Children's hospitals are growing up fast. Once confined to modest community buildings or attached to adult hospitals, the nation's more than 250 pediatric hospitals are expanding their reach, both in terms of breadth and depth. They've opened new facilities, launched specialized research institutes and spun off satellite locations, including free-standing emergency departments and full-service mini-hospitals.

   Growing pains are inevitable.

   Hospital administrators must balance community needs with a desire to raise their institution's research profile to garner national attention and recruit scarce subspecialists. They have to wrestle with budget and space limitations even as they vie with other pediatric facilities to see who can open the largest and most family-friendly patient rooms. And they must position themselves to compete with, and protect against, the adult hospitals for certain pediatric services. Contact for complete article.