How To Choose The Right Hospital For Your Child

How to Choose the Right Hospital for Your Child, Reduce Anxiety and Maximize Treatment

Hospitalization is a scary experience for anyone, but for children, it can be especially traumatic. Whether your child is admitted for a broken bone or a complicated heart surgery, the facility you choose can make a huge difference in both the success of their procedure and their emotional state before and after their stay.

Sadly it’s a known fact that not all hospitals are created equal. Great hospitals — whether they treat adults or children — prioritize patient safety and satisfaction, and ultimately, tend to have better outcomes. In contrast, “bad” hospitals make more medical errors, which in turn lead to higher rates of complications and contribute to hundreds of thousands of patient deaths each year.

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In fact, research has shown that patients being treated for common conditions at the worst-performing hospitals are 13 times more likely to experience complications and three times more likely to die than patients treated at the best hospitals. As a parent, this alone can be worrying, but that’s not the only thing to consider.

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The right medical environment is particularly important in pediatric care because children have their own set of needs and considerations that don’t always come up when treating adults. In addition to differences in physical development, children’s emotional needs play a huge role in how they react to medical care.

Of the more than five million children who undergo surgery in the United States each year, the vast majority suffer from anxiety related to their operation. If not handled properly, these experiences can lead to worse outcomes after surgery, as well as long-lasting emotional and psychological effects.

As such, the best hospitals for children are well-equipped to deliver the specialized care they need and have implemented specific solutions for managing anxiety for both young patients and their families.

The importance of the right medical environment for children

Imagine the process of being hospitalized through the eyes of a young child. They are in a completely unfamiliar setting, overwhelmed by a barrage of wires, tests and beeping machines, and they’re likely terrified about how much pain they will experience. If mom and dad are anxious, this doesn’t help either, since children tend to mirror their parent’s emotions.

Then comes the most stressful part — the anesthesia. As the anesthesiologist places a mask over his face, the child might find it difficult to breathe or begin to feel lightheaded and unsure of what happens next. In some situations, kids might be so hysterical that they need anti-anxiety medication to calm down before receiving the anesthesia.

This kind of anxiety can be especially severe for toddlers and young children who don’t always understand what exactly is happening to them. In fact, it’s not unusual for kids to cry, scream, lash out in anger, or even wet themselves in fear.

Dr. Zeev Kain has pioneered research which shows that, apart from being difficult to watch, extreme anxiety in children before surgery can have lasting effects on the outcome of the procedure.

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Children with less pre-operative anxiety tend to have better appetites, feel less pain and recover more quickly. And, not surprisingly, their parents also report greater satisfaction with their experience.

On the other hand, kids who feel extreme stress before their surgery are more like to spend more time in the hospital, feel more pain, and experience eating and sleep disorders during the recovery period. What’s more, the behavioral changes can last for weeks or months.

This is a big deal because research shows that traumatic events during childhood — which could include a particularly unpleasant hospital stay — can have long-term effects that continue after kids grow up. Childhood trauma has been linked to anxiety, depression and other behavioral problems, for example. At the very least, severe anxiety before a surgery can make the prospect of being hospitalized perpetually terrifying, even in adulthood.

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So how can parents use this knowledge when choosing a hospital and planning for their child’s surgery?

Thankfully, the quality of pediatric care has improved greatly over the last few decades and more hospitals are becoming aware of the importance of managing children’s anxiety as part of the preparation process for surgery. Still, not all are equipped to give children the specialized care they need.

How to vet hospitals for your child

All parents want the best care for their children, but it’s not always easy to figure out how to get it. If you’re like most people, you might be tempted to choose the hospital closest to you or make your pick based on what your insurance will cover.

While these are important factors to consider (and they may be your only option in an emergency), there are other things to keep in mind when trying to find the best hospital for your child – especially if you have time to plan in advance.

One thing to consider is whether the institution and staff are specialized in pediatric care. As the well-worn saying goes, children aren’t just miniature versions of adults. Young patients often need more time, more attention to their emotional needs, and even things as simple as smaller equipment and beds.

But while there are more than 5,000 hospitals in the United States, only six percent of emergency departments are equipped to care for children, according to a policy statement by the American Academy of Pediatrics. This means that the vast majority of children report to an E.R. that is unprepared to deal with their specific needs.

For complex surgeries, it’s especially important to choose a hospital that caters to children. In fact, the entire surgical team, from the nurses to the anesthesiologist, should be trained in the intricacies of pediatric care. Pediatric anesthesia is a tricky business, as children often require specific medication dosages and more monitoring time, and the risk of complications is higher.

In many cases, this may mean going to a children’s hospital, which specializes in the treatment and care of children. However, if that’s not an option, speak to your local hospital to find out if there are pediatric surgeons on staff.

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Another factor to consider if your child needs surgery is how many times the hospital has performed the procedure in question. It’s also important to find out about your surgeon’s success rate and whether he has experience treating patients the same age as your child. As a general rule, the more times they’ve done the surgery you need, the more comfortable you should feel.

That said, volume alone isn’t a great predictor of success, since pediatric surgeries are less common than adult procedures.

To round out the picture, you can also research a hospital’s quality outcomes before making a decision. While they don’t tell the whole story, low rates of mortality, readmission and infection, as well as high patient satisfaction scores, signal that a hospital is committed to safety and has higher standards of care.

Medicare’s Hospital Compare tool assigns star ratings to hospitals based on all these factors. You can also check to search databases like The Leapfrog Group and U.S. News and World Report’s Best Hospitals to see if the hospital you’re considering is included.

How the best hospitals prepare children for surgery

Given the special care children require, hospitals that cater to children should have protocols in place to make the process smoother for kids and their families. While the hospital you choose will ultimately depend on a number of factors, your experience could be greatly improved if the facility practices what’s known in the medical field as “family-centered care.”

Simply put, it means you and your child are involved in the care and decision-making alongside the medical team.

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Particularly for surgical procedures, family-centered care programs focus on reducing not only your child’s anxiety, but yours and your family’s through greater transparency and education about coping strategies before, during and after your child’s hospital stay. Nurses are trained in preparing children for surgery, starting with a preoperative visit days before the procedure and continuing after the child is discharged and parents take over at home.

There is strong evidence that this kind of transformational approach makes a real difference.

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Studies have shown that family-centered interventions geared towards reducing children’s and parent’s anxiety before surgery lead to quicker discharges, less pain and fewer episodes of emergence delirium — which occurs when children become highly agitated while waking up from anesthesia.

Different hospitals employ different strategies for making children and their families more comfortable. They might include giving kids more information about what to expect, practicing with the anesthesia mask or teaching ways to cope with anxiety and pain. Parents might be allowed to be in the room with children as they receive anesthesia or to participate in family-centered bedside rounds so they can stay up to date on the decisions being made about their child’s care.

In all cases, patients and their families are seen as key parts of a coordinated care team.

No one likes being admitted to the hospital, and it might never be possible to completely eliminate anxiety for either you or your child. However, choosing a hospital that not only has a record of success, but is experienced in dealing with children can mean the difference between a terrible hospital stay and one that goes well.

How To Choose The Right Hospital For Your Child