CHOC Included Among Nation’s Best Children’s Hospitals in U.S. News Survey

CHOC Children’s has been named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2017-18 Best Children’s Hospitals rankings.

CHOC ranked in seven specialties: cancer, diabetes/endocrinology, neonatology, neurology/neurosurgery, orthopedics, pulmonology and urology, which earned a top 20 spot on the coveted list.

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.”

Learn more about survival rates, adequacy of nurse staffing, procedure and patient volume, availability of programs for particular illnesses and conditions and more. 

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CHOC’s Surgical NICU Offers Pioneering Coordinated Treatment

ICHOC Children's Surgical NICU nfants needing surgery require special attention, and a unique feature of CHOC’s Neonatal Intensive Care Unit (NICU) provides just that.

CHOC’s Surgical NICU, a dedicated space within the NICU, uses a comprehensive approach to care for these tiny patients. A coordinated treatment protocol – used in many adult intensive care units nationwide – has shown to result in fewer patient complications, better outcomes and faster discharges. And, CHOC’s Surgical NICU physicians and staff continue to research new ways to make the care even better.

“CHOC has one of the only two Surgical NICUs like it at any children’s hospital in the country,” says Dr. Mustafa H. Kabeer, who with Dr. Irfan Ahmad, a neonatologist, co-directs the Surgical NICU at CHOC.

“We have a room dedicated with eight beds and a second room with two beds that allow for surgeries to be done right there in the NICU. It’s a unique setting in which we have multi-disciplinary, coordinated care.”

“Babies in the NICU are very critical to start with and things can change minute by minute. When you add in the risks of surgery, it becomes more complex. We coordinate care through better communication with physicians and the nurses and the family. We involve all of these groups so everybody is on the same page. We have joint rounds with residents and fellows, and have initiatives on research and teaching, with monthly lectures on select topics. We are collecting data on outcomes and how the babies do,” says Dr. Kabeer.

Dr. Ahmad adds, “The experience has been so positive. We are all really happy with the care our patients are receiving. The surgeries and anesthesia have become safer.”

In a new effort, CHOC’s Surgical NICU team has begun a new research project to examine better pain control for babies following surgery. “This is going to be really big and is being planned by Dr. Kabeer from surgery, myself from neonatology, and Dr. Rebecca Sangster from anesthesia,” says Dr. Ahmad.

Other projects include investigating ways to decrease the occurrence of hypothermia, or low body temperatures, for babies having surgery. In addition, the Surgical NICU staff is maintaining a patient database that will help the staff design future quality improvement projects and clinical studies.

The Surgical NICU is special in other ways. Patient rounds there often include a dozen or more specialists who join the physician and nurses. “These rounds are very different than what goes on anywhere else. We try to educate the families about what this means and how unique this is,” says Dr.  Kabeer.

Babies in CHOC’s Surgical NICU receive consistent and coordinated care from a multidisciplinary healthcare team that includes neonatologists, nurses, surgeons, respiratory therapists, nutritionists and other specialists who may be needed. Parents and family members round out the team. The family joins the clinicians to discuss care plans, share information and make care decisions. Each patient receives a well-coordinated and consistent treatment plan.

Pediatric surgeons perform many types of surgeries in the Surgical NICU, including lung and thoracic surgeries, robotics surgeries, head and neck surgeries, repairs of umbilical and inguinal hernias, among a variety of different operations.

More posts about neonatology:

  • CHOC Included Among Nation’s Best Children’s Hospitals in U.S. News Survey
    CHOC Children’s has been named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2017-18 Best Children’s Hospitals rankings.
  • Birth Defects
    Common birth defects include heart defects, cleft lip and cleft palate, Down syndrome and spina bifida. Congenital heart defects are the most common type of birth defect in the United ...
  • Testing for Birth Defects
    Advances in medicine have allowed doctors to diagnose birth defects and genetic conditions before a baby is born. Pregnant women older than 35, those with a history of miscarriages or health ...

Birth Defects

girl_braidCOMING TO TERMS WITH UNEXPECTED BIRTH DEFECTS
Common birth defects include heart defects, cleft lip and cleft palate, Down syndrome and spina bifida. Congenital heart defects are the most common type of birth defect in the United States, affecting nearly 1 percent of, or about 40,000, births per year, according to the Centers for Disease Control and Prevention. Birth defects can be minor to severe. “Some of these can be corrected by surgery and some can be treated by involving many different physicians with different specialties,” says Dr. Ahmad.

COPING LONG-TERM
“The most important thing for the parents is they still have to love their baby because all babies are precious,” says Dr. Ahmad. “As these babies grow up, we have the ability to provide these babies developmental help to cope.” Parents can reach out to the Regional Center of Orange County for help and therapy, public school districts offer assistance to disabled children, and pediatricians are a great source of information and resources as well. “Try to learn as much about the condition as possible. This will help parents cope and make sure that their baby gets the best possible care,” says Dr. Ahmad.

PREVENTING BIRTH DEFECTS
One of the best things a pregnant woman can do for her baby is to take good care of her health. Not all birth defects can be prevented but there are some things a woman can do before and during pregnancy to increase the chance of having a healthy baby, says Dr. Ahmad. They include:

  • Taking folic acid before becoming pregnant and during pregnancy to help prevent neural tube defects (defects of the brain and spine).
  • If the woman is diabetic, making sure her diabetes is under control. Uncontrolled diabetes can lead to different malformations and problems for the baby.
  • Avoiding alcohol use while pregnant. Drinking alcohol while pregnant can cause fetal alcohol syndrome.

FAST FACTS

  • Number of babies born with a birth defect in the U.S. each year: About 1 in every 33
  • Babies born annually with Down Syndrome in the U.S. each year: 1 in 691
  • Approximate percent of infant deaths caused by birth defects: Over 20%

View the full feature on Kids and Birth Defects

Dr. Ahmad
Dr. Irfan Ahmad
CHOC Children’s Neonatologist

PHYSICIAN FOCUS: DR. IRFAN AHMAD

Dr. Ahmad served as chief fellow and completed his neonatal-perinatal fellowship at the University of California Irvine Medical Center. He completed his pediatric internship and residency at the University of Oklahoma in Oklahoma City. Dr. Ahmad is an associate professor of Pediatrics at UCI and also the director of the Surgical Neonatal Intensive Care Unit at CHOC. His current focus is on babies born with congenital anomalies that can be treated through surgery.

Dr. Ahmad’s philosophy of care: “My philosophy is to provide evidence based care which can benefit both the child and the family.”

EDUCATION:
Aga Khan University Medical College, Karachi, Pakistan

BOARD CERTIFICATIONS:
Neonatal-Perinatal Medicine Pediatrics

More about Dr. Irfan Ahmad

This article was featured in the Orange County Register on June 16, 2014, and was written by Amy Bentley.

Testing for Birth Defects

Advances in medicine have allowed doctors to diagnose birth defects and genetic conditions before a baby is born.Testing_Birth_Defects

Pregnant women older than 35, those with a history of miscarriages or health problems, and women with a family history of certain disorders or birth defects are often tested for birth defects, says Dr. Irfan Ahmad, a CHOC Children’s neonatologist.

During pregnancy, mothers-to-be can undergo genetic counseling and genetic testing. Specially trained professionals can help prospective or expectant parents learn about genetic conditions they may face and their chances of having a child with a genetic condition. Genetic counseling and testing can also screen for diseases more common in certain ethnic groups. This helps people make informed decisions about family planning, testing and treatment.

Pregnant women can also have an ultrasound, an amniocentesis, or a blood test called a Quad Screen. Dr. Ahmad says these tests can help to diagnose birth defects including Down syndrome, heart conditions, neural tube defects such as spina bifida, and intestinal obstructions.

When diagnosed during pregnancy, some of these problems can be fixed or treated with surgery. Knowing ahead of time about a possible birth defect or other medical problem with the fetus allows the parent and their physicians to better prepare for the birth and treatments or surgery that may be needed, says Dr. Ahmad.

“You can also speak to a specialist, including a neonatologist and a surgeon, before the baby is born to offer counseling,” Dr. Ahmad says. “We can have a plan in place for when the baby is born and what we will do, so parents and physicians are prepared.”

Related articles:

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  • CHOC Expert Discusses Support Services For Down Syndrome Patients
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Neonatology: Then and Now

sbu_thenandnowCHOC Children’s has always done a great job of treating premature babies, and infants with heart problems, infections or birth defects. Over the last 50 years, I’ve seen technology and medicine change a lot in neonatology.

An extra special place at CHOC is its Small Baby Unit, a program within its neonatal intensive care unit (NICU). Reserved for the smallest and sickest babies, this unit gives hope to babies who wouldn’t have had a chance in 1964.

There, every newborn receives care from dedicated staff members. The space also has shrouded incubators to keep light away from the baby’s sensitive eyes and everyone (even family members) speaks gently to help create a calm, comforting and healing environment.

Kangaroo Care is another technique in neonatology that has grown in popularity since 1964. As babies spend time lying on their parents’ chests, they become more alert, cry less often and even a find feeding rhythm. Premature babies benefit from this practice by facing fewer complications, gaining weight and growing closer to their parents.

I know the doctors and nurses at CHOC care about the precious lives in the NICU. They provide exceptional service, but they’re not just focused on treating symptoms or reading monitors. They are also committed to giving newborns and families a strong chance of living healthy lives.

Tell me how CHOC helped your newborn baby and family by using the hashtag #thxCHOC on social media.

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CHOC Children’s 67-bed NICU includes four multi-patient rooms, six single care rooms, four private rooms for “rooming in,” and two four-bed suites. The unit also features a two-bed Extracorporeal Membrane Oxygenation (ECMO) unit. The life-saving ECMO unit is the only one of its kind in Orange County and CHOC also offers Orange County’s only ECMO transport unit.