Clinical Programs & Services, Hospital Happenings

U.S. News Names CHOC One of the Nation’s Best Children’s Hospitals

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From treating the most complicated cases of epilepsy and repairing complex urological conditions, to curing cancer and saving premature lives, CHOC Children’s physicians and staff are committed to delivering the highest levels of safe, quality care. That commitment has earned CHOC its most recent accolade:  inclusion on the coveted U.S. News & World Report’s Best Children’s Hospitals rankings.   CHOC ranked in eight specialties: cancer, neonatology, neurology/neurosurgery, pulmonology, orthopedics, gastroenterology and GI surgery, diabetes and endocrinology, and urology, which earned a “top 25” spot.

U.S. news

According to U.S. News, the Best Children’s Hospitals rankings are intended to help parents determine where to get the best medical care for their children. The rankings highlight the top 50 U.S. pediatric facilities in 10 specialties, from cancer to urology. Of the 183 participating medical centers, only 78 hospitals ranked in at least one specialty. For its list, U.S. News relies on extensive clinical and operational data, including survival rates, clinic and procedure volume, infection control measures and outcomes, which can be viewed at http://health.usnews.com/best-hospitals/pediatric-rankings. An annual survey of pediatric specialists accounts for 15 percent of participants’ final scores.

“The Best Children’s Hospitals highlight the pediatric centers that offer exceptional care for the kids who need the most help,” says U.S. News Health Rankings Editor Avery Comarow. “Day in and day out, they offer state-of-the-art medical care.”

Dr. James Cappon, chief quality and patient safety officer at CHOC, points to the survey as an invaluable tool for him and his colleagues to evaluate programs and services, determining best practices, and making plans for the immediate and long-term future.

“CHOC is certainly honored to be recognized once again by U.S. News. But our dedication to serving the best interests of the children and families in our community is what truly drives us to pursue excellence in everything we do. Our scores, especially in the areas of patient-and-family-centered care, commitment to best practices, infection prevention, breadth and scope of specialists and services, and health information technology, for example, reflect our culture of providing the very best care to our patients,” explains Dr. Cappon. To hear more about CHOC’s commitment to patient safety and quality care—and what parents need to know— listen to this podcast.

CHOC’s culture of excellence has it earned it numerous accolades, including being named, multiple times, a Leapfrog Top Hospital. Additional recent honors include the gold-level CAPE Award from the California Council of Excellence; Magnet designation for nursing; gold-level Beacon Award for Excellence, a distinction earned twice by CHOC’s pediatric intensive care unit team; “Most Wired Hospital”; and The Advisory Board Company’s 2016 Workplace Transformation Award and Workplace of the Year Award. Inspiring the best in her team, CHOC’s President and CEO Kimberly Chavalas Cripe was recently named a winner of the EY Entrepreneur of the Year Award in the “Community Contributions” category.

Health & Safety

How to Prevent Common Play Injuries in Children

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Childhood cplayground injuriesan be a wonderful time, but it can also be a dangerous period when children can get hurt from the normal activities associated with playing and just growing up.

Dr. Carl Weinert, a CHOC orthopaedic surgeon, treats many children who are hurt from falls off playground equipment. The most common playground and fall injuries are fractures to wrists and elbows, he says. In addition, falls from scooters, bikes and backyard trampolines are a big cause of injuries in children. Children also get injured in bounce houses, he noted.

Trampoline injuries are much more common when there are multiple children using the trampoline at once, Dr. Weinert says. As more kids climb on the trampoline,  the risk of injury increases.

“Trampolines are far more dangerous if there is more than one child on it at a time because the recoil of the trampoline from one of the kids landing can launch another child off of it,” says Dr. Weinert.

Injuries incurred in bounce houses are frequently found in the elbow, Dr. Weinert says.

If you fall and try to force the elbow to bend backward instead of forward, it breaks, no matter how soft the surface is,” he says. “The most common injuries we see that need surgery are fractured elbows.”

Ailments that are more preventable are wrist and forearm injuries from skateboards and skates, Dr. Weinert says.

“Children should wear wrist guards,” he advises. “They are readily available and relatively inexpensive. Knee guards and elbow guards really only protect against scrapes.”

Signs of a serious injury from a fall can include lacerations, lots of swelling, an obvious broken bone or a bone protruding through the skin. If a parent notices any of these signs or if the child can’t walk, it’s time to see the doctor or emergency department quickly,  says Dr. Weinert.

“These injuries can be emergencies and they need help as soon as possible to avoid infection and to get the best outcome,” he says. “The fracture starts to heal when the child hits the ground. The longer treatment is delayed, the harder treatment is and the more compromised the result.”

Orthopaedic specialists at CHOC can help. The CHOC Orthopaedic Institute specializes in the diagnosis and treatment of complex orthopaedic injuries, illnesses and disorders in children and adolescents.  To make an appointment, call 888-770-2462.

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Health Features

Kids and Spine Issues

Girl_at_the_beachDEFINING THE CURVE

“If you look at the spine from the front and the back, it should be straight. When scoliosis is present, there is always a sideways [“S” or “C”-shaped curvature] shifting of the spine from the right or left,” says Dr. Aminian. The cause of scoliosis is unknown, but scientists have recently identified genetic markers that are contributing to individuals with it. The condition is more prevalent in girls during their growth spurt years. “Usually, the majority of cases don’t become progressive, but a small subset do and might require surgery in the future,” says Dr. Aminian.

SCREEN TEST

“California is one of a number of states that requires screening students for scoliosis in schools. It’s important that children get screened with their school nurse or their pediatrician,” says Dr. Aminian. The Adam’s Forward Bend Test checks for scoliosis by having the child lean forward and looking at rib asymmetry. Others signs can be shoulder height (when one shoulder is higher than the other), uneven hips and waistline asymmetry.

BRACE YOURSELF

“If we catch the scoliosis at younger ages and smaller curves, we’re able to control it with a bracing program,” says Dr. Aminian. The more often the customized brace is worn, the better. Some kids may feel self-conscious wearing it at first, but CHOC’s counseling program helps them cope. “We work with them to increase the number of hours they wear it at school. We stress they wear it at night,” says Dr. Aminian. And they can even sleep in it.

STRAIGHTEN WITH SURGERY

“Surgery is reserved for curves that are major that we think will cause problems in the future, including breathing, balance and pain,” says Dr. Aminian. “Luckily, it’s a standardized surgery. It’s very safe and effective.”

FAST FACTS

  • Grades when girls should be evaluated for scoliosis: 5th and 6th Grade
  • Grades when boys should be evaluated for scoliosis: 7th and 8th Grade
  • Percentage of the population that have a small (insignificant) curve in their spine: 10 %

View the full feature on Kids and Spine Issues

Dr. Aminian
Dr. Afshin Aminian
CHOC Children’s Orthopaedic Institute

PHYSICIAN FOCUS: DR. AFSHIN AMINIAN

Dr. Aminian is the director of the CHOC Children’s Orthopaedic Institute. He completed his general surgery internship  and orthopaedic surgery residency at Northwestern Memorial Hospital and is affiliated with the Pediatric Orthopaedic Society of North America, the American Academy of Orthopaedic Surgery and the Scoliosis Research Society.

Dr. Aminian’s philosophy of care: “I try to put myself in the parents’ shoes and explain to them in the most common terms what we’re doing and why we’re doing it, reminding them of the hospital’s capabilities.”

EDUCATION:
Washington University School of Medicine

BOARD CERTIFICATIONS:
Orthopaedic Surgery

More about Dr. Aminian | More about the CHOC Children’s Orthopaedic Institute

This article was featured in the Orange County Register on December 23 , 2013 and was written by Shaleek Wilson.

Clinical Programs & Services

Children and Fractures – What Every Parent Should Know

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Young wrists, forearms and elbows are vulnerable to injury. Did you know up to 30 percent of all childhood fractures involve the growth plate? Growth plate fractures require prompt treatment to avoid surgery or life-long deformity.

Few kids grow up without breaking something. Prompt, expert care of fractures, especially those involving a bone’s growth plate, ensures childhood misadventures don’t linger into adulthood. CHOC Children’s Fracture Clinic offers rapid access to specialized fracture care. Patients are usually evaluated and treated within three to five days of injury, well within the narrow treatment window recommended by the American Academy of Orthopaedic Surgeons. Afshin Aminian, M.D., medical director of the CHOC Children’s Orthopaedic Institute, explains what every parent should know about growth plate fractures.

Q. Why do children’s fractures need to be treated so quickly?

Dr. Aminian: Growth plates, located near the ends of long bones, help regulate and determine a bone’s eventual shape in adulthood. However, growth plates are very soft and vulnerable to fracture. They also heal very quickly, which gives us a very short window to do minor, non-surgical manipulations to set broken bones correctly. Ideally, a growth plate fracture should be set within a week of injury. After that, surgery is necessary to prevent a life-long deformity.

Q. What are the main causes of growth plate fractures you commonly see? 

Afshin Aminian, M.D., Medical Director, CHOC Children’s Orthopaedic Institute

Dr. Aminian: An estimated one-third of growth plate injuries occur during competitive sports such as football, basketball or gymnastics. Monkey bars, skateboards, snowboards and “heelies” (roller shoes) are also very rough on young wrists, arms and elbows. Wrist guards provide some protection, but more importantly, children should always wear a helmet when engaging in those activities. I always tell my patients that it is much easier to fix a broken arm than a broken head.

 

For more information about the CHOC Children’s Fracture Clinic, please visit www.choc.org/orthopaedics.

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    Health & Safety

    Tips to Prevent Common Sports Injuries for Female Athletes

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    Do you have a young female athlete at home? Check out this segment from American Health Journal, where Dr. John Schlechter, orthopaedic surgeon at CHOC Children’s, discusses how to prevent sports injuries for female athletes.

    Learn more about the CHOC Children’s Orthopaedic Institute, ranked among the best in the nation.

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