Side effects of a 1st place US News ranking

The first thing you do when your hospital is deemed best in the nation: feel the affirmation, the verification, the pride. The second thing you do: get back to work. 

In some ways, executives' jobs get more complicated following a No. 1 ranking, according to Evaline Alessandrini, MD, chief operating officer of Cincinnati Children's Hospital Medical Center. The hospital was recently named America's best children's hospital by U.S. News & World Report — a first-time feat. 

"Why we're so proud of the U.S. News No. 1 ranking is because that, in and of itself, is not the end game, right? It is an affirmation or a verification of the way that we operate. And the way that we deliver care, it's working," Dr. Alessandrini told Becker's. "We're going to keep doing what we've been doing, so in some ways, it makes it easy for me as the chief operating officer. But sometimes, it makes it a little bit hard, too." 

With previous No. 1 rankings in certain specialties, Cincinnati Children's saw patient volumes increase up to 25 percent. In a post-COVID world, the system is planning for a 10 to 15 percent rise in high-complexity cases — a prediction that is holding true so far. 

And patients aren't just coming from all over the country. They're coming from all over the world. 

"Our international audiences have a fairly strong line of sight to the U.S. News rankings, and really utilize those rankings as a filter or decision tool in terms of where they're sending their patients," Dr. Alessandrini said. "It's a big deal, right? If you're traveling internationally, I think it's a good yardstick to use to help people decide where to send their kids for care." 

As a result, Cincinnati Children's has been pouring into programs for global patients. The hospital has increased interpreter services, especially for languages less commonly spoken in the U.S. It is ensuring patients use its online "second opinion" program to improve asynchronous access. And it is working to expand the "destination excellence" program, which helps match international families with lodging and other needs. 

How do you ensure operational excellence as care gets increasingly complex? You lean into your foundation, per Dr. Alessandrini. The system implements a triad leadership model at every care site — a nurse, physician and operations leader — to ensure all perspectives are represented. Access and flow remain key considerations, so the system crafted a pre-authorization team to ease clinicians' administrative burdens. And as a children's hospital, the organization aims to foster a playful environment, even when the going gets tough. 

"We deeply feel that we were built for the complexity, we were built for complex patients," Dr. Alessandrini said. "That's why we are here."

Read more about Cincinnati Children's first place ranking in this Becker's interview with CEO Steve Davis, MD.

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