According to U.S. News, the Best Children’s Hospitals rankings were introduced in 2007 to help families of children with rare or life-threatening illnesses find the best medical care available.
The 11th annual rankings recognize the top 50 pediatric facilities across the United States in 10 pediatric specialties.
The U.S. News Best Children’s Hospitals rankings rely on clinical data and on an annual survey of pediatric specialists. The rankings methodology considers clinical outcomes, such as mortality and infection rates, efficiency and coordination of care delivery and compliance with “best practices.”
“At CHOC Children’s, we are steadfastly committed to delivering high-quality, safe and reliable health care to our patients,” said Dr. James Cappon, CHOC’s chief quality officer. “Recognition from U.S. News of our excellence in these seven subspecialties validates our efforts, but also provides our patients and families with even more assurance of our commitment to excelling in all areas of care.”
“The pediatric centers we rank in Best Children’s Hospitals deliver exceptionally high-quality care and deserve to be recognized for their commitment,” U.S. News Health Rankings Editor Avery Comarow said. “Children with life-threatening illnesses or rare conditions need the state-of-the-art services and expertise these hospitals provide every day.”
Lizzie Boyle is mom to CHOC Children’s patient and cancer warrior Ella, age 6 and serves as team caption for CHOC Walk’s Team Brave Boyle
There are many ways that grateful families can support CHOC. Why do you participate in CHOC Walk every year?
Walking was the most crucial part in Ella’s recovery. As she braved her 14 rounds of chemotherapy, multiple surgeries, and many scans and procedures under anesthesia, I knew as a mom that it was important to get her moving. CHOC encouraged us as parents to be active participants in Ella’s recovery, and how crucial it was that she must get out of bed and walk the halls of the hematology/oncology unit to survive. The CHOC Walk is a direct reflection of what happens inside that unit at CHOC. Get up, survive, and walk alongside people who you may never know by name. We learned that the power of being together, all for the purpose of knowing someone in their lives was affected by this hospital, is a tremendous feeling.
What inspired you to become part of CHOC Walk? How long have you been participating?
The CHOC Walk was always been something we knew about within our community, however not until my daughter was a patient herself did we walk. Last year, my sister Caitlin and brother-in-law Rhett took it upon themselves to create Team Brave Boyle, and by the grace of God and many other hands we were able to walk that day. Some members of our team have participated for years in support of the care their own children received years ago, but much of our team was experiencing it for the first time. The phrase I heard the most from our team that day was, “We will do this every year. This is amazing.”
What is your favorite memory from a previous CHOC Walk?
Well that is a tough one to answer! I will say it was when we were in a holding pattern waiting to walk down Main Street. The Brave Boyle team was stretched out five people wide and at least 40 feet back. I looked ahead of us and saw a group of our oncology nurses; I looked behind me and saw my sisters; I looked around me and saw Ella’s classmates sprinkled around with their parents. To see the sacrifices that so many of our supporters made to be there that day was humbling, and I felt so sad that Ella wasn’t able to walk with us that day. Then I looked to my right and there was a large group holding a sign for their daughter who is now an angel. I quickly became overwhelmed with emotion. Just then, over the Disneyland speaker, “Shake it Off” by Taylor Swift started playing. The entire group began to sing, and it brought me back to day one of Ella’s treatment when we started the tradition of singing that song for her. It was exactly what we needed at that very moment.
What would you say to a community member to encourage them to participate in their first CHOC Walk?
It is an experience that allows you to celebrate all life, and your support system—the child, the sibling, the grandma…the people who hold us up. The day is beyond a fundraiser, it changes your entire outlook on what a hospital represents.
What inspires you most about the care being delivered at CHOC?
In our 12 months living off and on at CHOC, my daughter walked onto that 5th floor each time to be greeted as if, ‘Welcome Home.’ In the same respect, days later as we were discharged, they celebrated, praised her, and said, ‘Say hi to your sister!’ They knew Ella Grace Boyle, and every 5-year-old should feel that love no matter what they are facing.
When most adults think back to their earliest memory, they might remember a field trip in preschool or a vacation with family. But Caroline, a registered nurse in the Hyundai Cancer Institute at CHOC Children’s, remembers CHOC. She was diagnosed with cancer at age two, and spent the next two and a half years in and out of treatment.
“I remember the playrooms, my nurses, the child life specialists, and the friends I made in the hospital,” she recalls. “Several families got really close because of our shared experiences and regularly got together for years after we all finished treatment.”
Caroline now works alongside several of the nurses and physicians who helped her beat cancer as a young child.
Karen DeAnda, a registered nurse at CHOC, was the first one to care for Caroline after her diagnosis, and started Caroline’s very first IV.
“I do recall the day Caroline came in for the first time. She was tiny, and I was a brand new nurse,” DeAnda says. “Those initial first days when a patient is being diagnosed is very difficult on the entire family. I clearly remember the day she was diagnosed and helping her through that first evening in the hospital. It was a surreal experience to see her so many years later as a grown woman; it made my heart pound. She is truly an inspiration to our patients and families.”
Caroline’s parents were at her bedside as often as they could be, but when they weren’t able to be there, her nurses stepped in.
“My nurses were the people who were always there with me when my parents couldn’t be. It was like a big family,” she says. “My mom was a huge worrier, and for her to trust my nurses was a big thing.”
Although Caroline was very young when she was diagnosed with cancer, she has a unique connection to the patients she now cares for and their families.
“Caroline’s compassion and firsthand experience is a gift to our patients and their families. Whether or not she even shares her story with her patients, the fact that she has walked that walk, regardless of her young age at the time, allows her to have immense empathy and understanding for what the entire family is experiencing,” DeAnda says.
The impact that Caroline’s care team had on her as a patient directly influenced her career path.
“I’ve always been interested in medicine,” she says. “There was never a question about what I wanted to do when I grew up; I always knew that I would become an oncology nurse at CHOC.”
For a short time during her undergraduate studies, she momentarily lost sight of that goal, and was struggling in school. At the time, CHOC was in the midst of constructing the Bill Holmes Tower, and Caroline’s dad arranged for the two of them to have a behind-the-scenes tour. One of Caroline’s primary nurses during her cancer treatment, Melanie Patterson, now the vice president of patient care services and chief nursing officer at CHOC, showed them the new technology and amenities that would be coming to CHOC, and it reignited Caroline’s passion.
She applied to nursing school the next day, and began volunteering in CHOC’s oncology unit, two things that made her former nurse very proud.
“I remember Caroline’s beautiful hair the day she was diagnosed. This beautiful toddler girl— my heart melted for her immediately. She was very young when she was treated, but this prepared her for the emotional, mental and physical toll of oncology nursing” Patterson says. “We have many former patients working at CHOC, and it makes my heart and soul glow knowing that CHOC nurses have impacted kids growing into adults that way.”
Once on the receiving end of the small acts of kindness from nurses — who once went out of their way to pick up Caroline’s favorite food when she was sick from treatment and wouldn’t eat—Caroline now understands the importance of going the extra mile for patients and families.
“Remembering how a mom takes her coffee in the morning, or seeing a child who is cold and bringing them a heated blanket when they didn’t even know we had those, can sometimes be the thing that changes their outlook on the whole day, and such a welcome surprise for them,” Caroline says.
Transitioning from patient to nurse did not happen without a few unexpected revelations.
“When I became a nurse, I was surprised at how much this career is a labor of love. When I was a patient, I had no idea how much work nurses did behind the scenes when I wasn’t looking,” Caroline says. “I felt like the center of their whole world. I didn’t know they had a lot of centers of their world.”
As much as Caroline enjoys caring for pediatric oncology patients the way she once was cared for, she loves even more when she gets to send them home.
“What I love most about working at CHOC is seeing patients get healthy and sending them home, where they belong,” Caroline says. “I also love seeing so many people come together for one child’s health. Seeing that happen day after day is really powerful.”
Meet three members of the CHOC Children’s care team who recently shaved their heads to raise awareness and research funds for pediatric cancer.
Erika Crawford, RN, Oncology
“I used to work in Portland, Oregon as a pediatric hematology/oncology nurse and it was just part of the nursing culture there to at least participate once in this process. As the clippers were shaving my head in 2010, I found that it was a very emotional experience. I imagined the many patients I had taken care of that had experienced the same thing. At work, the patients and parents verbalized gratitude and some parents were inspired to shave their own heads for their children. I told myself then, that I would like to participate in another head shaving event once again in my lifetime.
Not only is it a great way to raise awareness and much-needed funds for pediatric cancer research, but it’s a way for nurses to participate in their patient’s journey. Our patients don’t get a choice in losing their hair (which is a very difficult thing to experience), but as a nurse we can choose to join them in a small way on their journey by choosing to experience being bald.
Even though I have been down this road before, I still struggle internally with my approaching baldness. However, those same insecurities, feelings and fears are experienced by our young patients. I think it’s important to walk with them on this journey in some way shape or form.”
Karen DeAnda, RN, CN Oncology
“When I first met Erika, she had a cute bald noggin. She had just participated in another head shaving event to raise money for childhood cancer research. Over the years I have thought it would be something I’d like to do. When Erika told me she was participating again this year I decided it was now or never. As Erika has expressed, it is a very emotional process. When I tell people what I am doing they are absolutely amazed and shocked that I would do such a thing. This is a very small way that we can show our patients our respect for the difficult road they travel. I can honestly say that I am terrified, but also extremely proud and committed to this process. I love my job and this small gesture is one way I can give back to the wonderful children I have had the privilege of caring for here at CHOC.
I am fortunate to work with some amazing nurses who have been so generous with their donations and emotional support. My family has been fundraising on my behalf as well, and the response has just been phenomenal.”
Viri Harris, clinical associate, Outpatient Infusion Center
“I have been at CHOC for 18 months, and this is the second time shaving my head as a form of honoring the children we serve. I wanted to do something to show my love for them and to show gratitude for the way they and their families have inspired me on a daily basis. To be completely honest, I was nervous about how my head would look bald- I had an intense fear that my head would be oddly shaped. But, then I thought about how I wanted to come alongside these beautiful kids, and my nervousness went away. We witness these kids and their families struggle on a daily basis and this has inspired me to support them in any way I can. If that means shaving my head to bring awareness and raise funds, that is what I will do- it is the least I can do.”
Two oncologists have joined the team of nationally-recognized specialists of the Hyundai Cancer Institute at CHOC Children’s. Dr. Josephine HaDuong and Dr. Ashley Plant were both fellowship trained at two of the country’s top cancer programs, and share research interest in immunotherapy and targeted therapies.
Dr. Josephine HaDuong is board-certified in pediatric hematology and oncology, and was drawn to the Cancer Institute for what she refers to as its gold standard of care.
“The Hyundai Cancer Institute is a growing center that strives to be among the best. The team provides patients access to cutting-edge clinical trials that may lead to breakthroughs in pediatric cancer,” says Dr. HaDuong.
Her research is driven, in large part, by her clinical interest in caring for patients with solid tumors. A published author and principal investigator in a number of studies, Dr. HaDuong’s major research activities include exploring developmental therapeutics in solid tumors using immunomodulatory and targeted agents, as well as functional imaging in bone and soft tissue sarcomas using magnetic resonance spectroscopy.
Following medical school at the University of Pittsburgh, where she earned a full tuition merit scholarship, Dr. HaDuong completed her residency and pediatric hematology/oncology fellowship training at Children’s Hospital Los Angeles. She was honored with the Fellow of the Year, Excellence in Teaching Award.
She is a member of numerous professional associations, including American Society of Clinical Oncology, American Society of Pediatric Hematology and Oncology, and North American Consortium for Histiocytosis. In addition to English, she speaks Spanish and Vietnamese.
Raised in Orange County, Dr. HaDuong is thrilled to be back in her hometown. “I have always wanted to return home to serve the children and families in Orange County. I look forward to being a part of an incredible team who works relentlessly to end cancer,” says Dr. HaDuong.
Dr. Ashley Plant is committed to growing CHOC’s neuro-oncology treatment program, and eager to bring new therapies to patients with brain tumors. “I look forward to collaborating with academia and industry to bring early clinical trials to CHOC, especially in the area of immunotherapy. I am also excited to partner with my new colleagues to advance the work the Cancer Institute has been doing to reduce the long-term toxicities of cancer therapy,” says Dr. Plant.
Dr. Plant is a published author whose research interests include early phase clinical trial design for pediatric brain tumors. Her most recent project is a phase 1 clinical trial for a neo-antigen heat shock protein vaccine for diffuse intrinsic pontine glioma, a fatal brain tumor. She hopes to enroll patients in this trial within the next year. She considers herself fortunate to have worked under world-renowned immuno-oncologists Dr. Glenn Dranoff and Dr. Jerome Ritz at Dana Farber Cancer Institute in Boston. There, she won the Young Investigator Award for a project evaluating clonality of T cell receptors in pediatric gliomas.
Following medical school at Stanford University, Dr. Plant finished her residency at University of California, Los Angeles. Her fellowship training in pediatric hematology/oncology was completed at Boston Children’s Hospital. She received additional training in clinical trials and public health at Harvard Chan School of Public Health.
“I was attracted to CHOC because the hospital prioritizes excellent clinical care of patients above all else,” says Dr. Plant. “The hospital’s commitment to patient-and-family-centered care is something I wholeheartedly support. Cancer affects everyone in the family – physically, emotionally, psychologically and sometimes even financially. If we fail to address these issues, we are not completely caring for our patients and their families.”
And when CHOC nurse Erika Crawford heard Christine playing a familiar song on a piano while receiving chemotherapy treatment one day, she spoke up.
“I told her I knew that song on the ukulele, and that we should play together,” Erika recalls.
Since then, the pair has regularly jammed together while Christine, 17, is in CHOC’s Outpatient Infusion Center. Inspired by Erika, Christine started learning the ukulele and the pair will tinker on songs together.
They even gave their duo a name: E.C. Teal, which incorporates their initials and the color they both happened to wear one day.
Because infusions can take hours, music helps Christine pass the time and take her mind off her condition.
“I’ve always loved music,” she says. “Going through cancer made me realized just how much I loved music.”
Erika began playing the ukulele only a year ago. She was previously learning the guitar and thought its smaller cousin might help her learn faster. And now, it serves as another way for her to connect with patients like Christine.
“It’s fantastic,” she says. “It’s the best part of the job.”
As a typical, happy-go-lucky six-year-old, Shaina was playing outside with her brother before dinner time, when her back started hurting.
She laid down on the couch to rest, but when her mom called her for dinner, she was too weak to even make it to the table. A trip to a local emergency room followed, and kidney stones were suspected. She was eventually transferred to CHOC Children’s. After additional testing, Shaina was diagnosed with neuroblastoma, a cancer that often starts in the tissue of the adrenal glands, on top of the kidneys. What they thought originally might be kidney stones, was actually the pain of her kidneys being crushed by a tumor that was growing inside her.
She underwent emergent surgery two days later to remove the tumor and one of her kidneys, and overcame the odds that were stacked against her.
“I was so young when I was diagnosed, so I don’t remember a lot of the scary parts of that time, but ever since, my family has been telling me stories about how wonderful my physicians and nurses were to our whole family during that time,” she says.
Those stories are part of the reason that six-year-old Shaina grew up to be a hematology/oncology nurse with the Hyundai Cancer Institute, in same hospital that saved her life almost two decades ago.
After surgery, Shaina was in and out of the hospital for chemotherapy treatments and a stem cell transplant. The first one hundred days after such a transplant are crucial to ensure a patient’s health and safety, and her family had to be abundantly cautious that her environment was as clean and safe as possible. At the end of those hundred days, her family threw a big party at their house to celebrate making it over the hump.
She relapsed a few months later.
Experimental treatment at various hospitals throughout Southern California followed, and three years later, she was cancer free for good.
Even during this time, Shaina knew she would return to CHOC someday.
Fast forward a few years and Shaina was a high school student. Searching for volunteer hours as part of her curriculum, she sought out volunteer opportunities at CHOC as a way to say thank you to the hospital that saved her life as a child.
She joined the Child Life team as a play room volunteer, helping normalize the hospital environment for patients utilizing the same play rooms she had sought an escape in while she was a patient.
She now works alongside some of the same physicians and nurses that cared for her as a child.
One of her primary oncology nurses, Dana Moran, gives her a big hug whenever they pass each other in the hallways.
“Shaina was so little when she was a patient here- she was so fragile and scared, but she was a strong kid with a strong personality, and that helped her get through her challenges,” Dana says. “Now it makes me proud to see her happy and healthy and back at CHOC caring for other kids.”
Her pediatric oncologist, Dr. Lilibeth Torno, keeps a photo from Shaina’s nursing school graduation on the desk in her office.
“I am really proud to have seen her grow and mature as a person and as a colleague in oncology,” Dr. Torno says. “I have seen her strength as she overcame challenges that cancer survivors go through and she did it successfully!”
She was barely through her first year of high school, but Emily Gruendyke was determined to be a nurse. A pediatric oncology nurse, specifically. The young teen carefully mapped the steps she would take to achieve her career goal. Nothing was going to stand in her way. And, sure enough, today Emily is a hematology/oncology nurse at the Hyundai Cancer Institute at CHOC Children’s.
Emily’s family supported her calling from day one, especially her younger sister Amanda. Better than anyone, Amanda knew Emily would be a great oncology nurse. She experienced Emily’s nurturing care often, especially after being diagnosed with a type of cancer called neuroblastoma. The diagnosis—delivered when Amanda was 9 and Emily was 14—affected the entire family. Emily quickly learned just how isolating the disease could be — not just for the patient, but for parents and siblings.
“During the first year of Amanda’s treatment, she and my mom spent 200 nights at the hospital, which was about an hour from our home. I would only get to see them on weekends. And, as much as my friends cared, they didn’t really understand what we were all going through,” explains Emily.
When Emily was able to visit Amanda at the hospital, she noted the impact nurses had on her mom and sister.
“My hospital visits really opened my eyes to what nursing could do. I witnessed the difference a good nurse had on my mom and Amanda,” says Emily.
One experience was particularly impactful for Emily.
“The first night my mom and sister were home, following the start of her treatment, a nurse stopped by the house to show my mom how to hook up all of the medical equipment. Though I don’t blame the nurse, she breezed through all of the steps and didn’t really make sure my mom was comfortable with what she had to do. Later in the evening, I remember my mom crying at not being able to recall everything. Another nurse came out and did an amazing job educating my mom. More than that, the nurse empowered my mom as a caregiver. I knew that was the kind of nurse I wanted to be,” shares Emily.
As a CHOC hematology/oncology nurse, Emily is steadfastly dedicated to providing her patients’ families with the knowledge and confidence to take care of their children. She works hard to help her patients and families get through treatment and adjust to their “new normal.” And, just as she was inspired by her sister’s strength, she admires the inspiring resiliency of her patients. She also takes the time to acknowledge her patients’ siblings.
“A cancer diagnosis is tough on everyone and sometimes siblings can get inadvertently left out. I understand siblings’ point of view. I take time to not only ask if they have questions about cancer and involve them in the care—if that’s what they want—but I also ask them about their own interests,” says Emily, who is proud to be part of a team committed to patient- and family-centered care.
Emily’s sister lost her battle to cancer after a brave 12-year fight. Emily had been CHOC hematology/oncology nurse for four years at that point, of which Amanda was very proud. And despite the difficulties that came with having a sister with cancer, Emily’s family was grateful that she found a calling that would positively impact so many other hurting families. Emily can’t imagine doing anything else.
“Even though my sister passed away from her cancer, which was devastating to our family, I feel so strongly that being a pediatric oncology nurse is what I was made to do. I would not want any other job in the world. And I know Amanda wouldn’t want me doing any other job either,” says Emily.
Hello there! My name is Claire Nakaki. I am a freshman in college, but a little over a year ago, I was a soon-to-be high school senior when I was diagnosed with osteosarcoma, a type of bone cancer. I was a healthy, active volleyball player and I could not understand why this had happened to me. The initial shock was debilitating; cancer had never been something I saw in my future and certainly not my present. I began chemotherapy the month before school started, knowing that I was going to be completing my senior year of high school from a hospital bed. However, after my head and heart had cleared from the turmoil that my diagnosis had brought upon me, I realized that the upcoming year was really just a year. While cancer was something that I knew was going to affect me for the rest of my life, I refused to let it control my life. My surgeon Dr. Nassif asked me before my big surgery (which removed the tumor and replaced the bone with a prosthesis) to set some goals for the upcoming year. Two prominent goals immediately came to mind: I wanted to walk at graduation with my class, on time, without a walker, a wheelchair, or crutches, and I wanted to attend a four-year university after that. These goals did not seem far off, but I unknowingly delved into the hardest year of my life.
I found myself wanting to meet other patients my age almost immediately, begging the Child Life staff to introduce me to any other teens on the floor. I found so much comfort in knowing that there were other teenagers like me experiencing something similar. While no one’s story is identical, discussing the things we do have in common definitely helps soothe an anxious mind. I attended an AYA (Adolescent and Young Adult) support group meeting in my first few months of treatment and then the next following few months, then as often as I could. I had no idea it was even a support group until almost six months in. It felt more like a group of friends who coincidentally have this one big thing in common rather than a solemn meeting to talk about our hardships. Sure, we occasionally brought up things we were going through when someone needed support, but other than that it was just a safe space to be accepted with open arms. This AYA group has become like a second family to me, a fun group of people in all different stages of treatment and survivorship with whom I feel comfortable discussing anything and everything with. I do not know where I would be in my survivorship without this group of people, as well as the entire Child Life staff and AYA facilitators.
I am often asked if the experience was difficult and if I am sad that I missed my senior year of high school. I always have the same answer. Yes, of course it was difficult. I had no idea how difficult it would be. And I am painfully aware that my treatment went much smoother than most. I stayed on the same treatment plan and had very few bumps along the road. I am sure that my classmates enjoyed their senior year at school, but I would not trade this past year for any other situation. I truly mean that. I have learned so much from the genuinely kind and empathetic people that I met at CHOC, both patients and staff members. I reiterate time and time again that I feel so lucky to have had 17 years of life before cancer entered my life and I know that I have many more to come. I met so many younger kids during my stay at CHOC, mainly just a “hello” in the hallway, but there were a small few that I really got to know personally. These kids hold such a special place in my heart. I served as somewhat of a mentor to a few, due to my age and stage in my treatment, what kinds of procedures I had undergone, and what kinds of machines I was attached to. The kids I got to know made such a huge impact on my general attitude towards life and I truly hope that I made a positive impact on them. One piece of advice that I want everyone who goes through cancer to grasp is that no matter how bad you feel or how hard it is to meet your daily goals, your journey is always just one day at a time. It is so important to remind yourself that every day is just 24 hours. All you have to do is just get through the day. Take every step of the way just one day at a time. Soon enough, you will begin to see the light at the end of the tunnel.
As I mentioned in the beginning of the post, I am now a first-year college student, which means that yes, I did meet my goals. I finished the last step of my treatment and was released from the hospital on June 9th and walked at my graduation without a wheelchair, a walker, or crutches one week later. I was accepted to college in the middle of my treatment, and completed all of my required courses in order to attend in the fall. I achieved these goals with a year of incredibly difficult work and with the unconditional support from my family, friends, and CHOC staff. There will always be things I cannot do because of what happened to me and I still go to physical therapy twice a week and have to take extra precautions in almost everything I do, but I am so happy to be back in the real world, living my new normal.
In honor of Childhood Cancer Awareness Month, we share a poem written by Kim, a registered nurse in the hematology/oncology unit at CHOC Children’s, at the time she finished her training. Kim is a cancer survivor and former CHOC patient.
I had no idea what this was going to bring up
All these memories and feelings I have folded so neatly in a cup
Tucked away never again to be touched
Walking back into CHOC, oh how I have forgotten so much
You see, I once had cancer too
I came back as a nurse to see what I could do
I once told my own nurses, now peers, I will be back. Something I am sure they heard before
10 years later I walk through CHOC’s door
As a registered nurse I am proud to be
But I never underestimate the patient that is still inside of me
People have told me it takes certain strength to face it again
“Doesn’t it remind you of all your pain?”
My pain?, I think, I am one of the lucky ones.
I get to come to work and I have fun
I am allowed to make funny faces
I make kids laugh and participate in car chases
I am able to share in life’s precious moments daily
Except for the need of possibly doing a Foley
Even when I am running around like a chicken with no head
I will always take time for that scared kiddo sitting in the bed
There are times when I step back and remember
When that was once me waiting for a cure
This hasn’t been easy, seeing the chemo’s and procedures
And sitting through those late effects lectures
Sometimes when the day has been hard I ask myself, “Why did I pick THIS? What else could I have been?”
But I quickly remind myself I didn’t pick this- it picked me way back when.
I am surrounded by hope, a side people do not see
For I am a proud survivor and now registered nurse of pediatric oncology.