Tufts Children’s Hospital announced at a Jan. 20 press conference that it would convert its 41 pediatric inpatient beds to adult ICU medical and surgery beds in hopes of increasing adult critical care by 20%.
Wellforce, the hospital’s parent company, reached an agreement to transfer pediatric patients in need of inpatient care to Boston Children’s Hospital. Level three neonatal intensive care services will continue to be offered at Tufts Medical Center, while general inpatient pediatric care and level two special care will be offered at Lowell General Hospital. Pending regulatory approval from state health officials, this change will take effect on July 1, 2022.
The decision to close Tufts Children’s Hospital — formerly and familiarly known as the Floating Hospital for Children — was created in response to an observed shift in the health care needs of the community. According to Tufts Medical Center, the number of adult patients requiring specialized care has increased, while fewer pediatric patients are requiring hospitalizations. At the same time, children who do require inpatient care are in need of more complex services and resources that may be unavailable at smaller pediatric hospitals such as Tufts.
Jeremy Lechan, media relations manager of Tufts Medical Center, told the Daily that the hospital has been following this trend for years.
“Our adult beds at Tufts Medical Center are full and they have been for a long time,” Lechan said."This is not just a pandemic phenomenon."
According to Lechan, with adult beds in high demand, the medical center is often forced to turn away hundreds of critically ill adults every month. At times, the center's pediatric beds were half empty, although the delta surge in COVID-19 cases increased the number of occupied beds in recent months.
“Our analytics show that likely once the surge is passed and the pandemic is over, [pediatric bed capacity] is going to return to that level,” Lechan said.
According to Lechan, Tufts Medical Center announced its decision now to give five months to iron out all of the details.
What's next for employees and patients
Many pediatric patients,hundreds of employees and physicians and tens of Tufts University Medical School students and residents will be impacted by this change. Physicians, nurses and other TCH employees are likely to lose their jobs.
Tufts Medical Center and Wellforce have committed to assisting affected TCH employees and physicians with their transition, according to Lechan.
“Our HR departments in all of our organizations are committed to working with each affected employee to try to make sure that they have a job waiting for them and that [the] transition is smooth and seamless,” Lechan said.
TMC further assured that child patients and their families would continue to receive care from TCH.
Though aforementioned bed capacity patterns have existed for years and Tufts’ decision has been in the works for months, many community members were shocked by the announcement.
“To me, it was like an unfair, blindsided attack,” Tim O’Connell, founder of Tommy’s Place — a vacation home for kids fighting cancer — and creator of a petition to save the hospital, said.
Community backlash
Community members share a number of concerns about the transition, such as continuity of care for pediatric patients, especially for those with complex, critical conditions.
For Tara Forrest, mother of TCH patient Alexa Pantoja, maintaining the same quality and consistency of care through this transition is a major concern. After spending months with Pantoja during her treatment of acute myeloid leukemia, Pantoja’s care team got to know her very well, from her favorite school subjects to her reactions to medications.
“[Her care team] knew absolutely everything that she had gone through,” Forrest said. "They treated her like family."
Forrest recalled a conversation that she had with her daughter following the announcement.
“She said to me, 'at this point in my plan, if I’m going in every other month, and I’m going to a different hospital, who is going to have time … [to] read my chart and memorize it, and know me the way that [Tufts’] doctors know me?'” Forrest said.
Mary Havlicek Cornacchia, an operating room nurse at TMC who has worked at Tufts for nearly 34 years, expressed concerns about how the transition will impact patients’ access to care. In contrast to TCH, Boston Children's Hospital does not accept MassHealth, Massachusetts’ combined Medicaid and Children’s Health Insurance Program plan.
As the co-chair of the Massachusetts Nurses Association bargaining committee at TMC, Havlicek Cornacchia also spoke about her concerns for nurses' job transitions.
“My concern is that we’re not going to find a place for those 100 nurses for a lot of reasons," she said.
These reasons include pediatric nurses’ reluctance to transition to adult care as well as the domino-effect displacement that inevitably results from job loss, according to Havlicek Cornacchia.
Both O’Connell and Havlicek Cornacchia regretted that Wellforce and the hospital did not communicate or collaborate with the community before making this decision.
“A lot of nurses wish … the Wellforce corporation had come to us because there are probably ways that we could have helped with the bottom line,” Havlicek Cornacchia said.
Since the announcement, thousands have mobilized in opposition to the closing of TCH. As of Feb. 6, O’Connell’s Change.org petition to save the hospital garnered over 62,000 signatures. Tufts’ MNA bargaining committee is in the process of negotiating several demands with administrators, including a better severance package and an early retirement package.
Remembering Tufts Children's Hospital
Many refer to the hospital’s rich history and contributions to the Boston community as primary reasons to save the hospital. The Floating Hospital for Children was founded in 1894 as a hospital ship that brought sick children out to the harbor for fresh air. The hospital is home to several medical accomplishments, including the invention of the first artificial milk product Similac, the development of the first growth hormone treatment and Boston’s first implementation of a playroom to counteract children’s anxiety of hospitalization.
Others look back on TCH staff’s high-quality treatment of its patients as something that will be missed.
“Every single nurse that came on shift would treat [Alexa] as if they would treat their own child,” Forrest said. "They valued her and gave her a voice where she didn’t realize she would even have one. It just doesn’t happen anywhere else.”
