After more than a century of treating sick children, Tufts Medical Center will close its 41-bed pediatric hospital in July and use those beds to treat more adult patients.
Tufts will refer children who need hospitalization to Boston Children’s Hospital, its longtime competitor and the dominant pediatric hospital in the state.
The changes at Tufts, announced Thursday, will affect thousands of young patients and hundreds of employees.
Tufts, located in Boston’s Chinatown neighborhood, is among the city’s smaller academic medical centers, with a total of 415 licensed beds for adults and children. The plan to close inpatient pediatric services is a sharp departure for an institution that has treated acutely ill children since 1894, starting on a ship that sailed around Boston Harbor and became known as the Floating Hospital for Children. The changes are likely to be emotional for care providers, patients, and families with deep ties to what’s now known as Tufts Children’s Hospital.
But hospital leaders said they must respond to several trends: fewer children need to be hospitalized, thanks to advances in outpatient medical care, while the kids who need to be admitted often require specialty services unavailable at smaller pediatric hospitals such as Tufts. In addition, the number of seriously ill adults with heart problems, strokes, sepsis, and other conditions is on the rise, and Tufts is turning away dozens of adult patients a day because it doesn’t have enough adult hospital beds.
Meanwhile, the pediatric units often are just half full.
“The market’s changing, the demands are changing, the community needs are changing,” Dr. Michael Tarnoff, chief executive of Tufts Medical Center, said in an interview. “We feel this is really in the best interest of children and in the best interest of our institution.”
Tarnoff said “several hundred” staff would be affected, including 140 physicians, 100 nurses, and others. Some are likely to lose their jobs, but others could find new positions at Tufts or Boston Children’s. Tufts and its parent company, Wellforce, have 2,000 job openings and Boston Children’s is looking to hire nearly 1,300.
Tufts must seek approval from state health officials to close its pediatric beds and add beds for treating adults.
Tufts and its affiliated hospitals and doctors treat about 70,000 patients annually, most of them in outpatient clinics. About 1,900 children were hospitalized and discharged from Tufts last year: in the future, these patients would be referred to Boston Children’s.
“We want to create a stable transition,” Tarnoff said. “Ideally, we will coordinate care with Boston Children’s in a way that is seamless and well-managed for patients.”
Mary Havlicek Cornacchia, cochair of the nurses union at Tufts, said nurses were “beyond devastated” that the iconic children’s hospital, at the forefront of pediatric health care for over 125 years, would close.
“Caring for children is just so different. You develop really strong connections to the pediatric families. It’ll be a big loss,” she said, becoming emotional.
Executives from Tufts and Boston Children’s have been talking privately for months, and in January they signed a formal agreement to work together in pediatrics.
Dr. Kevin Churchwell, chief executive of Boston Children’s, said his hospital will be able to accommodate the additional patients, particularly after the planned opening of a new building at the hospital’s Longwood campus in June. With the new tower, the hospital’s capacity initially will increase from about 400 to 438 beds and, after other renovations, to 475 beds.
Churchwell said there may be some tough days when Boston Children’s is crowded, but “we’ll figure out those days,” he said. “These are not insurmountable problems.”
Tufts leaders said that they, not Boston Children’s, first proposed the partnership. Still, it represents the latest in a string of developments that could boost business for the state’s largest pediatric health care provider.
Boston Children’s is seeking approval to build an outpatient surgery center in Needham and is also planning to acquire Franciscan Children’s in Brighton.
Boston Children’s discharged 21,743 patients last fiscal year — more than 10 times the total of pediatric patients at Tufts — including children with heart conditions, cancer, and complex surgical needs.
Tufts and its parent company, Wellforce, have long promoted themselves as high-quality health care providers that are less costly than competitors such as Mass General Brigham and Boston Children’s, which typically command higher payments from insurers for the same medical services. This means statewide health care costs could rise when patients with private health insurance move from less expensive Tufts to more expensive Boston Children’s.
But Wellforce chief executive Michael Dandorph said the company’s planned changes will help contain health spending overall because Tufts will be able to treat more adult patients who otherwise might be admitted to higher-cost hospitals.
The Wellforce hospital network includes Tufts, Lowell General Hospital, and MelroseWakefield Healthcare.
“Our analysis shows that this is going to lower the cost of care for the Commonwealth,” Dandorph said.
Leemore Dafny, a health economist and professor at Harvard Business School, said the plan to shift patients from Tufts to Boston Children’s bears similarities to a merger — “even if that’s not bricks and mortar that’s changing hands.”
“To the extent that Tufts is less expensive than Children’s Hospital, that has cost implications,” she said.
Under this plan, Tufts will not accept a new class of pediatric residents this year. After July, the current group of 24 pediatric residents will complete their inpatient training at Boston Children’s.
Tufts will continue operating its 40-bed newborn intensive care unit in Boston. Outpatient pediatric programs at Tufts and affiliated hospitals will continue for now.
Tufts and Boston Children’s are discussing a plan to collaborate on outpatient pediatric services, but they have yet to share details.
Though Boston Children’s is by far the biggest pediatric hospital in the region, Massachusetts General Hospital and Boston Medical Center also treat children who need hospitalization. Mass. General has 58 pediatric beds, in addition to dozens of beds for newborn babies, while BMC has 26 pediatric beds and more for newborns.
At Tufts, hospital officials said one thing won’t change: the iconic 12-foot bronze bear outside their building, which came from the former FAO Schwarz toy store on Boylston Street, isn’t going anywhere.