Hospital Homework

Southern California is home to some of the world’s best medical facilities. Learn the landscape now, so you’re ready if you need them.

By Elena Epstein

Levine familyWendy and Eric Levine, of West Los Angeles, describe themselves as “recovering attorneys.” The ability to evaluate a situation and conduct thorough analysis is part of their DNA. So, when faced with the premature birth of their son and surgeries for both of their children, it was natural for them to go into research mode.

“We talked to everyone we could,” says Wendy. “We asked all of our friends who were in the medical field, we did a lot of research online and we asked a lot of questions.”

Their 4-year-old daughter, Alexis, recently had her tonsils and adenoids removed, had a bronchoscopy and a hernia operation. Their 18-month-old son, Tyler, had tubes placed in his eardrum. This all took place at UCLA Medical Center in Westwood, where both kids were born and Tyler spent the first 66 days of his life in the Neonatal Intensive Care Unit. “We evaluated all of our options and chose based on what was best for our family,” says Eric.

Southern California is home to some of the top hospitals in the nation, but understanding and navigating the vast system to find the best medical facility for your child’s particular needs requires careful research. “The best time to do your homework is now, before an emergency strikes,” says Mary Dee Hacker, MBA, RN, vice president of patient care services and chief nursing officer at Children’s Hospital Los Angeles.

“When your child is ill or injured, you become vulnerable, and it’s hard to think clearly in that situation,” says Hacker. “As parents, our primary job is to raise healthy, confident young adults. We have to gather all the information we can find and educate ourselves in order to make sound decisions for our family.”

Dr. TreimanKnow the Key Quality Indicators

Look for critical distinctions among the various hospitals, including:

Physicians who are board certified. This is a good indication that the hospital is committed to maintaining excellence.

Gentle imaging. “If your child requires multiple scans, make sure you are at a facility that uses the lowest level of radiation for growing bodies. Parents must be the advocates here and insist on gentle imaging,” says Hacker.

Magnet designation, meaning the hospital has gone through a rigorous evaluation and has shown commitment to patient safety in areas such as reducing medication errors, infections and falls.

Pediatric pharmacists. Expert knowledge of medication dosage and drug interaction for growing bodies is critical.

Parent support. “I would never leave my child at a hospital that asks parents to step away,” says Hacker. “Children need to feel safe and secure, and hospitals need to ensure that parents can stay with their child.”

Child and family resources. “You have to look beyond the physicians, to the nurses and other specialists. It’s a whole package,” says Evan Michael Zahn, M.D., director of the Congenital Heart Program in the Heart Institute and the Department of Pediatrics at Cedars-Sinai.

Dr. ZahnKnow What’s Available in Your Neighborhood

Most of us live within a short distance of one or more community hospitals, but Stephen Treiman, M.D., director of the Pediatric Intensive Care Unit at Huntington Memorial Hospital in Pasadena, says that “Not all doctors are the same, and not all hospitals are the same.“ Take time to understand what your local hospitals offer. Some important criteria to look for include:

A designated pediatric unit or floor,

A pediatric intensive care unit,

A pediatric anesthesiologist on staff.

“As a mom and a doctor, I like to always prepare for the worst-case scenario,” says Nina Shapiro, M.D., director of Pediatric Ear, Nose and Throat at Mattel Children’s Hospital UCLA, who performed surgeries on the Levine siblings. “When I was pregnant, I wanted to deliver at a hospital with a neonatal intensive care unit even though I had a normal pregnancy. You want to make sure you’re at a facility that can handle any problem, in case something does go wrong.”

Seek Out the Best Programs

If your child is faced with a chronic illness such as congenital heart disease, asthma or diabetes, or a serious injury such as a sports-related fracture that could cause permanent damage, you should seek out the best specialized program for your particular needs.

When 13-year-old Lucia Barker, of Los Angeles, was suffering from intense hip pain that sidelined her ballet training, which began at age 3, “All she wanted was to find someone to make her better,” says her mom, Susan Macdonald. “Having something she loved so much taken away from her was beginning to really affect how she felt about herself.”

Corey Daniel Their quest brought them to Children’s Hospital Los Angeles and J. Lee Pace, M.D., director of Sports Medicine and an expert on injuries in young athletes who had been a physician for the Boston Ballet. Lucia had a right-hip impingement. When physical therapy failed to relieve the pain, physicians recommended anthroscopic surgery to repair the impingement. Following her surgery in June, Lucia went through three more months of physical therapy and is now back in ballet class three times a week.

“She is pain-free and so happy to be working towards her point shoes,” says Macdonald.

When searching for a specialist, the best place to begin is with your pediatrician. “He knows your needs and expectations and typically knows the specialists in the community,” says Shahram Yazdani, M.D., an academic general pediatrician whose clinical and scholarly focus is on rare and complex/chronic diseases at UCLA Medical Center. The Levines affectionately call their pediatrician their “general manager,” because he is in constant contact with the various specialists treating Alexis and Tyler.

In cases where the condition is rare or very complex, the treatment will come down to your physician’s understanding of that condition, Yazdani says. In these cases, it’s critical to seek out as much information as you can. “Ask other parents, friends, neighbors, search the Internet,” advises Charles Simmons, Jr., M.D., chair of the Deparment of Pediatrics and director of the Division of Neonatology at Cedars-Sinai.

When researching hospital programs, focus on:

The specialists’ contribution to their field. Do they conduct research or speak at medical conferences?

Familiarity with your child’s condition. How many similar cases have they and the hospital treated?

Breadth of services provided. How comprehensive is the hospital’s program? What type of follow-up care does it provide? What type of education, resources and support groups does it provide for parents?

“I see parents at the worst time in their life,” says Treiman. “We are very honest and clear with our information and we want parents to ask their questions. I won’t be offended if you ask me how many times I have done a procedure or a surgery. This is your child. Ask all your questions.”

Samone Daniel, of Bellflower, credits the specialists at Miller Children’s Hospital in Long Beach for giving her 12-year-old son, Corey, a chance at a normal life. He suffers from severe asthma and food allergies. “There are about 10 foods that Corey can eat, and until recently he couldn’t go to the park or just ride his bike around the neighborhood without a severe asthma attack,” says Samone.

Corey was diagnosed with an autoimmune disease at Miller Children’s in 2010. In the hospital’s Pulmonary, Cystic Fibrosis, Allergy and Asthma Center, specialists built him a comprehensive treatment plan. And the hospital’s new Food Allergy Center offers a safe environment where Corey can test different foods.

“It’s very comforting knowing that we have doctors who understand the complexity of Corey’s condition and how quickly he can become critically sick,” says Samone.

In the last three years, Corey’s quality of life has changed dramatically. While he still carries two EpiPens at all times and takes several types of medication, he now rides his bike with friends, plays basketball, goes to the park and is thrilled to be able to eat French fries from In-N-Out Burger. “For the first time, he can have a normal childhood,” says Samone.

If your child needs multiple specialists, Eliezer Nussbaum, M.D., medical director of Pediatric Pulmonology, Allergy & Cystic Fibrosis at Miller Children’s Hospital, recommends finding a hospital with all the experts in one location and experience working with multiple diagnoses. Even a condition as common as asthma can be severe and complicated to treat. “We perform very complex asthma testing,” says Nussbaum. “At some medical facilities this type of testing is done maybe once a month, but we’re doing it 10 to 20 times a day.”

When you have found a specialist you want to work with, call and set up a meeting. “This is a great way to find out what this physician’s accessibility is and also to see what your chemistry with him is. Is he friendly? Did he give you enough time to ask all your questions?” says Simmons.

Another important area to examine is the specialist’s methodology. “Our goal is to make sure we spare kids every discomfort we can,” says Zahn. “Parents should always ask if there is a less invasive way to do this.”

Ballet PhotoStay Organized

Hospitals can be overwhelming, but there are simple steps you can take to make the navigation a little easier.

Be prepared for every appointment with a list of questions.

For appointments where a lot of complex information will be shared, consider bringing someone else with you to take notes and be another ear in the room.

Keep a file folder for each child that has all his or her medical records, including lists of medications, operations and procedures, and results of X-rays and scans. Your pediatrician and the hospital should provide copies of all records.

Get the direct phone number and email for physicians during your appointment, as some hospital phone systems can be difficult to navigate. Some specialists do provide email addresses for questions, so always ask.

Elena Epstein is Director of Content at L.A. Parent.

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