like the Hulk,” says Smith, of Hastings, Michigan. “Or we tell them if they eat all their fruit and vegetables, they’ll be able to wrestle their dad. Their goal is to try to be stronger than their dad.”

Unbeknownst to Smith, she’s also strengthening the vast networks of bacteria that live in her children’s digestive tracts. The human body contains trillions of microbes that play a key role in moderating important functions like immunity, metabolism and brain function. In fact, an improper balance of good and bad bacteria in the gut has been tied to an increased risk of several disorders, includ ing obesity, asthma and allergies.

Recent advances in gene sequencing have allowed researchers to unravel the ge netic codes of many of the bacteria in the gut, and to link those microbes with the roles they play in maintaining good health. As microbiome science advances, scien tists are learning more about how everyone can adopt habits that will boost levels of beneficial bacteria in the body while keeping the bad bugs at bay.

Smith’s OB-GYN, Dr. J. Daniel Woodall of Spectrum Health Pennock in Michi gan, hasn’t mentioned the term “microbiome” to her. But much of his advice has cen tered around establishing a diet and lifestyle that contribute to healthy gut bacteria, both for her and her children. “The infant microbiome mirrors that of the mother for three to six months,” he says. “We know a healthy diet leads to healthy gut flora,

and that breast milk has good bacteria.”

Indeed, research shows that the road to a healthy microbiome starts before birth. Several studies have found that a mother’s fat intake can influence the establishment of good bacteria in her baby’s microbiome, for example. Researchers at Baylor Col lege of Medicine and Texas Children’s Hospital in Houston studied 162 pregnant women and their newborns and found a tight correlation between the amount of fat in the diet during pregnancy and the depletion of some strains of healthy bac teria in the babies’ guts. Specifically, a diet consisting of 35% or more of fat led to a stark reduction in Bacteroides, bacteria that may influence immune system devel opment and inflammation. The impact of Mom’s diet on the microbiome of her baby can persist as long as six weeks after birth.

There hasn’t been enough research in people to determine exactly what the con sequences of that might be, but in nonhu man primates, that shift in the microbi ome causes newborns to be vulnerable to later obesity, insulin resistance and metabolic syndrome, says the study’s lead author, Dr. Kjersti Aagaard, a pro fessor at Baylor College of Medicine and Texas Children’s. “Just how much of that is reversible we don’t know,” she adds.

After birth, the evidence of breast feeding’s benefits to the microbiome continues to build. In 2020, Harvard researchers published a study in the journal Nature showing that mouse mothers pass on protective antibodies to their offspring via both the placenta and milk. That protects them from diseasecausing bacteria like E. coli.

Although further studies need to be done to confirm that the same phenom enon occurs in people, it could explain why mother’s milk is so beneficial, says Dr. Dennis Kasper, lead author and pro fessor of medicine and immunology at Harvard Medical School. “It’s long been thought that many antibodies against in fections have to come from the mother’s blood, passed across the placenta. But we saw clear protection against infection from just breast milk.”

Protecting the good. There’s grow ing suspicion that use of antibiotics early in life may be one explanation for the prevalence of childhood obesity – that wiping out the good bugs along with the

bad may change the microbiome in a way that predisposes children to the condi tion, as well as to others. In a 2019 study, a research team from the Uniformed Ser vices University in Bethesda, Maryland, studied the records of infants born be tween 2006 and 2013 and found a high association between antibiotic use dur ing the first two years of life and later development of obesity.

A subsequent study from the team found that children prescribed antibiot ics in their first six months were more apt to develop allergies or asthma later in life than were those who didn’t receive the drugs. Those who took more than one type of antibiotic faced a higher risk. The overall increase in risk ranged from 8% for food allergies to 47% for asthma. And in another study published in April 2022, the team found that kids who were pre scribed antibiotics in the first two years of life had a 71% in creased risk of being treated for psychiatric disorders later on in childhood.

to a healthy microbiome

Research shows the road starts before birth.

That’s not to say parents should avoid giving antibiotics to their children to treat con firmed bacterial diseases, says Dr. Cade Nylund, professor of pediatrics at the Uniformed Services University and co-author of both studies. But they should make sure the drugs are truly needed.

“The most common indication for an tibiotics prescriptions in infants is upper respiratory infections, primarily ear in fections,” Nylund says. “However, a lot of times, parents come in with an infant who has a fever but no clear indication of an ear infection, and as a precaution, an tibiotics are given. Maybe we shouldn’t be doing that.”

When babies are born prematurely, they almost always receive antibiotics to protect against potentially deadly infec tions. Now some physicians are rethink ing that practice, including those who treat preemies at St. Louis Children’s Hospital. They were disturbed by a 2019 study from Washington University School of Medicine in St. Louis suggesting that antibiotics cause long-lasting damage to the gut microbiome.

The researchers found that 18 months after babies were discharged from the

UP CLOSE AND PERSONAL: A RENDERING OF THE HUMAN MICROBIOME

neonatal intensive care unit, those who received antibiotics had more bacteria that can cause serious diseases than did healthy full-term babies. What’s worse, those bugs had grown resistant to an tibiotics. That’s a problem for the developing microbiome, says lead author Gautam Dantas, professor of pathology and immunology and molecular microbiology at Washington University School of Medicine.

“The microbiome and all of its important action is happen ing at exactly the same time in these (premature infants) as you’re bombarding them with the exact chemicals that can do the most damage,” Dantas says. That not only kills off good bugs that the baby might need, but it creates drug-resistant bad bacteria that can pass on their genes, potentially setting the child up for a future illness that’s hard to treat. “And that could happen 40 years later,” Dantas says.

There is one major caveat inherent in many of the studies drawing a link between antibiotics and negative changes to the microbiome, however. It could be that children who de velop diseases that require antibiotic treatments early in life are also more susceptible to infections, allergies and obesity, and it would be challenging to design a study to definitively answer the question of which came first.

That said, all of the mounting evidence argues for consider ing steps parents can take to better arm their kids. Studies

have shown that diets high in animal protein and fat, as well as highly processed carbohydrates like white bread and pastries, can deplete beneficial bugs such as Bifidobacterium, which is essential for healthy digestion and preventing infections. Up ping your children’s consumption of peas and other vegetables and fruits, downplaying sugary breakfast cereals and candy, as well as feeding them protein from sources like milk and yogurt, can boost levels of Bifidobacterium.

Get a pet. Early exposure to pets can increase the diver sity of gut microbes and boost the population of bacteria that protect against obesity and allergies, according to a long-term Canadian study of pregnancy and early childhood.

Some women who undergo cesarean sections immediately swab their children’s eyes and skin with vaginal fluid – a prac tice called “vaginal seeding” – hoping to pass along beneficial bacteria that their infants are unable to acquire because they’re not passing through the birth canal. But there’s limited evidence to back up that claim, Woodall warns, and the practice could risk passing on bacterial diseases like streptococcus to infants. The American College of Obstetricians and Gynecologists ad vised against vaginal seeding in 2017.

For now, commonsense habits like following a healthful Mediterranean diet and breastfeeding offer the best path to a healthy microbiome in your children, Woodall says. This sci ence is “definitely one piece of the pie in terms of overall infant health.” Expect to be hearing more about it, he says. l

Leveling the Playing Field for All Kids

by Jocelyn Carter

THE OMICRON VARIANT has helped some NBA players realize their hoop dreams, with teams sud denly adding their names to the roster to cover for teammates sidelined by COVID-19.

Apart from such slivers of a silver lining in the professional ranks, though, the pandemic has large ly wreaked havoc on the present and future dreams of many young athletes. Even before March 2020, when widespread lockdown orders went into effect, regular participation by kids in recreational team sports like basketball, soccer, baseball and softball had dropped. Ad ditional data from the Aspen Institute shows that 44% of families said their community-based sports programs had shuttered, merged with another program or returned with a lower capacity limit because of COVID-19.

As with so many other aspects of the pandemic, the fallout wasn’t distributed equally. In September 2021, approximately 50% of parents agreed that the risk of illness was a potential barrier to their child resuming sports, and this sports-related fear of illness was higher among Hispanic (58%) and Black parents (53%) than whites (47%). Meanwhile, many families who rely on free or low-cost sports teams in their communities, often through a school or park district, were left without options while families like mine, who pay thousands of dollars a year for travel teams, were able to pay their coaches to pro

vide smaller specialized group instruction during the pandemic to maintain our chil dren’s competitive edge.

As I’ve continued to research this prob lem and hear stories from parents, college athletes, coaches and, yes, even my own children, I’ve become more convinced that we need to redefine our American ap proach to youth sports and create a more positive sports climate for all children.

A positive sports climate frequently leads to opportunities later in life. The only reason that I attended an Ivy League school, for example, was because I was a talented runner. Without attracting the notice of these coaches, I probably would not have ended up where I am in life –nor, as a result, would my own children.

As a psychologist, I know that children who participate in sports are less likely to suffer from issues such as depression or anxiety and are less likely to die by suicide.

My own research done in pre-pandemic

©

It’s time to make youth sports more equitable, positive and fun

times shows that children of color who can ac cess high-quality sports programming through community and school partnerships are less likely to experience issues like depression and anxiety after nine months. Even for athletes who don’t continue to compete in college or beyond, sports can change lives by fostering teamwork, discipline, belonging and fun.

KIDS WHO PARTICIPATE IN SPORTS ARE LESS LIKELY TO SUFFER FROM DEPRESSION AND ANXIETY OR DIE BY SUICIDE.

But the reality is that not all children have access to the benefits of sports. And the children who have the most to gain – children of color and those from less resourced backgrounds – are less likely to participate due to access issues. These children face the problems of poor access to sports equipment and facilities, and have other de mands on their time that make consistent engagement in intensive sports practices challenging. For kids in these situations, sports may be seen as a “way out,” but the reality is that disinvestment in chil dren’s holistic development means that far too many youth are stuck in under-resourced environments. After all, only a small number of children earn athletic scholarships or become professional athletes.

A better way. Children of color from middle- and upper-class backgrounds may not face the same access issues, but they can ex perience their own sets of problems. They frequently experience pi geonholing into one type of sport they are assumed to be better suited

for, or they’re the only one on their team who looks like them. These children also experience discrimination on their own teams, and when they com pete against other teams, they frequently have to bear that burden alone. I’ve spoken with numerous college athletes who can recount the racial trauma they endured as children. This racial trauma didn’t just come from competitors on the play ing field, it sometimes came from their own coaches and teammates. While these chil dren may reap the benefits of sports, it comes at the cost of their positive racial identity.

We can create a better sports climate for all youth as we transi tion out of the pandemic and rec ognize the mental and physical health benefits that sports yield. We can do this by offering more sports opportunities in schools – especially for younger elemen tary school-aged children.

Chicago Public Schools, the third-largest school system in the nation, does not offer schoolbased sports programming until youth are in fifth grade. Non profit organizations such as Urban Initiatives and Girls in the Game have stepped in to fill the gap by offering school-based sports pro gramming with social and emotional components, but these organizations cannot do it alone.

We can equip nonprofit and community-based sports organizations with tools to improve their eq uity and inclusion practices. We can train coaches and parents on how to prevent, address and heal from racism on the field. Organizations like the Center for Healing and Justice through Sport are doing both in their work to train coaches on creating a healingcentered sports climate.

The COVID-19 pandemic has altered the way we play sports at all levels. We can use this moment to change youth sports for the better. Even if the chil dren in your life don’t have plans to become profes sional basketball players, we should take this oppor tunity to make youth sports more equitable, positive and fun – for all kids. l

Jocelyn Carter is a professor of psychology and the director of clinical training at DePaul University. She is a Public Voices Fellow with The OpEd Project.

We’re proud to be one of the top 3 children’s hospitals in the nation— but our rankings are only the beginning. From research to clinical care, we’re tackling the big things so kids can enjoy the small things.

Building a world where all kids can live their best possible lives.

HONOR ROLL Children’s Hospitals Best

This elite list showcases hospitals with unusual breadth of excellence in pediatric specialty care. For each specialty, each hospital that ranked among the top 50 earned points toward the Honor Roll: 25 points for ranking No. 1, 24 points for No. 2 and so on; hospitals ranked 21-50 received 5 points. The hospitals with the most points define the Honor Roll.

1

Boston Children’s Hospital Boston, Massachusetts 243 points

Texas Children’s Hospital Houston, Texas 224 points

Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio 207 points

Children’s Hospital of Philadelphia Philadelphia, Pennsylvania 205 points

5

Children’s National Hospital Washington, D.C. 166 points

UPMC Children’s Hospital of Pittsburgh Pittsburgh, Pennsylvania 164 points

Children's Hospital Colorado Aurora, Colorado 153 points

8

Children's Hospital Los Angeles Los Angeles, California 142 points

Nationwide Children’s Hospital Columbus, Ohio 140 points

Lucile Packard Children’s Hospital Stanford Palo Alto, California 135 points

UNMATCHED EXPERTISE

Jonah, 2, travels from his Texas home to CHOP, where he receives expert care for his rare genetic syndrome.

THAT GOES THE EXTRA MILE.

When it came to finding expert care for their son’s rare genetic condition, making the trip from Texas to Philadelphia was an easy decision for his parents. Children’s Hospital of Philadelphia has clinicians who specialize in PallisterKillian syndrome — and a multitude of other complex diseases. Unmatched expertise in the uncommon is just one reason we have been on the U.S. News & World Report Honor Roll of Best Children’s Hospitals since its inception.

From developing advanced therapies to expertly treating rare diseases, we’re here for your child at every step.

4 CHILDREN’S HOSPITAL OF PHILADELPHIA

THE COUNTRY'S FIRST HOSPITAL DEDICATED JUST TO PEDIATRIC CARE TYPICALLY COUNTS MORE THAN 1 MILLION ADMISSIONS AND OUTPATIENT VISITS ANNUALLY.

CHILDREN’S NATIONAL HOSPITAL

BASED IN WASHINGTON, D.C., CHILDREN'S NATIONAL HAS MORE THAN 300 INPATIENT BEDS AND IS ON THE LEADING EDGE OF PEDIATRIC RESEARCH.

in Pediatrics

by Ben Harder

HERE SHOULD anxious parents take a newborn with a life-threatening heart defect, or find ongoing care for a child with failing kidneys or lung-clogging cys tic fibrosis? A local hospital’s pediatric department might be perfectly capable of managing ear infections, allergies, flu and other common childhood ailments. But it may not have the expertise to treat severely ill kids. That’s where children’s hospitals come in. There are approximately 200 hospitals in the country that either exclusively treat pediatric patients or possess a pediatric department that functions like a self-contained

children’s hospital. Even within that group, some centers are better than others. U.S. News created the Best Children’s Hospitals rankings to help parents, in consultation with their doctors, find those best suited to their child.

The 2022-23 rankings highlight top children’s centers in 10 specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal surgery, neonatology, nephrology, neurology and neurosurgery, ortho pedics, pulmonology and lung surgery, and urology. This year, 90 hospitals ranked in at least one specialty, and 10 were named to the Honor Roll for scoring near the top in most or all special ties. Regional rankings for each of seven multi-state regions

We gathered over 1,000 data points per hospital.

(Page 210) list hospitals according to the number of specialties in which they were among the best.

Rich data. Judging the excellence of children’s hospitals is challenging, and no single metric or ranking should be viewed as a definitive guide.

U.S. News gathered more than 1,000 data points on each hospital to determine its strengths and weaknesses. Many summary measures appear in the ranking tables that follow; more can be found at usnews.com/childrenshospitals, which also fea

tures data on dozens of additional children’s hospitals.

Almost all of the medical data used in these rankings were obtained by ask ing hospitals to complete a lengthy on line data-collection process. This year, 119 hospitals surveyed by U.S. News provided enough data to be evaluated.

RTI International, a North Car olina-based research firm, oversaw data collection and produced the rankings. Collaborating with RTI staff, 168 pediatric experts serving in working groups helped design the data-collection survey.

Whether and how high an institu tion was ranked depended on three elements: its clinical outcomes (such as survival and surgical complica tions), its delivery of care (such as ad hering to safe and effective practices), and its resources (such as staffing and technology). Each element contrib uted one-third of a hospital’s overall score in most specialties. A detailed FAQ about the rankings is available at usnews.com/aboutchildrens. Here are the basics:

Clinical outcomes. These reveal a hospital’s success at keeping kids alive after their treat ment, protecting them from infections and complications, and improving their quality of life. While tough to measure, outcomes tend to matter most to both families and doctors.

Delivery of care. How well a hospital handles day-to-day care was determined in part by com pliance with accepted “best practices,” such as performing neuropsychologi cal evaluation of patients with certain cancers. Another factor: a hospital’s demonstrated commitment to diversi ty, equity and inclusion by, say, screen ing patients for social determinants of health like food insecurity. U.S. News also surveyed pediatric special ists, asking them to identify up to 10 hospitals they consider best in their area of expertise for kids with complex medical problems.

Resources. Surgical volume, nursepatient ratio, clinics and programs for conditions such as asthma, and dozens of other measures were considered.

Every child, everywhere, deserves the very best. It’s why Children’s Hospital & Medical Center combines the largest group of pediatric specialties in the region, the most advanced technology and the biggest hearts all in one place. Together, in this safe and welcoming environment of excellence, we’re shaping the future of pediatric medicine to deliver the very best for kids.

A Word on the Terms

USED IN MORE THAN ONE SPECIALTY

A Nurse Magnet hospital: hospital recognized by American Nurses Credentialing Center as meeting standards for nursing excellence. Infection prevention score, ICU: ability to prevent central-line bloodstream infections in intensive care units. Infection prevention score, overall: ability to prevent infections through mea sures such as hand hygiene and vaccination. No. of best practices: how well hospital adheres to recommended ways of diagnosing and treating patients, such as documenting blood sugar levels for a high percentage of outpatients (diabetes & endocrinology) and conducting hip exams with ultrasound specialists (orthopedics). Nurse-patient ratio: balance of full-time registered nurses to inpatients.

Patient volume score: relative number of patients in past year with specified disorders. % of specialists recommending hospital: percentage of physician specialists surveyed in 2020, 2021 and 2022 who named hospital among best for very challenging patients. Procedure volume score: relative number of tests and nonsurgical procedures in past one, two or three years, such as implanting radioactive seeds in a cancerous thyroid (diabetes & endocrinology) and using an endoscope for diagnosis (gastroenterology). Surgical procedures are included in orthopedics.

Surgery volume score: relative number of patients who had specified surgical procedures in past year. Surgical complications prevention score: ability to prevent surgery-related complications and readmissions within 30 days (neurology & neurosurgery, orthopedics, urology).

U.S. News score: 0 to 100 summary of overall performance in specialty.

NA: not applicable; service not provided by hospital.

NR: data not reported or unavailable.

USED IN ONE SPECIALTY

CANCER

Bone marrow transplant survival score: survival of stem cell recipients at 100 days. Five-year survival score: survival five years after treatment for acute lymphoblastic leukemia, acute myeloid leukemia and neuroblastoma. Palliative care score: how well program meets specified training and staffing standards for children with terminal or life-limiting conditions, and number of cancer patients referred to program.

CARDIOLOGY & HEART SURGERY

Catheter procedure volume score: relative number of specified catheter-based procedures in past year, such as inserting stents and treating heart rhythm problems. Length of stay after surgery score: success in minimizing how long certain congenital heart patients spend in the hospital for care related to their heart condition. Norwood/hybrid surgery survival score: survival at one year after the first in a series of reconstructive surgeries, evaluated over past four years.

Risk-adjusted surgical survival score: survival in the hospital and 30 days from discharge after congenital heart surgery, adjusted for operative and patient risk, evaluated over past four years.

DIABETES & ENDOCRINOLOGY

Diabetes management score: ability to prevent serious problems in children with Type 1 diabetes and to keep blood sugar levels in check. Hypothyroid management score: relative proportions of children treated for underac tive thyroid who test normal and of infants who begin treatment by 3 weeks of age.

GASTROENTEROLOGY & GI SURGERY

Liver transplant survival score: one- and three-year survival after liver transplant. Nonsurgical procedure volume score: relative number of tests and noninvasive procedures. Selected treatments success score: shown, for example, by high remission rates for inflammatory bowel disease and few complications from endoscopic procedures.

NEONATOLOGY

Infection prevention score, NICU: ability to prevent central-line bloodstream infections in neonatal ICU. Keeping breathing tube in place score: ability to minimize inappropriate breathingtube removal in intubated infants. Leaves NICU on breast milk score: relative percentage of infants discharged from NICU receiving some nutrition from breast milk.

NICU temperature management score: success in managing NICU patients’ temperature at the time of admission and postoperatively.

NEPHROLOGY

Biopsy complications prevention score: ability to minimize complications after kidney biopsy. Dialysis management score: relative proportion of dialysis patients in past two years who tested normal. Infection prevention score, dialysis: ability to minimize dialysis-related infection. Kidney transplant survival score: based on patient survival and functioning kidney at one and three years.

NEUROLOGY & NEUROSURGERY

Epilepsy management score: ability to treat children with epilepsy. Surgical survival score: survival at 30 days after complex surgery and procedures, such as those involving brain tumors, epilepsy and head trauma.

ORTHOPEDICS

Fracture repair score: ability to treat complex leg and forearm fractures efficiently.

PULMONOLOGY & LUNG SURGERY

Asthma inpatient care score: ability to mini mize asthmatic children’s asthma-related deaths, length of stay and readmissions. Cystic fibrosis management score: ability to improve lung function and nutritional status.

Lung transplant survival score: reflects number of transplants in past two years, one-year survival, and recognition by United Network for Organ Sharing.

UROLOGY

Minimally invasive volume score: relative number of patients in past year who had specified nonsurgical procedures. Testicular torsion care score: promptness of emergency surgery to correct twisted spermatic cord.

Dana-Farber/Boston

St. Jude Children’s Research Hospital, Memphis,

Cincinnati Children’s Hospital Medical Center

Texas Children’s Hospital, Houston

Children’s Hospital of Philadelphia

Children’s National Hospital, Washington, D.C.

Children’s Healthcare of Atlanta

Children’s Hospital Colorado, Aurora

Hopkins Children’s Center,

Ann and Robert H. Lurie Children’s Hospital

Children’s Hospital, Columbus, Ohio

U. of Michigan Health C.S. Mott Children’s Hospital,

UPMC Children’s Hospital of Pittsburgh

Children’s Hospital Los Angeles

Cleveland Clinic Children’s Hospital

Children’s Medical Center Dallas

Arbor

15 30

15 30

8 45.7%

8 29.9%

8 34.0%

8 34.5%

8 44.5%

8 17.2%

8 19.9%

8 17.6%

10.6%

9.1%

8 14.5%

15 30

13 30

8 3.9%

8 4.8%

15 30 3.8 Yes 8 21.6%

15 26 3.5 Yes 8 1.2%

15 30 3.3 Yes 8 3.3%

UCSF Benioff Children’s Hospitals, San Francisco and Oakland 83.0 14 4 41 13 29 4.2 Yes 7 9.8%

18 MSK Kids at Memorial Sloan Kettering Cancer Center, New York 82.3 12 5 35 11 23 5.8 Yes 8 10.9%

19 Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tenn. 82.1 14 5 42 12 30 3.5 Yes 8 2.3%

20 Seattle Children’s Hospital 82.0 13 4 41 8 16 3.6 Yes 8 26.3%

21 Children’s Wisconsin Hospital, Milwaukee 81.7 15 5 38 15 16 4.0 Yes 8 1.8%

22 Lucile Packard Children’s Hospital Stanford, Palo Alto, Calif. 81.3 13 5 42 15 15 4.3 Yes 6 7.6%

23 Children’s Cancer Hospital-U. of Texas MD Anderson Cancer Center 80.9 12 5 39 15 23 3.3 Yes 8 4.1%

24 Riley Hospital for Children at IU Health, Indianapolis 80.7 12 6 39 11 28 4.3 Yes 8 2.1%

25 CHOC Children’s Hospital, Orange, Calif. 80.3 12

Rainbow Babies and Children’s Hospital, Cleveland 80.3 15

Nemours Children’s Hospital-Delaware, Wilmington, Del. 79.9 13

New York-Presbyterian Hospital-Columbia and Cornell, New York 79.5 13

Rady Children’s Hospital, San Diego 79.4

Doernbecher Children’s Hosp. at Oregon Hlth. & Sci. U., Portland, Ore.

Children’s Medical Center, New Hyde Park, N.Y.

Shawn Jenkins Children’s Hospital, Charleston, S.C.

Carolina

Hospital

40 12 20 3.8 Yes 8 3.5%

9 19 3.1 Yes 8 1.1%

11 14 3.3 Yes 8 2.1%

13 23 4.0 Yes 7 3.5%

12 27 3.5

8 2.2%

15 18 4.3 Yes 8 1.0%

12 12 4.0 Yes 8 1.0%

14 10 2.5

8 0.8%

Children’s HealthSM and UT Southwestern Pediatric Group physicians are making life better for children. In fact, Children’s Medical Center Dallas was ranked in all 10 pediatric specialties by U.S. News & World Report With advanced research and lifesaving treatments, we’re leading the way in pediatrics.

H.

Rady Children’s Hospital, San Diego

Children’s Hospital Los Angeles

Children’s Hospital Colorado, Aurora

Nationwide Children’s Hospital, Columbus, Ohio

24.7%

8 15 3.5 3.7%

11 15 3.8 16.7%

3 10 19 4.1 13.9%

7 16 3.3 10.4%

Cincinnati Children’s & Kentucky Children’s Hosp. Joint Heart Program 76.9 2 24 9 48 1 11 21 4.5 25.9%

16 Johns Hopkins Children’s Center, Baltimore 76.9 4 18 7 48 3 5 9 3.6 1.8%

18 Children’s Healthcare of Atlanta 76.4 2 22 8 44 5 13 20 5.3 16.5%

19 Children’s Mercy Kansas City Hospital, Mo. 75.1 3 22 7 47 5 9 15 4.2 2.6%

19 Le Bonheur Children’s Hospital, Memphis, Tenn. 75.1 4 22 7 42 5 6 12 2.6 3.4%

Virginia Congenital Cardiac Collaborative, Charlottesville & Norfolk 74.8 4 23 7 46 3 9 17 3.0 1.5%

Levine Children’s Hospital, Charlotte, N.C. 74.1 4 23 8 47 4 6 16 3.3 2.2%

Seattle Children’s Hospital 74.0 3 23 7 47 2 11 15 3.6 9.9%

St. Louis Children’s Hospital-Washington University 73.3 3 20 7 45 3 6 19 3.7 3.4%

Hassenfeld Children’s Hospital at NYU Langone, New York

Lucile Packard Children’s Hospital Stanford, Palo Alto, Calif.

UF Health Shands Children’s Hospital, Gainesville, Fla.

Children’s Hospital of Alabama at UAB, Birmingham

Children’s Medical Center Dallas

Carell Jr. Children’s Hospital at Vanderbilt,

Wisconsin Hospital, Milwaukee

Family Children’s Hospital, Madison, Wis.

State Health Children’s Hospital, Hershey,

5 5 10 3.1 1.3%

5 14 19 4.3 32.4%

5 8 10 2.8 1.9%

2 9 12 3.7 2.0%

3.9%

4.2%

5.6%

0.8%

Hopkins Children’s Center,

Health Shands Children’s Hospital, Gainesville, Fla.

North Carolina Children’s Hospital at UNC, Chapel Hill

Rainbow Babies and Children’s Hospital, Cleveland

Norton Children’s Hospital, Louisville, Ky.

13

119 21.2%

25.3%

117 15.7%

115 16.0%

109 11.0%

8.8%

3.7%

103 14.5%

109 6.5%

Yes 118 6.1%

Yes 111 2.4%

11 3.1 Yes 117 3.3%

14 3.1 No 116 1.2%

Ann and Robert H. Lurie Children’s Hospital of Chicago 77.7 40 6 36 33 12 2.8 Yes 109 6.9%

18 Yale New Haven Children’s Hospital, New Haven, Conn. 77.4 29 8 38 33 8 4.1 Yes 118 10.4%

19 Nationwide Children’s Hospital, Columbus, Ohio 77.3 27 9 36 34 8 3.3 Yes 111 7.5%

20 St. Louis Children’s Hospital-Washington University 77.1 37 5 37 32 13 3.7 Yes 106 5.6%

Children’s Medical Center Dallas 75.8 26 9 37 34 14 3.3 Yes 110 5.4%

Children’s Mercy Kansas City Hospital, Mo. 75.7 37 6 38 33 8 4.2 Yes 107 4.1%

U. of Michigan Health C.S. Mott Children’s Hospital, Ann Arbor 75.7 33 8 36 31 9 4.9 Yes 111 3.3%

MassGeneral Hospital for Children, Boston 75.0 31 8 28 32 14 3.7 Yes 113 5.5%

University of Iowa Stead Family Children’s Hospital, Iowa City 75.0 44 6 34 34 7 3.5 Yes 99 1.8%

CHOC Children’s Hospital, Orange, Calif.

Cohen Children’s Medical Center, New Hyde Park, N.Y.

Arnold Palmer Hospital for Children, Orlando

Arkansas Children’s Hospital, Little Rock

Monroe Carell Jr. Children’s Hospital

Benioff Children’s Hospitals,

Healthcare of

York-Presbyterian

Hopkins All Children’s

32 11 3.8 Yes 104 2.0%

33 14 4.0 Yes 113 1.4%

30 12 3.0 Yes 115 0.2%

31 13 3.5 Yes 113 1.1%

3.7%

2.4%

7.5%

Amazing is care that saves your heart and your future.

Suri had a bad stomach ache that turned out to be myocarditis, a serious inflammation of the heart. Specialists from our multidisciplinary pediatric critical care team worked together to regulate her heartbeat—and got Suri back to thinking about what comes next. nyp.org/pediatrics

Clinic Children’s Hospital

Lucile Packard Children’s Hospital

Alto,

St. Louis Children’s Hospital-Washington University

New York-Presbyterian Hosp.-Columbia and Cornell, New York

Riley Hospital for Children at IU Health, Indianapolis

Children’s National Hospital, Washington, D.C.

Children’s Wisconsin Hospital, Milwaukee

North Carolina Children’s Hospital at UNC, Chapel Hill

Seattle Children’s Hospital

Levine Children’s Hospital, Charlotte, N.C.

UCSF Benioff Children’s Hospitals, San Francisco and Oakland

U. of Michigan Health C.S. Mott Children’s Hospital, Ann Arbor

Yale New Haven Children’s Hospital, New Haven, Conn.

Children’s Hospital of Michigan, Detroit

Rady Children’s Hospital, San Diego

Children’s Mercy Kansas City Hospital, Mo.

Monroe Carell Jr. Children’s Hosp.

Children’s

and Robert H. Lurie

Hospital for Children,

Kravis Children’s

13

18

Yes 14.5%

Yes 2.0%

11 16 4.3 Yes 9.3%

12 14 3.7 Yes 4.6%

11 18 4.0 Yes 5.2%

26 10 18 4.3 Yes 3.9%

21 11 14 3.9 Yes 5.4%

24 11 17 4.0 Yes 4.4%

17 11 11 4.5 Yes 1.4%

24 9 13 3.6 Yes 12.7%

23 7 15 3.3 Yes 1.1%

23 6 16 4.2 Yes 6.2%

27 10 16 4.9 Yes 2.2%

19 8 13 4.1 Yes 2.5%

26 6 12 2.7 No 0.4%

24 11 13 3.5 Yes 2.8%

24 11 14 4.2 Yes 4.3%

2.3%

3.2%

At CHOC, we know that research and innovation can lead to lifesaving decisions. Our culture encourages out-of-the box thinking and problem solving guided by our passion for giving every child

healthiest life possible.

This philosophy of “Go Beyond” can lead to the discovery of new medical devices or medications. It also can reveal how therapies used for certain diagnoses can be applied to other ones.

In a recent example of the latter, a device used by gastroenterologist Dr. Ashish Chogle for functional gastrointestinal disorders now is being studied in a clinical trial to treat patients with Post-Concussion Syndrome (PCS). The device, called IB-Stim, attaches to the ear and electrically stimulates the vagal nerve, the most important nerve of the autonomic nervous system.

CHOC was the first pediatric hospital to use the IB-Stim on patients (outside of a research study) suffering from irritable bowel

syndrome and other GI issues. Neurologist Dr. Sharief Taraman says the device shows great potential in its new application for patients with PCS, in which dysfunction of the autonomic nervous system is believed to play a critical role. Innovation requires looking at the bigger picture. Research can bring breakthrough ideas to real-life solutions. At CHOC, both are happening across our enterprise as we continue to advance care for the children and families we serve.

READ STORIES OF

Translating patient needs into innovative

National

Hospital,

18.3%

Packard

Children’s Hospital

St. Louis Children’s Hospital-Washington University

Children’s Hospital, San Diego

Ann & Robert H. Lurie Children’s Hosp.-Prentice Women’s Hosp.,

Cleveland Clinic Children’s Hospital

Nationwide Children’s Hospital, Columbus, Ohio

Rainbow Babies and Children’s Hospital, Cleveland

CHOC Children’s Hospital, Orange, Calif.

Children’s Mercy Kansas City Hospital, Mo.

85 16.7%

85 23.1%

85 10.1%

86 5.2%

26 3.1 83 7.6%

20 2.7 85 3.5%

44 5 33 3.1 83 16.7%

41 5 18 4.0 84 8.2%

43 5 30 3.8 83 3.3%

47 5 35 4.0 86 3.8%

Riley Hospital for Children at IU Health, Indianapolis 84.4 2 5 12 44 5 33 3.0 85 4.0%

16 New York-Presbyterian Hospital-Columbia and Cornell, New York 83.5

7 44 5 28 2.7 82 10.1%

17 Children’s Hospital of Philadelphia 83.3 3 5 8 45 1 37 4.0 84 36.2%

18 Children’s Medical Center Dallas 82.8

5 10 44 5 22 3.1 84 4.1%

19 Children’s Hospital Colorado, Aurora 82.7 3 4 12 44 3 33 2.9 85 11.7%

19 Children’s Hospital Los Angeles 82.7 3 5 11 41 3 31 3.2 85 9.5%

20 UCLA Mattel Children’s Hospital, Los Angeles 82.2 3 5 10 37 5 16 4.1 81 7.6%

22 Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tenn. 82.0 2 5 12 39 5 19 2.7 80 6.4%

23 North Carolina Children’s Hospital at UNC, Chapel Hill 81.4

24 Cohen Children’s Medical Center, New Hyde Park, N.Y. 81.2

Duke Children’s Hospital and Health Center, Durham, N.C. 81.2

University of Iowa Stead Family Children’s Hospital, Iowa City 81.0

Johns Hopkins Children’s Center, Baltimore 79.2

Seattle Children’s Hospital

UC Davis Children’s Hospital, Sacramento, Calif.

Valley Children’s Healthcare and Hospital, Madera, Calif.

Levine Children’s Hospital, Charlotte, N.C.

University of Virginia Children’s Hospital, Charlottesville

5 12 45 5 25 2.5 83 2.0%

12 45 5 23 3.3 83 1.0%

11 44 5 25 2.7 83 3.0%

11 42 5 24 2.5 78 6.6%

8 47 4 32 3.3 80 4.7%

30 5.0 74 10.6%

25 3.3 83 1.6%

25 2.2 77 1.4%

24 2.5 82 1.4%

Different kids need different care.

Kids aren’t just different from adults — they’re also different from each other. That’s why each kid needs incredibly different care. Inspired by the kids we treat at Children’s Hospital Colorado, we’re creating a culture that continuously encourages curiosity and discovery. Questions once asked within the silos of specific specialties are now being addressed by collaborative multidisciplinary teams to create individualized diagnoses and treatments. These remarkable advances lead to better health outcomes for each child and allow us to deliver the dedicated difference every kid deserves.

Children’s Hospital Colorado is proud to be nationally ranked in every pediatric specialty by U.S. News & World Report.

Children’s

Children’s Hospital,

National

Children’s Hospital

Children’s

Children’s Hospital of

Healthcare of

Children’s Hospital,

Children’s Hospital of Pittsburgh

Johns Hopkins Children’s Center, Baltimore

Hospital for Children at IU Health,

UCLA Mattel Children’s Hospital, Los Angeles

Benioff Children’s Hospitals, San Francisco

Ann and Robert H. Lurie Children’s Hospital of Chicago 85.5

Rady Children’s Hospital, San Diego 85.2

Children’s Hospital Los Angeles 83.9

UC Davis Children’s Hospital, Sacramento, Calif. 83.3

Doernbecher Children’s Hosp. at Oregon Hlth. & Sci. U., Portland 82.6 24

U. of Michigan Health C.S. Mott Children’s Hospital, Ann Arbor 82.6 22

Children’s Hospital Colorado, Aurora 82.0 23

New York-Presbyterian Hosp.-Columbia and Cornell, New York 82.0 22

Children’s Medical Center Dallas

St. Louis Children’s Hospital-Washington University

Levine Children’s Hospital, Charlotte, N.C.

Cohen Children’s Medical Center, New Hyde Park, N.Y.

University of Iowa Stead Family Children’s Hospital, Iowa City

Cleveland Clinic Children’s Hospital

Phoenix Children’s Hospital

MUSC Shawn Jenkins Children’s Hospital, Charleston, S.C.

Children’s Hospital of Richmond at VCU, Va.

Hospital

Alabama

Linda University Children’s

Children’s Hospital,

Sanzari

Hovnanian

12 64

14

12

28.3%

42.0%

Yes 41.5%

Yes 39.1%

Yes 23.4%

20.2%

11 3.3 Yes 10.0%

Yes 14.1%

Yes 7.9%

4.6 Yes 11.3%

Yes 5.8%

7 14 2.8 Yes 13.3%

9 14 3.5 Yes 3.8%

57 5 9 13 3.8 Yes 6.3%

64 5 9 12 7.8 Yes 1.7%

12 58 5 9 8 4.3 Yes 2.3%

11 61 5 6 14 4.9 Yes 5.6%

9 64 3 8 12 4.1 Yes 7.3%

10 62 5 9 11 4.0 Yes 4.0%

64

9 13 3.3 Yes 6.6%

60 3 7 12 3.7 Yes 6.0%

12 64 4 8 12 3.3 Yes 1.7%

12 65 2 8 10 4.0 Yes 0.8%

7 14 3.5 Yes 4.7%

9 11 3.5 Yes 1.7%

9 14 3.2 No 1.3%

7 14 2.5 Yes 1.2%

patient

Boston Children’s Hospital

Texas Children’s Hospital, Houston

Children’s National Hospital, Washington, D.C.

Children’s Hospital of Philadelphia

St. Louis Children’s Hospital-Washington University

Cincinnati Children’s Hospital Medical Center

Lucile Packard Children’s Hospital Stanford, Palo Alto, Calif.

Rady Children’s Hospital, San Diego

Nationwide Children’s Hospital, Columbus, Ohio

UPMC Children’s Hospital of Pittsburgh

Children’s Healthcare of Atlanta

Children’s Hospital Colorado, Aurora

Seattle Children’s Hospital

recommending hospital

36 4.0 Yes 43.3%

38 4.2 Yes 26.1%

34 3.9 Yes 20.2%

33 3.5 Yes 35.5%

36 3.7

17.6%

37 4.5 Yes 19.6%

29 4.3 Yes 9.2%

39 3.5 Yes 4.2%

Yes 13.4%

9.7%

36 5.3 Yes 3.4%

32 4.1 Yes 15.7%

29 3.6 Yes 17.3%

New York-Presbyterian Hospital-Columbia and Cornell, New York 84.7 11 22 6 41 27 4.0 Yes 7.2%

Children’s Hospital Los Angeles 84.2 12 22 4 40 34 3.8 Yes 7.8%

UCSF Benioff Children’s Hospitals, San Francisco and Oakland 83.5 12 17 4 43 32 4.2 Yes 12.7%

Intermountain Primary Children’s Hosp.-U. of Utah, Salt Lake City 82.7 11 22 6 42 36 3.3 No 7.4%

Children’s Mercy Kansas City Hospital, Mo. 81.2 12 20 6 43 29 4.2 Yes 2.1%

18 Johns Hopkins All Children’s Hospital, St. Petersburg, Fla. 81.2 12 22 6 44 29 3.9 Yes 1.5%

19 Phoenix Children’s Hospital 81.1 12 20 6 44 36 3.2 No 4.4%

20 Cohen Children’s Medical Center, New Hyde Park, N.Y. 80.8 12 22 4 43 32 4.0 Yes 2.5%

21 Children’s Medical Center Dallas 80.4 12 22 3 44 38 3.3 Yes 3.4%

23 Johns Hopkins Children’s Center, Baltimore 78.4 12 19 2 45 24 3.6 Yes 12.5%

23 Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tenn. 78.4 11 14 6 43 32 3.5 Yes 4.1%

25 Nicklaus Children’s Hospital, Miami 77.7 12 17 6 36 23 2.9 Yes 5.5%

Children’s Hospital of Michigan, Detroit 77.3 12 22 6 41 27 2.7 No 0.9%

27 Children’s Memorial Hermann Hospital, Houston 77.1 12 19 6 39 23 3.3 Yes 1.6%

Children’s Hospital of Alabama at UAB, Birmingham 76.6 12 18 5 44 31 3.7 No 5.0%

Cook Children’s Medical Center, Fort Worth 76.5 12 20 5 40 28 3.2 Yes 3.2%

UCLA Mattel Children’s Hospital, Los Angeles 76.1 12 18 5 37 19 4.6 Yes 5.3%

Yale New Haven Children’s Hospital, New Haven, Conn. 76.1

Mayo Clinic Children’s Center, Rochester, Minn.

Valley Children’s Healthcare and Hospital, Madera, Calif.

UF Health Shands Children’s Hospital, Gainesville, Fla.

Children’s Wisconsin Hospital, Milwaukee

12 4.1 Yes 0.9%

19 3.7 Yes 4.9%

20 3.8 Yes 0.6%

14 2.8 Yes 1.3%

20 4.0

Boston Children’s Hospital

Children’s Hospital, San

Medical Center

Hospital of Philadelphia

Children’s Hospital

Hospital Los Angeles

Rite Hospital

Center

Children’s National Hospital, Washington, D.C.

Texas Children’s Hospital, Houston

Children’s Pavilion-Hospital

Louis Children’s Hospital-Washington

Healthcare of Atlanta

Children’s Hospital Colorado, Aurora

Johns Hopkins Children’s Center, Baltimore

UCLA Mattel Children’s Hospital, Los Angeles

Nationwide Children’s Hospital, Columbus, Ohio

16 Mayo Clinic Children’s Center, Rochester, Minn.

17 Rainbow Babies and Children’s Hospital, Cleveland

26

79 43.2%

79 30.1%

79 34.6%

78 38.4%

78 15.7%

Yes 75 15.9%

Yes 73 6.3%

Yes 80 11.2%

4.6%

78 8.4%

79 11.7%

26

Yes 70 14.6%

12 16 3.6 Yes 78 4.2%

20 20 4.6 Yes 77 4.1%

23 23 3.3 Yes 77 8.7%

9 15 3.7 Yes 77 3.1%

8 10 36 20 16 3.1 Yes 79 5.5%

18 Lucile Packard Children’s Hospital Stanford, Palo Alto, Calif. 76.6 8 10 41 8 24 4.3 Yes 68 3.5%

19 UC Davis Children’s Hospital/Shriners Hospitals N. Calif., Sacramento 76.5 8 8 39 21 25 7.8 Yes 76 5.6%

20 Nemours Children’s Hospital-Delaware, Wilmington, Del. 75.7 6 9 39 17 22 3.3 Yes 77 16.5%

21 Valley Children’s Healthcare and Hospital, Madera, Calif. 75.4 7 13 39 21 17 3.8 Yes 78 0.3%

22 Cohen Children’s Medical Center, New Hyde Park, N.Y. 73.8 7 11 40 15 18 4.0 Yes 80 0.7%

23 North Carolina Children’s Hospital at UNC, Chapel Hill 73.6 7 12 42 14 12 4.5 Yes 70 0.8%

24 Levine Children’s Hospital, Charlotte, N.C. 72.7 8 11 41 13 17 3.3 Yes 71 0.5%

25 Akron Children’s Hospital, Ohio

CHOC Children’s Hospital, Orange, Calif.

Ann and Robert H. Lurie Children’s Hospital of Chicago

UCSF Benioff Children’s Hospitals, San Francisco and Oakland

UPMC Children’s Hosp. of Pittsburgh-Shriners Hosps.

Mercy Kansas City Hospital, Mo.

Carell Jr. Children’s Hospital at

Primary Children’s Hosp.-Shriners Hosps. for Children-U.

38 18 19 3.3 Yes 75 2.1%

15 15 3.8 Yes 69 1.2%

39 12 20 2.8 Yes 66 5.0%

12 17 4.2 Yes 75 3.1%

73 2.5%

Yes 76 2.5%

Yes 77 5.1%

Hospital

Children’s

Hospital

Hospital

Hospital for Children

National Hospital,

Children’s

Health,

13.0%

Carolina Children’s Hospital

Johns Hopkins Children’s Center, Baltimore

St. Louis Children’s Hospital-Washington University

Children’s Hospital Los Angeles

Children’s Healthcare of Atlanta

Rainbow Babies and Children’s Hospital, Cleveland

23.2%

10.8%

15 3.6 Yes 10.1%

12 3.7 Yes 11.7%

5 14 3.8 Yes 13.9%

45 5 15 5.3 Yes 3.6%

44 5 13 3.1 Yes 4.8%

18 UF Health Shands Children’s Hospital, Gainesville, Fla. 85.0 8 5 15 47 5 12 2.8 Yes 1.5%

19 Ann and Robert H. Lurie Children’s Hospital of Chicago 84.1 7 NA 19 46 3 13 2.8 Yes 9.4%

19 Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tenn. 84.1 8

18 47 2 13 3.5 Yes 7.0%

21 Children’s Medical Center Dallas 82.6 7 NA 16 48 5 14 3.3 Yes 2.9%

21 New York-Presbyterian Hospital-Columbia and Cornell, New York 82.6

23 Rady Children’s Hospital, San Diego 82.4

24 Arkansas Children’s Hospital, Little Rock 82.1 8

24 Children’s Mercy Kansas City Hospital, Mo. 82.1 8

UCSF Benioff Children’s Hospitals, San Francisco and Oakland 82.1

U. of Michigan Health C.S. Mott Children’s Hospital, Ann Arbor 82.0

Children’s Wisconsin Hospital, Milwaukee

Valley Children’s Healthcare and Hospital, Madera, Calif. 81.0

Clinic Children’s Hospital

New Haven Children’s Hospital, New Haven, Conn.

Children’s Medical Center, New Hyde Park, N.Y.

Hospital for Children, Boston

Children’s

14 42 5 13 4.0 Yes 6.1%

18 51 2 11 3.5 Yes 3.2%

19 43 5 11 3.5 Yes 1.1%

17 46 5 11 4.2 Yes 2.9%

17 49 3 9 4.2 Yes 3.6%

16 47 5 17 4.9 Yes 2.5%

17 45 5 12 4.0 Yes 1.5%

18 51 5 9 3.8 Yes 0.1%

1.3%

Yes 1.3%

1.3%

3.4%

ACPC QUALITY NETWORK

The ACC's comprehensive offerings of adult and pediatric congenital heart disease (CHD) programs drive quality improvement and help advance optimal patient care for children and adults with heart disease. Choose one of these top hospitals and clinics that deliver the best heart-focused care and are dedicated to treatment of patients of all ages.

Adult Congenital & Pediatric Cardiology (ACPC) Quality Network™

is a national network of CHD clinics dedicated to developing best practices and advancing standards for patient care.

Boston Children's Hospital Boston, MA

Cardiology Care for Children Lancaster, PA

Child Cardiology Associates Fairfax, VA

Children's Healthcare of Atlanta Atlanta, GA

Children's Hearts Nashville, TN

Children's Hospital Colorado Aurora, CO

Children's Hospital of Los Angeles Los Angeles, CA

Children's Hospital Medical Center of Akron Akron, OH

Children's Hospital of New Orleans New Orleans, LA

Children's Hospital of Orange County Orange, CA

Children's Hospital of Philadelphia Philadelphia, PA

Children's Mercy Kansas City Kansas City, MO

Children's National Medical Center Washington, DC

Cincinnati Children's Hospital Medical Center Cincinnati, OH

Eastern Maine Medical Center Bangor, ME

Intermountain Primary Children's Hospital Salt Lake City, UT

Johns Hopkins All Children's Hospital, Inc St. Petersburg, FL

Le Bonheur Children's Hospital Memphis, TN

Lee Health - HealthPark Medical Center Fort Myers, FL

Lucile S. Packard Children's Hospital at Stanford University Palo Alto, CA

Lurie Children's Hospital of Chicago Chicago, IL

Mayo Clinic Hospital - Saint Mary's Campus Rochester, MN

Miami Children's Health System Miami, FL

Nationwide Children's Hospital Columbus, OH

Nemours Children's Health Wilmington, DE

New York - Presbyterian Weill Cornell Medical Center New York, NY

NorthWest Congenital Heart Care Tacoma, WA

Pediatric and Congenital Cardiology Associates Austin, TX

Pediatrix Cardiology Associates of San Antonio San Antonio, TX

Pediatric Cardiology Associates and Tampa Bay Adult Congenital Heart Center St. Petersburg, FL

Pediatrix Cardiology of Broward West Palm Beach, FL

Pediatrix Cardiology of Dallas Dallas, TX

Pediatrix Cardiology of North Texas Dallas, TX

Phoenix Children's Hospital Phoenix, AZ

Rainbow Babies & Children's Hospital Cleveland, OH

Riley Hospital for Children Indiana University Health Indianapolis, IN

Rocky Mountain Pediatric Cardiology Denver, CO

Sanger Heart & Vascular Institute Charlotte, NC

Seattle Children's Hospital Seattle, WA

Texas Children's Hospital Houston, TX

The Cleveland Clinic Foundation Cleveland, OH

The Mount Sinai Medical Center New York, NY

University of Kentucky Lexington, KY

University of Maryland Medical Center Cardiology Baltimore, MD

UCSF Benioff Children’s Hospital San Francisco, CA

UPMC Children's Hospital of Pittsburgh Pittsburgh, PA

Upstate Golisano Children's Hospital Syracuse, NY

Wellstar Kennestone Regional Medical Center Marietta, GA

1 Boston Children’s Hospital

Children’s Hospital of Philadelphia

Riley Hospital for Children at IU Health, Indianapolis

Cincinnati Children’s Hospital Medical Center

Texas Children’s Hospital, Houston

Ann and Robert H. Lurie Children’s Hospital of Chicago

Children’s Hospital Colorado, Aurora

Children’s Hospital Los Angeles

Monroe Carell Jr. Children’s Hospital at Vanderbilt,

UPMC Children’s Hospital of Pittsburgh

Children’s Healthcare of Atlanta

Seattle Children’s Hospital

Nationwide Children’s Hospital, Columbus, Ohio 79.2 11

14 Mayo Clinic Children’s Center, Rochester, Minn.

14

mending

27 24 6 4.0 Yes 54.4%

26 22 6 3.5 Yes 54.4%

26 21 6 4.3 Yes 36.9%

24 21 6 4.5 Yes 31.1%

22

Yes 26.7%

26 22 5 2.8 Yes 37.4%

26 23 6 4.1 Yes 13.4%

24 21 5 3.8 Yes 13.1%

18 5 3.5 Yes 28.0%

23 16 4 3.3 Yes 8.7%

20 21 6 5.3 Yes 7.8%

21 16 5 3.6 Yes 23.0%

33 25 21 5 3.3 Yes 21.8%

32 16 15 4 3.7 Yes 9.8%

15 Children’s Medical Center Dallas 78.3 12 2 35 22 20 6 3.3 Yes 13.8%

16 Rady Children’s Hospital, San Diego 77.2 12 2 36 22 12 5 3.5 Yes 9.8%

17 Children’s Mercy Kansas City Hospital, Mo. 76.8 14 2 35 15 17 5 4.2 Yes 2.4%

17 Children’s National Hospital, Washington, D.C. 76.8 10 2 36 26 16 5 3.9 Yes 14.3%

18 St. Louis Children’s Hospital-Washington University 76.1 14 2 35 20 17 4 3.7 Yes 2.0%

20 Cohen Children’s Medical Center, New Hyde Park, N.Y. 75.6 14 2 34 19 15 3 4.0 Yes 2.5%

21 Johns Hopkins Children’s Center, Baltimore 73.6 11 2 36 13 16 3 3.6 Yes 11.0%

22 Lucile Packard Children’s Hospital Stanford, Palo Alto, Calif. 73.1 12 2 35 20 11 3 4.3 Yes 3.4%

23 UCSF Benioff Children’s Hospitals, San Francisco and Oakland 72.7 10 2 35 24 16 3 4.2 Yes 8.2%

24 Cleveland Clinic Children’s Hospital 72.6 13 2 32 14 14 4 3.5 Yes 0.7%

24 U. of Michigan Health C.S. Mott Children’s Hospital, Ann Arbor 72.6 12 2 34 19 15 3 4.9 Yes 5.0%

Norton Children’s Hospital, Louisville, Ky. 72.2 15 2 29 25 15 6 3.1 No 0.9%

Duke Children’s Hospital and Health Center, Durham, N.C. 69.4 11 2 33 23 17 3 3.6 Yes 7.6%

UCLA Mattel Children’s Hospital, Los Angeles 69.0 14 2 28 11 12 2 4.6 Yes 3.2%

Valley Children’s Healthcare and Hospital, Madera, Calif. 68.7 15

Yale New Haven Children’s Hospital, New Haven, Conn.

University of Chicago Comer Children’s Hospital

Children’s Hospital New Orleans

Children’s Hospital of Richmond at VCU, Va.

Connecticut Children’s Medical Center,

York-Presbyterian

Wisconsin Hospital,

Carolina

Hospital,

33 13 15 3 3.8 Yes 0.8%

16 14 2 4.1 Yes 4.8%

8 14 6 3.4 Yes 0.8%

11 15 4 1.9 Yes 1.9%

11 12 4 2.6 Yes 1.9%

The IMPACT Registry®

assesses key information of CHD patients undergoing diagnosis catheterizations and catheter-based care. The Physician Champion is listed with the hospital.

Adventhealth Orlando Matthew Zussman, MD

Advocate Children’s Hospital Oak Lawn Alexander Javois, MD

Arkansas Children’s Hospital

Michael Angtuaco, MD

Ascension St. Vincent Hospital

Brenda Erner, MD

Atrium Health’s Carolinas Medical Center

Joseph Paolillo, MD

Boston Children’s Hospital Brian Quinn, MD

Cedars - Sinai Health Systems Evan Zahn, MD

Children’s Healthcare of Atlanta Dennis Kim, MD, PHD

Children’s Hospital and Medical Center - Omaha Christopher Curzon, DO

Children’s Hospital Colorado Ryan Leahy, MD

Children’s Hospital Medical Center of Akron David Waight, MD

Children’s Hospital of Los Angeles Neil Patel, MD

Children’s Hospital of New Orleans Marla Johnston, MD

Children’s Hospital of Orange County Michael Recto, MD

Children’s Hospital of Philadelphia Jonathan Rome, MD

Children’s Hospital of San Antonio Srinath Gowda, MD

Children’s Hospital of the Kings Daughters, Inc. Michael Vance, MD

Children’s Medical Center of Dallas Surendranath Veeram Reddy, MD

Children’s Mercy Kansas City Stephen Kaine, MD

Children’s Minnesota Marko Vezmar, MD

Children’s National Medical Center Joshua Kanter, MD

Children’s Wisconsin Susan Foerster, MD

Cincinnati Children’s Hospital Medical Center

Shabana Shahanavaz, MD

Cleveland Clinic

Bradley Martino, MD

Cohen Children’s Medical Center

Dipak Kholwadwala, MD

Connecticut Children’s Medical Center Cesar Mesia, MD

Cook Children’s Medical Center Deborah Schutte, MD

Dell Children’s Medical Center of Central Texas Byron Holt, MD

Duke University Hospital Gregory Fleming, MD

Geisinger Medical Center Robert Mangano, MD

Indiana University Health Methodist Hospital Georges Ephrem, MD

Inova Fairfax Medical Campus IHVI Harvey Sherber, MD

Intermountain Primary Children’s Hospital Robert Gray, MD

Jackson Memorial Hospital - Jackson Health System Satinder Sandhu, MD

Joe Dimaggio Children’s Hospital K Chan, MD

Johns Hopkins All Children’s Hospital, Inc Jim Thompson, MD

Johns Hopkins Hospital John Thomson, MD

Kaiser Permanente Oakland Medical Center Luis Alesandro Larrazabal Martinez, MD

Le Bonheur Children’s Hospital Shyam Sathanandam, MD

Loma Linda University Medical Center Brent Gordon, MD

Lucile S. Packard Children’s Hospital at Stanford University Kara Motonaga, MD

Lurie Children’s Hospital of Chicago Alan Nugent, MD

Maine Medical Center Jon Donnelly, MD

Massachusetts General Hospital Ignacio Inglessis, MD

Mayo Clinic Hospital - Saint Mary’s Campus Allison Cabalka, MD

Medical City Dallas Hospital Vivian Dimas, MD

Medical University of South Carolina Varsha Bandisode, MD

Memorial Hermann Hospital - TMC Kiran Mallula, MD

MemorialCare Long Beach Medical Center Saar Danon, MD

Methodist Hospital/Methodist Children’s Hospital Rolando Zamorasalinas, MD

Miami Children’s Health System Lourdes Prieto, MD Michigan Medicine Wendy Whiteside, MD

Montefiore Medical Center Nicole Sutton, MD

Nationwide Children’s Hospital Darren Berman, MD Nemours Children’s Health Wolfgang Radtke, MD

Nemours Children’s Hospital Mike Bingler, MD

New York - Presbyterian Weill Cornell Medical Center Ralf Holzer, MD

New York Presbyterian - Morgan Stanley Children’s Matthew Crystal, MD

Newark Beth Israel Medical Center Rajiv Verma, MD

Norton Children’s Hospital Edward Kim, MD

NYU Langone Health - Tisch Hospital Physician Michael Argilla, MD

Ochsner Clinic Foundation Ivory Crittendon, MD

Oregon Health & Science University Ali Mumford, MD

Orlando Health David Nykanen, MD

OSF Healthcare Saint Francis Medical Center Priti Patel, MD

OU Medicine, Inc. Charles Sperrazza, MD

Penn State Hershey Medical Center Howard Weber, MD

Phoenix Children’s Hospital Joseph Graziano, MD

Presbyterian/St. Luke’s Medical Center David Miller, MD

Providence Sacred Heart Medical Center

Carl Garabedian, MD

Rady Children’s Hospital - San Diego Howaida Elsaid, MD

Rainbow Babies & Children’s Hospital

Martin Bocks, MD

Riley Hospital for Children Indiana University Health Larry Markham, MD

Seattle Children’s Hospital

Agustin Rubio, MD

Spectrum Health

Joseph Vettukattil, MD

SSM Cardinal Glennon Children’s Medical

Robert Petersen, MD

St. Christopher’s Hospital for Children

Boban Abraham, MD

St. Joseph’s & St. Joseph’s Children’s Hospitals

Jeremy Ringewald, MD

St. Louis Children’s Hospital

David Balzer, MD

Straub Medical Center

James Sim, MD

Sutter Medical Center - Sacramento

Peihsiu Huang, MD

Texas Children’s Hospital

Gary Stapleton, MD

The Mount Sinai Medical Center

Barry Love, MD

UC San Diego Health System Sulpizio

Cardiovascular Center

Laith Alshawabkeh, MD

UCSF Benioff Children’s Hospitals, Oakland

Suzanne Strong, MD

UF Health Shands Hospital

James Fudge, MD

UNC Medical Center

Elman Frantz, MD

University of California (UCLA)

Mark Sklansky, MD

University of California Davis Medical Center

Frank Ing, MD

University of California San Francisco Medical Center

Phillip Moore, MD

University of Iowa Hospitals and Clinics

Osamah Aldoss, MD

University of Kentucky

Liliana Terziyskakuvlieva, MD

University of Maryland Medical Center Cardiology

Sudhir Vashist, MD, MBBS

University of Minnesota Health, Heart Care Gurumurthy Hiremath, MD

University of Mississippi Medical Center

Libby Poag, MD

UPMC Children’s Hospital of Pittsburgh

Jackie Kreutzer, MD

UR Medicine Strong Memorial Hospital

Rajiv Devanagondi, MD

UW Health Luke Lamers, MD

Valley Children’s Hospital Carl Owada, MD

VCU - Medical College of Virginia Kyongjin Lee, MD

Vidant Medical Center

Dennis Morris, MD

Wake Forest Baptist Health

Derek Williams, DO

Wayne State University - Children’s Hospital of MI

Thomas Forbes, MD

Westchester County Health Care Corp.

Markus Erb, MD

Wolfson Children’s Hospital

Robert English, MD

Yale New Haven Hospital

Jeremy Asnes, MD

BC Children’s Hospital

Shubhayan Sanatani, MD

CHU Sainte - Justine

Jeanluc Bigras, MD

Stollery Children’s Hospital

Elina Williams, MD

The Hospital for Sick Children

Audrey Marshall, MD

Best Regional Hospitals

Great Care Near Home

F YOU’RE LIKE MOST people facing hospi talization, you’d prefer to stay close to home. It’s more convenient. It might avoid a hefty bill for out-of-network care. Friends and family may be able to visit you. And getting follow-up care from the same medical team will be more practical.

Our Best Regional Hospitals listings showcase nearly 500 hun dred hospitals around the U.S. that offer high-quality care across a range of clinical services. These services include both complex, highly specialized care for the sickest patients – the focus of the Best Hospitals specialty rankings (see Page 110) – and safe, effec tive treatment for those whose medical needs are more common place, such as patients seeking hip or knee replacement surgery for age-related arthritis. The Best Regional Hospitals rankings, found in their entirety at usnews.com/bestregionalhospitals, offer readers in most parts of the country a number of high-quality choices near home.

These evaluations include ratings of how well hospitals handle 20 relatively common procedures and conditions in addition to their assessments in 11 specialties.* The 20 areas of care are colon can cer surgery, lung cancer surgery, ovarian cancer surgery, prostate cancer surgery, uterine cancer surgery, heart attack, heart failure, heart bypass surgery, heart valve surgery, transcatheter aortic valve replacement, abdominal aortic aneurysm repair, stroke, back sur

gery, hip replacement, knee replacement, hip fracture, diabetes, kidney failure, pneu monia and chronic obstructive pulmonary disease. Hospitals are assigned a rating of “high performing,” “average” or “below av erage” in each area in which they treated enough patients to be evaluated.

Recognition as a Best Regional Hospital means a hospital was nationally ranked in at least one of 11 specialties, or that it earned at least seven “high performing” ratings across the procedures and conditions. Each such hospital also had to meet certain other cri teria; an FAQ at usnews.com/best-hospitals offers more details.

The Best Regional Hospitals appear ranked by state on the following pages. Hos pitals are numerically ordered according to the following rules:

1. The higher rank went to the hospital with the better status in the Best Hospitals Honor Roll ranking (Page 109), if applicable.

*Cancer; cardiology & heart surgery; diabetes & endocrinology; ear, nose & throat; gastroenterology & GI surgery; geriatrics; obstetrics & gynecology; neurology & neurosurgery; orthopedics; pulmonology & lung surgery; and urology.

by Ben Harder  ©

How we identified and ranked the top hospitals state by state

2. Next, the higher rank went to the hospital that earned more points according to the following three rules: (a) A hospital received two points for each of the 11 specialties in which it was ranked among the top 50. (b) A hospital received one point for each specialty, procedure or condition in which it was rated high performing. (c) A hospital lost one point for each procedure or condition in which it was rated below average. Certain rare exceptions apply.

Based on the same rules, hospitals in major metropolitan areas also were ranked against other top hospitals in the metropolis. Our website displays these rankings for 92 metro areas with approximately 500,000 or more residents. The website also lists top hospitals in more than 100 U.S. News-defined regions, such as Kentucky’s Bluegrass Region, the Ozarks in Arkansas and the Florida Panhandle, to help consumers outside the biggest urban centers searching for high-quality care.

Our goal with the state and metro area rankings is to identify general medical-

surgical hospitals that provide both breadth and quality, so only hospitals that deliver a wide range of clinical services for adults were considered for the Best Regional Hospitals rankings.

Pediatric care did not factor into these rankings; instead, children’s hospitals are separately ranked by region (Page 210) based on their performance across the 10 children’s specialties (Page 165).

How a hospital performed in ophthalmology, psychiatry, rehabilitation and rheumatology did not factor into the Best Regional Hospitals rankings, either. While these four specialties are undeniably important, many hospitals treat few, if any, inpatients in these specialty areas. Additionally, specialty hospitals such as dedicated cancer centers, surgical hospitals and rehabilitation facilities were not considered for the regional rankings.

When choosing a hospital, you’ll want to consult with your physician or other health professional and combine your own research with ours to find the best possible care.

l

Tops at Routine Care

U.S. NEWS EVALUATED nearly 4,500 hospitals on their performance in 20 common procedures and conditions, ranging from treatment for stroke to surgery for colon cancer. While many hospitals demonstrated certain areas of strength, only these four hospitals were high performing in all 20 types of care.

l Barnes-Jewish Hospital

St. Louis, Missouri

l Cedars-Sinai Medical Center

Los Angeles, California

l Mayo Clinic Rochester, Minnesota

l NYU Langone Hospitals

New York, New York

MAINE MEDICAL CENTER IN PORTLAND

Best Regional Hospitals

help patients identify top hospitals near home, the table below compares hospitals across 11 of the areas of complex specialty care that comprise the Best

rankings

plus 20 routine procedures and conditions.

PROCEDURES

ANEURYSM

NATIONALLYRANKED

WHERE DISCOVERY LEADS TO WORLD-CLASS HEALTH CARE

NATIONALLYRANKEDCOLONCANCER SURGERY LUNGCANCER SURGERY OVARIANCANCER SURGERYUTERINECANCER SURGERYPROSTATECANCER SURGERY HEARTATTACKHEARTFAILUREHEARTBYPASS SURGERY HEARTVALVE SURGERY TAVR†ABDOMINALAORTIC ANEURYSM STROKEBACKSURGERY

HIPREPLACEMENTKNEEREPLACEMENT

Providence Saint John’s Health Center, Santa Monica

Kaiser Permanente Los Angeles Medical Center

Eisenhower Medical Center, Rancho Mirage

21 Kaiser Permanente Anaheim and Irvine Med. Centers, Anaheim

21 Providence St. Joseph Hospital-Orange

24 PIH Health Hospital-Whittier

24 Sharp Chula Vista Medical Center, Chula Vista

26 Adventist Health Glendale

26 Kaiser Permanente San Diego Zion and San Diego Med. Ctr.

26 Mercy General Hospital, Sacramento

26 Providence Little Company of Mary Medical Center Torrance

26 Providence St. Joseph Medical Center-Burbank

31 MemorialCare Orange Coast Medical Center, Fountain Valley

31 Providence St. Jude Medical Center, Fullerton

33 Kaiser Permanente Fontana and Ontario Med. Centers, Fontana

33 MemorialCare Saddleback Medical Center, Laguna Hills

33 Santa Barbara Cottage Hospital, Santa Barbara

36 Community Memorial Hospital-Ventura

37 Community Hospital of the Monterey Peninsula, Monterey

37 Kaiser Permanente Roseville

NATIONALLYRANKED

LUNGCANCER SURGERY OVARIANCANCER

SURGERY

NATIONALLYRANKEDCOLONCANCER

LUNGCANCER SURGERY OVARIANCANCER SURGERYUTERINECANCER

PROSTATECANCER SURGERY

HEARTBYPASS

HEARTVALVE SURGERY

ANEURYSM

Vincent’s

Cleveland Clinic Indian River Hospital, Vero Beach

Mease Countryside Hospital, Safety Harbor

Memorial Hospital West, Pembroke Pines

Memorial Regional Hospital, Hollywood

Ascension Sacred Heart Pensacola Hospital, Pensacola

Holy Cross Health-Fort Lauderdale

St. Anthony’s Hospital, St. Petersburg

24 Tallahassee Memorial Healthcare, Tallahassee

24 UF Health Jacksonville

AdventHealth Waterman, Tavares

Health First Holmes Regional Medical Center, Melbourne

Cleveland Clinic Martin Health, Stuart

Lakeland Regional Health, Lakeland

Physicians Regional-Pine Ridge, Naples

University Hospital, Atlanta13

St. Joseph’s Hospital, Atlanta

Hospital Atlanta

NCH

AS ONE OF

TOP 100 HOSPITALS

NCH RANKS BETTER THAN 98% OF ALL HOSPITALS NATIONWIDE*

The NCH Healthcare System has received the Healthgrades 2022 America’s 100 Best Hospitals Award™. This notable distinction places NCH in a small, elite group of hospitals who are in the top two percent of nearly 4,500 hospitals assessed nationwide for superior clinical care and patient outcomes for the treatment of the most common conditions and procedures as measured by Healthgrades, the leading resource that connects consumers, physicians and health systems.

For more information on the award-winning services of the NCH Healthcare System, please visit NCHmd.org.

NATIONALLYRANKED

SURGERY LUNGCANCER

Lutheran General Hospital,

Edward Hospital,

Good Shepherd Hospital, Barrington

Northwestern Medicine-McHenry, Huntley & Woodstock, McHenry

Advocate Sherman Hospital, Elgin

Northwestern Lake Forest Hospital, Lake Forest

Northwestern Medicine Central DuPage Hospital, Winfield

Advocate Good Samaritan Hospital, Downers Grove

14 Advocate Illinois Masonic Medical Center, Chicago

14 Northwestern Medicine Palos Hospital, Palos Heights

14 OSF HealthCare St. Francis Medical Center, Peoria

18 Carle Foundation Hospital, Urbana

Elmhurst Hospital, Elmhurst

Advocate Condell Medical Center, Libertyville

Northwest Community Hospital, Arlington Heights

Northwestern Medicine Delnor Hospital, Geneva

Silver

NATIONALLYRANKED

Henry Ford Macomb Hospitals, Clinton Township

McLaren Northern Michigan Hospital, Petoskey

Mercy Health St. Mary’s Campus, Grand Rapids

Ascension Borgess Hospital, Kalamazoo

Ascension Genesys Hospital, Grand Blanc

Beaumont Hospital-Dearborn

Covenant Healthcare-Saginaw

St. Joseph Mercy Oakland, Pontiac

Ascension St. John Hospital, Detroit

McLaren Flint Hospital, Flint

Mayo Clinic, Rochester

Abbott Northwestern Hospital, Minneapolis21

NATIONALLYRANKEDCOLONCANCER

SURGERY LUNG CANCER

SURGERY OVARIAN CANCER SURGERY UTERINEPROSTATECANCER SURGERY

CANCER SURGERY

HEART ATTACKHEART FAILUREHEART BYPASS

SURGERY HEART VALVE SURGERY

TAVR †ABDOMINAL AORTIC

ANEURYSM

STROKEBACKSURGERY

HIP REPLACEMENTKNEEREPLACEMENT

NATIONALLYRANKEDCOLONCANCER SURGERY LUNGCANCER

SURGERY

SURGERYUTERINECANCER SURGERYPROSTATECANCER SURGERY

HEARTFAILUREHEARTBYPASS

HEARTVALVE SURGERY TAVR†ABDOMINALAORTIC ANEURYSM

MORE U.S. NEWS & WORLD REPORT-RANKED HOSPITALS THAN ANY OTHER SYSTEM IN NJ.

At Hackensack Meridian Health , we’re honored to have more U.S. News & World Report-ranked hospitals than any other system in New Jersey. We’re proud to be home to the state’s only nationally-ranked Urology and Neurology & Neurosurgery programs, as well as the best Cardiology & Heart Surgery program. As if that isn’t enough, we also offer our patients nationally recognized Orthopedics and Rehabilitation programs, and premier cancer care at John Theurer Cancer Center. Earning such high praise proves that we’re ready whenever and wherever New Jersey needs us.

To learn more about these rankings and find a doctor, visit HackensackMeridianHealth.org.

NATIONALLYRANKEDCOLONCANCER SURGERY LUNGCANCER SURGERY OVARIANCANCER SURGERYUTERINECANCER SURGERYPROSTATECANCER SURGERY HEARTATTACKHEARTFAILUREHEARTBYPASS SURGERY HEARTVALVE SURGERY

ANEURYSM STROKEBACKSURGERY

KNEEREPLACEMENT

Stony Brook University Hospital, Stony Brook

Huntington Hospital at Northwell Health, Huntington

New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn

St. Peter’s Hospital-Albany

13 Mount Sinai Morningside & Mount Sinai West Hosps., New York

13 Rochester General Hospital, Rochester

15 South Shore University Hospital at Northwell Health, Bay Shore

16 White Plains Hospital, White Plains

17 Mount Sinai Beth Israel, New York

17 Northern Westchester Hosp. at Northwell Health, Mount Kisco

17 St. Joseph’s Health Hospital, Syracuse

17 Strong Memorial Hospital of the University of Rochester

21 Buffalo General Medical Center

22 Albany Medical Center, Albany

22 Staten Island University Hosp. at Northwell Health, Staten Island

22 Upstate University Hospital, Syracuse

25

York-Presbyterian/Queens,

Samaritan Hospital-West

Brothers Medical Center,

Sinai South Nassau Hospital,

CAROLINA

NYU

Clinic

Valley Hospital,

General,

Toledo Hospital,

Health Main Campus,

Hospital,

North Hospital, Cincinnati

Clinic South Pointe Hosp., Warrensville

University Hospitals

Medical Center, Beachwood

NATIONALLYRANKEDCOLONCANCER

SURGERY LUNG CANCER SURGERY OVARIAN CANCER SURGERY UTERINEPROSTATECANCER SURGERY

CANCER SURGERY

HEART ATTACKHEART FAILUREHEART BYPASS

SURGERY HEART VALVE SURGERY

TAVR †ABDOMINAL AORTIC

ANEURYSM STROKEBACKSURGERY

HIP REPLACEMENTKNEEREPLACEMENT

Hospital,

Hospital,

Hospital,

Line Health Bryn Mawr Hospital,

Temple University Hospital, Philadelphia

UPMC Passavant, Pittsburgh

Chester County Hospital, West Chester

Jefferson Health-Abington Hospital, Abington

Geisinger Medical Center, Danville

Mary Medical Center-Langhorne

General Hospital,

Nittany Medical Center,

Hamot,

NATIONALLYRANKEDCOLONCANCER

SURGERY LUNG CANCER SURGERY OVARIAN CANCER SURGERY UTERINEPROSTATECANCER SURGERY

CANCER SURGERY

HEART ATTACKHEART FAILUREHEART BYPASS SURGERY HEART VALVE SURGERY TAVR †ABDOMINAL AORTIC ANEURYSM STROKEBACKSURGERY

HIP REPLACEMENTKNEEREPLACEMENT

HIP FRACTUREDIABETESKIDNEYFAILUREPNEUMONIA

NATIONALLYRANKEDCOLONCANCER

SURGERY LUNG CANCER SURGERY OVARIAN CANCER SURGERY UTERINEPROSTATECANCER SURGERY

CANCER SURGERY

HEART FAILUREHEART BYPASS

SURGERY HEART VALVE SURGERY TAVR †ABDOMINAL AORTIC

ANEURYSM STROKEBACKSURGERY

HIP REPLACEMENTKNEEREPLACEMENT

Baylor Scott and White Medical Center-Temple

Memorial Hermann Hospital, Houston37

Memorial Hermann Greater Heights Hospital, Houston

St. David’s Medical Center, Austin

Ascension Seton Medical Center Austin

Christus Mother Frances Hospital-Tyler

Houston Methodist Sugar Land Hospital, Sugar Land

Memorial Hermann Memorial City Medical Center, Houston

Methodist Hospital-San Antonio

Parkland Health-Dallas

Texas Health Presbyterian Hospital Dallas

Baptist Medical Center, San Antonio

Covenant Medical Center-Lubbock

Medical City Dallas

Dallas Medical Center

Health Harris Methodist Hosp. Southwest,

David’s South Austin Medical Center

NATIONALLYRANKEDCOLONCANCER SURGERY LUNG CANCER

SURGERY OVARIAN CANCER SURGERY UTERINEPROSTATECANCER SURGERY

CANCER SURGERY

HEART BYPASS

SURGERY

SURGERY

ANEURYSM

HIP REPLACEMENTKNEEREPLACEMENT

Best Regional Children’s Hospitals

or good reasons, parents of kids who need specialty care tend to seek a hospital close to home, usually within the state where they live or in a neighboring state. Designed to help families identify top pediatric centers near home, the region-by-region rankings below compare children’s hospitals on overall performance across 10 pediatric specialties.

CANCERCARDIOLOGY&HEART

Children’s Hospital, Charlotte,

Carolina Children’s Hospital

Arkansas Children’s Hospital, Little Rock

Arnold Palmer Hospital for Children, Orlando

Nicklaus Children’s Hospital, Miami

UF Health Shands Children’s Hospital, Gainesville, Fla.

Johns Hopkins All Children’s Hospital, St. Petersburg, Fla.

MUSC Shawn Jenkins Children’s Hospital, Charleston, S.C.

Le Bonheur Children’s Hospital, Memphis, Tenn.

Ochsner Hospital for Children, New Orleans

15 Children’s Hospital New Orleans

15 Joe DiMaggio Children’s Hospital at Memorial, Hollywood, Fla.

15 Nemours Children’s Hospital-Florida, Orlando

18 AdventHealth for Children, Orlando

18 Holtz Children’s Hospital at UM-Jackson Memorial Medical Center, Miami

18 Wolfson Children’s Hospital, Jacksonville, Fla.

Cincinnati Children’s Hospital

Nationwide Children’s Hospital, Columbus,

Children’s

CANCERCARDIOLOGY & HEART

DIABETES&

CANCERCARDIOLOGY & HEART

UC Davis Children’s Hospital, Sacramento, Calif.

Loma Linda University Children’s Hospital, Loma Linda,

Health Fairview Masonic Children’s Hospital-Children’s Minnesota

Primary Children’s Hospital-Shriners Hospitals for Children-University of Utah 13Children’s Medical Center Dallas-Scottish Rite Hospital for Children 14Jimmy Everest Center for Cancer and Blood Disorders in Children 15Doernbecher Children’s Hospital at OHSU/Shriners Hospitals for Children Portland 16UC Davis Children’s Hospital/Shriners Hospitals for Children-Northern California

LOS ANGELES

The best and brightest in medicine. x 2.

Uniting expertise from Columbia and Weill Cornell Medicine to innovate women’s health.

What’s better than the top minds from one of the nation’s best schools? Top minds from two of them. Dr. D’Alton, Dr. Riley, and their teams are working to achieve pioneering breakthroughs in all areas of women’s health and improve care for all our patients.