Health

What we know about the plans for patients and doctors as Tufts closes its children’s hospital

While outpatient pediatric care will remain at Tufts, Boston Children's will soon handle inpatient care.

Local nurses held a vigil last month to draw attention to the closure of Tufts' Children's Hospital. Craig F. Walker / Boston Globe Staff

In January, Tufts Medical Center announced plans to close its 128-year-old pediatric ward. Now, plans are accelerating and new details are emerging about what this closure means for patients, families, and doctors. 

Why is Tufts closing its children’s hospital?

In its announcement earlier this year, Tufts representatives cited a pressing need for increased capacity to care for critically ill adults. The hospital’s 41 pediatric beds will be converted into adult ICU and medical/surgical beds. Pediatric patients at Tufts will now be referred to Boston Children’s Hospital. The changes will go into effect July 1. 

The number of adult patients in need of highly specialized care has risen dramatically, according to the announcement. This has forced the hospital to turn away “hundreds” of patients each month. Tufts’ projections suggest that fewer children will need hospitalization in the future, and those who do need inpatient treatment will have serious health issues that require advanced, highly focused systems of care. Boston Children’s will open 50 new beds by mid-July as part of the first section of a new clinical building, the hospital announced. 

How could patients be affected?

Outpatient pediatric care will remain at Tufts. This includes pediatric primary care, day surgeries, the pediatric emergency room, and newborn intensive care unit. The hospital will keep the Pediatric and Adolescent Asian Clinic, a vital resource for residents of Chinatown. The Center for Children with Special Needs and New England Pediatric Care, a long-term care facility for children, will also remain open.

Also staying open is a special rheumatology clinic, The Boston Globe reported this week. Mental health and rheumatology often overlap in the conditions caused by the disorders treated at this clinic. 

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The 41 beds in Tufts’ pediatric ward translate to between 1,800 and 2,000 discharges per year that would be transitioned to Boston Children’s, according to the hospital. Eventually, that space will be repurposed to expand adult beds by about 20 percent.

Pediatric inpatient chemotherapy will no longer be provided at Tufts. This will impact 35 families, the Globe reported. While chemotherapy is usually provided on an outpatient basis for adults, children normally get the treatment on an inpatient basis. It will now be provided at Boston Children’s. 

Over 60 percent of Tufts Children’s Hospital patients are enrolled in Medicaid, meaning that the state controls reimbursement levels, Michael Dandorph, President and CEO of Tufts Medicine, said in the initial announcement. Tufts has “proven it manages adult care at a lower cost, while being one of the nation’s highest ranked academic medical centers from a quality and outcomes perspective,” Dandorph added. This will help the hospital continue to lower the overall cost of healthcare, he said.

While more low-cost inpatient beds are being prepared, the costs of pediatric care could very well increase. According to data from the state Center for Health Information and Analysis obtained by the Globe, “pediatric care is 25 percent more expensive at Boston Children’s than at Tufts for patients insured by Blue Cross Blue Shield of Massachusetts, the state’s largest insurer.”

How could doctors and nurses be affected?

This week, Tufts shared new information with the Globe about the impact these changes will have on doctors. Boston Children’s will create a foundation for current Tufts doctors, who will have privileges at Children’s, but Tufts would lease back and pay for the doctors’ time. The Tufts doctors will be professors and faculty at Tufts University School of Medicine, instead of having Harvard affiliations like other doctors at Boston Children’s, the Globe reported. 

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The details of how surgeons will be affected are still being ironed out, but non-surgical specialists will now refer inpatient care to doctors at Boston Children’s. Tufts told the Globe that three-quarters of its 140 physicians have decided to join the foundation or continue to work for the hospital. 

Tufts officials are planning to have enough doctors to maintain most specialty outpatient services, the Globe reported. However, there remains a possibility that Boston Children’s doctors will need to help cover shifts while Tufts hires more medical professionals. Some outpatient services could be transitioned completely to Boston Children’s. 

In total, these changes will affect 95 Tufts nurses, the hospital said. All of these nurses have either found jobs elsewhere at Tufts or with other organizations. Four affected nurses have taken early retirements, according to the Globe

In March, doctors and nurses told the Globe that the Tufts pediatric hospital could be forced to shut down sooner than July 1 due to staff leaving for new jobs.

Boston Children’s will add extra ambulances between the two hospitals, CEO Kevin Churchwell said at a Department of Public Health hearing in April. Boston Children’s will also create a portal to allow clinicians to share medical records, he said.

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