Pediatric medical care in Boston consolidates as Boston Children’s expands and Tufts shrinks

Two of the most important medical centers serving children in Massachusetts are moving in opposite directions.

Boston Children’s Hospital, Greater Boston’s largest pediatric healthcare provider, is expanding, while Boston’s Tufts Medical Center is closing inpatient services for children.

The changes reflect a continuing trend of large hospital systems becoming more powerful while smaller competitors sometimes struggle to keep services open.

Boston Children’s opens an 11-story addition with 150 new beds and more than a dozen high-tech operating rooms. The first patients arrive on Tuesday.

The hospital says its new Hale Family Building will allow it to meet the demands of families of children who need care for complex medical conditions and who sometimes face long waits for treatment.

The NICU in the Hale family building at Boston Children’s Hospital. (Jesse Costa/WBUR)

“This is an important milestone for us,” said Patty Hickey, associate chief nurse for cardiovascular, critical care and perioperative services for Boston Children’s. Prior to the expansion, the hospital often delayed and canceled surgeries due to a lack of space, she said. .

The billion-dollar expansion comes after years of planning and controversy. When it was first proposed, a group of opponents tried to block the project because it would replace the Jardin de Prouty, a beloved green space where sick children and their families found solace during long stays. to the hospital.

These attempts failed, and state officials approved the project in 2016.

About half of the new building is for children with heart problems, including babies born with congenital heart disease who need surgery in their first days of life. Boston Children’s has become a magnet for these patients from across the country and around the world, said Dr. Tal Geva, chief of cardiology at the hospital.

In many situations, he said, the team of local doctors did all they could. But Boston’s Children’s still offers families hope. “They come here.”

Boston Children's Hospital staff prepare to conduct a gene therapy simulation in the Hale Family Building.  (Jesse Costa/WBUR)
Boston Children’s Hospital staff prepare to conduct a gene therapy simulation in the Hale Family Building. (Jesse Costa/WBUR)

With more operating rooms, doctors expect to be able to treat more children faster.

“For some patients, the sooner you can get them operated on, the better it will be in terms of long-term outcomes,” said cardiac surgeon Dr. Francis Fynn-Thompson. Fynn-Thompson said the expansion could also be a huge relief for families, who have struggled with long wait times knowing their children need surgery.

One of the new operating rooms includes an MRI machine that can help surgeons locate brain tumors during an operation.

The building also includes a larger newborn intensive care unit, giving families more privacy with their babies and caregivers more space to care for small patients.

After Boston Children’s completes other renovations, including converting double rooms to single rooms, it will have 71 beds for a total of 475.

Meanwhile, a few miles from Boston, Tufts Medical Center is closing children’s inpatient wards by the end of June. Tufts executives say they don’t have enough patients to continue running pediatric beds — and they’re referring patients to Boston Children’s instead.

The decision sparked an outcry from doctors, nurses and patients when it was first announced in January. State officials asked Tufts to submit a plan to ensure patients will continue to have access to medical services, but they had no authority to stop the shutdown.

Tufts Medical Center is closing inpatient care for children this summer.  (Robin Lubbock/WBUR)
Tufts Medical Center is closing inpatient care for children this summer. (Robin Lubbock/WBUR)

This means fewer choices and potentially higher out-of-pocket expenses for families. According to state data, Boston Children’s is the most expensive academic medical center in Massachusetts, and insurance plans often charge higher copayments and deductibles for the more expensive hospitals.

Boston Children’s spokesman Jamie Kelly said the hospital is committed to controlling healthcare spending. The state requires all health care providers and insurers to limit spending growth to 3.6% per year.

Kelly said about 70 Tufts physicians and most of the hospital’s pediatric patients are transitioning to Boston Children’s. “We are actively working with Tufts to recruit additional physicians to support our clinical collaboration,” he said in an email.

Massachusetts General Hospital and Boston Medical Center also have children’s hospital beds, although Boston Children’s is much larger. It is also the highest ranked pediatric hospital in the country by US News & World Report.

Outside of the Longwood Medical Area, Boston Children’s is planning a $435 million expansion into Boston’s northern, southern and western suburbs, including a new outpatient surgery center in Needham. He is also working to acquire Franciscan Children’s in Brighton, a specialist provider of mental health and long-term rehabilitation for children.

David E. Williams, chairman of the Boston Health Business Group consulting firm, says Boston Children’s expansion is likely to help young patients access the care they need. But he said regulators needed to be careful as the hospital continued to grow.

“They don’t really have a lot of competition,” he said. “And any organization that doesn’t have competition needs extra oversight.”