Author: Erin Horan

Do hospital rankings matter?

Sree Bhagwat in the lobby of Boston Children's Hospital.
Bhagwat in the lobby of Boston Children’s Hospital

Everyone who works in health care is familiar with U.S. News and World Report’s annual Best Hospitals rankings. But the methods behind the numbers can seem complex and mysterious, even secretive. What do rankings really tell us about the quality of health care at various institutions? Are they even helpful? Do they impact care?

Sree Bhagwat, a senior marketing analyst at Boston Children’s Hospital who manages the hospital’s data collection and reporting to U.S. News, says “yes.”

“It’s not just about competition,” says Bhagwat. “It’s about improving the standards of health care everywhere. The rankings process reveals important metrics that can drive improvements in national health care. Data points are driven by expert clinicians who serve on the numerous U.S. News committees.”

…Read More

Dissecting the AAP’s new guidelines for child media use: Advice from The Mediatrician

baby-with-ipad

Children are exposed to screens earlier in life and for longer periods than ever before. Mobile technology has pervaded our society to the point where doctors and parents alike are asking: what effect is this having on young minds? On brain development? On socialization?

How much “screen time” is too much? How young is too young? And, of course, the follow-up question of our time: are all apps created equal?

Michael Rich, MD, director of the Center on Media and Child Health at Boston Children’s Hospital, has a crystal-clear message. “This is a critical part of parenting in the 21st century,” he says. “It is no longer a fringe issue. The first thing we have to do with pediatricians, he says, is get them to talk about it.

Rich, also known as “The Mediatrician,” conducted research that helped inform the American Academy of Pediatrics’ latest recommendations for children’s media use. …Read More

It’s complicated: Identifying and treating high blood pressure in children

high-blood-pressure-chidren-heart-center

High blood pressure is notoriously difficult to detect in children. And the consequences of undiagnosed hypertension can be severe.

Sustained high blood pressure can lead to target end-organ disease, meaning long term effects on:

  • the kidney, e.g. renal insufficiency and ultimately end stage kidney disease
  • the heart, e.g. left ventricular hypertrophy and ultimately congestive heart failure

In children, “the difference between normal and abnormal blood pressure can be small, depending on factors like age, height and weight,” says Sarah de Ferranti, MD, director of the Preventive Cardiology Program at Boston Children’s Hospital.

A reading of 120/75 would be:

  • Stage two hypertension in a two-year old
  • Stage one hypertension in a seven-year old
  • Pre-hypertension in an 11-year old
  • Either normal or pre-hypertension in a 17-year old
  • A normal reading for an adult

“Not all kids with high blood pressure are overweight, but all overweight kids are at risk for high blood pressure,” adds de Ferranti. …Read More

Encouraging exercise in children with special needs

yoga-downs-syndrome-special-needs-exerciseThree years ago, Emily Jean Davidson, MD, MPH, decided to become a yoga instructor. Her niche was unorthodox: she wanted to teach inclusive yoga for children with Down syndrome and other medical and developmental issues.

Davidson, a pediatrician specializing in Neurodevelopmental Disabilities in the Down Syndrome Program and the Complex Care Services at Boston Children’s Hospital, is passionate about promoting exercise in children of all abilities.

“A lot of parents of children with developmental disabilities struggle to find time and/or opportunities to engage their children in healthy physical activity,” says Davidson. “If you’re taking your kid to lots of appointments with specialists, sports and active play can fall by the wayside.”

Often, she adds, programs are designed exclusively for children with one particular condition, such as a ballet class for children with Down syndrome or a swimming program for kids with asthma, and that means others are excluded.

“The good news is there are lots of recreational programs out there,” says Davidson. “You just have to look into your local community’s offerings.” …Read More