The U.S. News & World Report Best Children’s Hospitals rankings are released annually each summer. Data from the previous calendar year is collected for the pediatric hospital survey, which participating hospitals submit to U.S. News each February.

In 2019, 10 specialties were included in the rankings: Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Gastroenterology & GI Surgery, Neonatology, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology and Urology.

In addition to the specialty rankings, an Honor Roll recognizes the 10 hospitals with the highest rankings across all 10 specialties.

This year, points were given to a hospital based on its rank in each specialty, and the points were totaled. The 10 hospitals with the most points were placed on the Honor Roll, with their ranking determined by their point totals.

U.S. News adjusts its methodology each year. In 2019, the organization made a few changes to the measures and weights, such as reducing the weight placed on bloodstream infections and pressure ulcers. More changes are expected in 2020.

Year-round, Johns Hopkins faculty members Aaron Milstone and Jessica Rice, along with other faculty members at children’s hospitals nationwide, work closely with U.S. News representatives to revise the methodology to reflect current literature and best practices, and to gauge the true quality of pediatric care.

To determine a hospital’s ranking, three main areas are assessed: structure, process and outcomes. Each component counts as one-third of a hospital’s score in nine of the 10 ranked specialties.*

STRUCTURE

This refers to hospital resources directly related to patient care. Examples include the ratio of nurses to patients, offering of specialized clinics and programs, and certification by recognized external organizations.

PROCESS

This refers to compliance with best practices, activities to prevent infections and expert opinion of pediatric specialists — in other words, reputation.

In 2019, over 15,000 pediatric specialists were asked for their opinion on which children’s hospitals provide the best care for patients with the most challenging conditions or who require particularly difficult procedures. Most specialists were surveyed online via doximity.com, and others responded to a limited-distribution paper survey.

OUTCOMES These measures include death but can also include functional success, such as that among children with cystic fibrosis, and adverse events such as bloodstream infections and failure of transplanted organs.

*In the Pediatric Cardiology & Heart Surgery specialty, the weight of the outcomes component is 38.3%; the weight of the process component is 28.3%.