The Top 5 Children's Hospitals on the West Coast

US News and World Report recently released its Children's Hospital Rankings for 2014-2015.  The rankings are based on an evaluation of a hospital's performance in ten children's medical specialties:  (i) cancer, (ii) neonatology, (iii) nephrology, (iv) orthopedics, (v) pulmonology, (vi) urology, (vii) neurology and neurosurgery, (viii) gastroenterology and gastrointestinal surgery, (ix) diabetes and endocrinology, and (x) cardiology and heart surgery.  The methodology employed to develop these rankings is discussed in more detail here.  Over the course of the next few commentaries we will provide some regional perspective on these rankings, starting today with a look at the Top 5 Children's Hospitals on the West Coast.

Topping the list is Children's Hospital Los Angeles (map).  As detailed here, Children's Hospital Los Angeles ranks in the top 20 nationally in all pediatric specialties measured in the US News survey, including in the top 10 nationally in 6 of those specialties.  It's two strongest specialties are orthopedics and cancer, where it ranks nationally at the #2 and #5 spots, respectively.  Children's Hospital Los Angeles, which has a teaching hospital relationship with The Keck School of Medicine of the University of Southern California, is also home to The Saban Research Institute, a major pediatric health research facility.  

Taking the 2nd spot of the list of the Top 5 Children's Hospitals on the West Coast is Seattle Children's Hospital (map).  Seattle Children's Hospital is in the top 30 in all pediatric specialties nationally per the US News survey, which includes ranking nationally in the top 10 for 3 specialties and in the top 20 nationally for 4 other specialties.  Its two strongest national specialty rankings are #5 for nephrology and #7 for cancer.  The primary teaching site for the University of Washington School of Medicine Department of Pediatrics, Seattle Children's Hospital also has a research institute that is among the top 5 pediatric research centers nationally in terms of grant funding from the National Institutes of Health.

The Lucile Packard Children's Hospital at Stanford (map) occupies third place on the list of Top 5 Children's Hospitals on the West Coast.  Rated in the top 30 in nine specialties in the US News survey, the Packard Children's Hospital has top 10 national rankings in 3 specialties (#7 nephrology, #8 cardiology and heart surgery and #10 pulmonology) and top 20 national rankings in two other specialties.  A primary teaching hospital of the Stanford University medical school, Packard Children's Hospital is part of the Stanford Children's Health network that provides care for close to 400,000 patient visits each year.

4th place on the list of the Top 5 Children's Hospitals on the West Coast belongs to Rady Children's Hospital San Diego (map).  Ranked in the top 30 in all pediatric specialties, only one Rady's specialty (#3 orthopedics) ranks in the top 10 nationally.  However,  the hospital is rated nationally between 11th and 20th in 4 other specialties and between 21st and 30th nationally in 5 more pediatric specialties.  Rady's Children's Hospital also functions as a teaching hospital for the University of California, San Diego School of Medicine.

Rounding out the list of the Top 5 Children's Hospitals on the West Coast is UCSF Benioff Children's Hospital San Francisco (map).  Ranked in the top 50 in all pediatric specialties covered by US News, Benioff Children's Hospital earned a top 10 national rank in only one specialty (#10 Diabetes & Endocrinology) and only two other top 20 specialty rankings nationally.  But the hospital earns it place on the list by ranking between 21st and 45th in the seven other pediatric specialties that comprise the US News survey.

Honorable mention recognition goes to four West Coast institutions that earned a top 50 rank in at least four pediatric medical specialties:

•  Mattel Children's Hospital UCLA, which received a #10 rank in nephrology in the US News survey and, overall, rated in the top 50 in eight specialties nationally
• Doernbecher Children's Hospital at Oregon Health and Science University, which ranked in the top 50 in all pediatric specialties in the US News survey, its highest rating being #15 in neonatology.
• Children's Hospital of Orange County, which earned top 50 ratings in seven specialties,  its highest rating being #17 in neonatology, and
• UC Davis Children's Hospital, which ranked in the top 50 in four specialties. 

Ten States Most Under-Served by Registered Nurses

According to Area Health Resource Files (AHRF) data available from the Health Resources and Services Administration, there are 839 registered nurses employed for every 100,000 people here in the United States .  Among all health professions, that is the largest number of practitioners per 100,000 population in the U.S., which is not really surprising given the essential role registered nurses (RNs) play in quality healthcare delivery.  What may be more surprising is how much disparity exists in registered nurse employment from State to State.  As this map of registered nurse employment per 100,000 population reveals, some areas of the country are much better served by RNs than are others:

There are 31 States in all that have registered nurse employment that exceeds the 839 per 100,000 population national average.  And within this group there are a dozen States, mainly in the Northeast and Great Plains regions, that are particularly well served by registered nurses with employment greater than 1,000 registered nurses per 100,000 population.  But while some States are well served by RNs, there are 19 States, predominantly in the South and West, where registered nurse employment lags behind the national average. Some of these laggards, like California and Texas, actually have RN employment numbers among the highest in the nation in absolute terms.  But even in these two big States, RN employment is proportionately weak given their size.  With 719 RNs employed per 100,000 population, only 9 States are more under-served by registered nurses than Texas.  And the situation in California is poorer still, where just 657 RNs employed per 100,000 population makes the State more under-served by registered nurses than all but three States.  The State most under-served by registered nurses is Nevada, which has just 609 RNs employed per 100,000 people.  Unfortunately, for Nevada and other States that lag behind the national average, the situation could easily get worse in coming years.  The job outlook for RNs indicates a growing need for registered nurses due to a variety of demographic and technological factors.  This trend will will only exert more pressure on States already struggling to attract RNs.  Besides Nevada, California and Texas, here are the Ten States Most Under-Served by Registered Nurses based on current HRSA data: