Childrens Hospital Corporation

PROVIDER OF PEDIATRIC HEALTHCARE, EDUCATION, RESEARCH & COMMUNITY SERVICE

CLINICAL CARE: THE SERVICES WE OFFER - FROM WELL CHILD VISITS AND TREATMENT FOR TYPICAL CHILD HEALTH ISSUES (BROKEN BONES, TONSILLITIS, ETC.) TO CHRONIC CARE (ASTHMA, DIABETES, OBESITY, ETC.) AND SPECIALTY SERVICES (ONCOLOGY, CARDIOLOGY, NEUROLOGY) - BENEFIT FROM OUR CLINICIANS' HIGH LEVEL OF SPECIALIZATION, OUR COLLABORATION WITH RESEARCH SCIENTISTS (MANY OF WHOM ARE ALSO PHYSICIANS) AFFILIATED WITH THE HOSPITAL, AND OUR SIGNIFICANT INVESTMENTS IN EQUIPMENT, FACILITIES AND CLINICAL AND SUPPORT STAFF. WE ALSO OFFER THE ONLY PEDIATRICS DEPARTMENT OF ADDICTION MEDICINE IN THE U.S., AS WELL AS THE ONLY ORTHOPEDIC SPORTS MEDICINE PROGRAM LOCATED AT A CHILDREN'S HOSPITAL. WE ALSO OFFER THE LARGEST PROGRAMS IN PEDIATRIC ANESTHESIOLOGY, PEDIATRIC CARDIOLOGY, AND PEDIATRIC CRITICAL CARE, IN THE NATION. BOSTON CHILDREN'S IS THE SAFETY NET INSTITUTION FOR VERY SICK CHILDREN THROUGHOUT THE REGION, SUPPORTING THE ENTIRE HEALTH CARE SYSTEM FOR THE MOST COMPLEX PEDIATRIC CASES. WE RECEIVE REFERRALS FROM COMMUNITY HOSPITALS AS WELL AS FROM OTHER ACADEMIC MEDICAL CENTERS THROUGHOUT NEW ENGLAND. APPROXIMATELY 25% OF OUR INPATIENTS ARE TRANSFERRED FROM HOSPITALS & MEDICAL CENTERS ACROSS MASSACHUSETTS FOR CARE THAT NO ONE ELSE CAN PROVIDE. IN FY23, BOSTON CHILDREN'S SAW APPROXIMATELY 1.2 MILLION OUTPATIENT VISITS, 60,000 EMERGENCY DEPARTMENT VISITS, 22,000 INPATIENT OR OBSERVATION STAYS, AND 26,000 INPATIENT OR DAY SURGERIES. OUR INPATIENT CASE MIX INDEX WAS 1.54 (MA ONLY) AND THE AVERAGE LENGTH OF STAY WAS 6.4 DAYS. OF THE BEDDED CASES, MORE THAN 19.1% (CMI > 2.00) CAN BE QUALIFIED AS CLINICALLY COMPLEX. OF THESE PATIENTS, APPROXIMATELY 35% (PATIENTS ON MEDICAID/MEDICARE) ARE CONSIDERED LOW INCOME.OUR MEDICAID ACO PROVIDES PRIMARY CARE TO 20% OF THE CHILDREN COVERED BY MEDICAID IN THE STATE. THE ABILITY TO SUPPORT THE HEALTH-RELATED SOCIAL NEEDS OF PATIENTS AND FAMILIES VIA THE ACO COMPLEMENTS THE WORK THAT WE ARE DOING IN COMMUNITIES TO ADDRESS THE MORE SYSTEMIC SOCIAL DETERMINANTS OF HEALTH. WE CAN ADDRESS "DOWNSTREAM" IMMEDIATE NEEDS OF CHILDREN AND FAMILIES, BUT ALSO TO WORK WITH COMMUNITIES AND PARTNERS TO AFFECT THE "UPSTREAM" FACTORS THAT DRIVE POORER HEALTH OUTCOMES FOR SO MANY. THIS INCLUDES A FOCUS ON POLICY THAT CAN IMPACT THE HEALTH. WE REMAIN COMMITTED TO ADVANCING HEALTH EQUITY THROUGH OUR SANDRA L. FENWICK INSTITUTE FOR PEDIATRIC HEALTH EQUITY AND INCLUSION. THROUGH THE INSTITUTE'S WORKS, WE SEEK TO TRANSFORM PEDIATRICS BY ADDRESSING PERSISTENT DISPARITIES IN THE DELIVERY OF CARE TO OUR NATION'S CHILDREN. IN 2023, WE CONTINUED TO WORK CLOSELY AND SUCCESSFULLY WITH TUFTS MEDICINE TO IMPLEMENT A COLLABORATION TO ENSURE CONTINUITY OF CARE FOR TUFTS MEDICINE PEDIATRIC PATIENTS AFTER TUFTS MEDICAL CENTER CONVERTED TUFTS CHILDREN'S HOSPITAL'S PEDIATRIC INPATIENT BEDS TO ADULT ICU AND MEDICAL/SURGICAL BEDS. WE CAME TOGETHER WITH A MUTUAL COMMITMENT TO EXPANDING TUFTS MEDICINE PEDIATRICS THROUGH THE CREATION OF A SHARED AND SUSTAINABLE MODEL OF COMPREHENSIVE PEDIATRIC CARE WITH BOSTON CHILDREN'S. OUR MUTUAL VISION FOR THE COLLABORATION IS ANCHORED IN FOUR GOALS:- IMPROVING THE HEALTH AND WELL-BEING OF THE PATIENTS, FAMILIES AND COMMUNITIES WE SERVE, WITH A PARTICULAR LENS ON EQUITY, DIVERSITY AND INCLUSION.- EXTENDING CARE INTO COMMUNITY SETTINGS CLOSER TO WHERE PEOPLE LIVE AND WORK.- INTEGRATING WITH COMMUNITY-BASED PEDIATRIC AND FAMILY MEDICINE CLINICIANS TO BETTER COORDINATE CARE.- CONTINUING THE IMPORTANT WORK OF RESEARCH, EDUCATION AND TRAINING THAT IS VITAL TO ANY ACADEMIC MEDICAL SYSTEM.IN 2023, WE ALSO FINALIZED OUR AFFILIATION AGREEMENT WITH FRANCISCAN CHILDREN'S HOSPITAL, THROUGH WHICH WE WILL CREATE A NEW, MORE EFFECTIVE AND EQUITABLE SYSTEM OF FULLY INTEGRATED BEHAVIORAL HEALTH AND REHABILITATIVE CARE, RESEARCH AND TEACHING THAT WILL SIGNIFICANTLY IMPROVE THE LIVES OF CHILDREN AND FAMILIES IN MASSACHUSETTS, NEW ENGLAND AND THROUGHOUT THE COUNTRY. INCREASINGLY, WE HAVE BEEN ABLE TO CARE FOR AND IMPROVE LIFE AND HEALTH OUTCOMES FOR MEDICALLY COMPLEX CHILDREN, MANY WITH CONDITIONS SUCH AS CONGENITAL HEART CONDITIONS, CHILDHOOD CANCERS & COMPLEX NEUROLOGICAL AND NEUROSURGICAL CONDITIONS. OUR CAPABILITIES ARE ACCELERATING RAPIDLY AS WE DEVELOP NEW CLINICAL & SURGICAL APPROACHES INCLUDING GENE THERAPIES, STEM CELL TRANSPLANT PROCEDURES, FETAL SURGICAL INTERVENTIONS, AND THE LIKE.BOSTON CHILDREN'S IS AT THE ABSOLUTE FOREFRONT NATIONALLY IN THESE & MANY OTHER AREAS. AS A RESULT, WE HAVE SEEN SIGNIFICANT GROWTH IN THE NUMBER OF COMPLEX PATIENTS SERVED - PATIENTS WHO STAY LONGER, REQUIRE MORE RESOURCES (SUCH AS INTENSIVE CARE UNIT-LEVEL CARE), USE A BROADER RANGE OF INTERDISCIPLINARY SPECIALISTS, AND FREQUENTLY REQUIRE SUBSTANTIAL SUPPORT FOR THEIR WHOLE FAMILY. SOME OF THEM TRAVEL GREAT DISTANCES, BUT EQUALLY MANY ARE FROM HERE IN MASSACHUSETTS.BOSTON CHILDREN'S MA/REGIONAL NETWORK CONSISTS OF OUR SATELLITE/PHYSICIAN OFFICE LOCATIONS, FORMAL PRIMARY CARE RELATIONSHIPS WITH GROUPS SUCH AS THE PPOC AND ATRIUS, COMMUNITY HEALTH CENTER RELATIONSHIPS AND A BROAD ARRAY OF RELATIONSHIPS WITH OTHER HOSPITALS IN MA AND NEW ENGLAND INCLUDING COMMUNITY HOSPITALS, ACADEMIC MEDICAL CENTERS AND SPECIALTY HOSPITALS. WE MAINTAIN RELATIONSHIPS OF VARYING STRUCTURES, SHAPES AND SIZES WITH NEARLY ALL OF THE MAJOR ACADEMIC MEDICAL CENTERS AND SPECIALTY HOSPITALS IN MA AND NEW ENGLAND, FROM A SINGLE SERVICE AGREEMENT SUCH AS PROVIDING REMOTE EEG INTERPRETATIONS TO ELLIOT HOSPITAL TO STAFFING COMMUNITY HOSPITALS 24/7 365 PER YEAR TO OUR MULTI-FACETED BRIGHAM RELATIONSHIP AND JOINT CANCER PROGRAM WITH DANA-FARBER. OUR SATELLITE/PHYSICIAN OFFICE LOCATIONS AND OUR COMMUNITY HOSPITAL RELATIONSHIPS IN EASTERN MA HAVE BEEN CENTRAL TO OUR COMMITMENT TO INCREASING ACCESS TO HIGH QUALITY PEDIATRIC SERVICES. OVER THE PAST 20+ YEARS WE HAVE GRADUALLY GROWN OUR NETWORK OF SATELLITES/PHYSICIAN OFFICE LOCATIONS AND COMMUNITY HOSPITAL RELATIONSHIPS PROVIDING A MIX OF NEONATAL, ED AND INPATIENT SERVICES. TODAY, NEARLY 40% OF OUR OUTPATIENT SPECIALTY VISITS AND SURGICAL CASES TAKE PLACE IN A BOSTON CHILDREN'S SATELLITE OR PHYSICIAN OFFICE LOCATION. OUR AFFILIATED COMMUNITY HOSPITALS ACCOUNT FOR NEARLY HALF OF OUR MA COMMUNITY HOSPITAL TRANSFERS AND 30% (~1,000) OF ALL INTRA-HOSPITAL TRANSFERS. THESE COMMUNITY HOSPITAL RELATIONSHIPS ALSO GENERATE IMPORTANT DOWNSTREAM REFERRALS TO OUR SPECIALISTS INCLUDING IMPORTANT NEONATAL REFERRALS FROM THE OBSTETRICAL PROGRAMS AT THESE COMMUNITY HOSPITALS. AS FEWER COMMUNITY HOSPITALS PROVIDE INPATIENT PEDIATRIC CARE, THESE HOSPITALS ARE INCREASINGLY SERVING AS REGIONAL PEDIATRIC HUBS TO HELP STEM THE TIDE OF PATIENTS WHO HAVE TO BE REFERRED TO BOSTON FOR COMMUNITY LEVEL CARE.

RESEARCH: OUR RESEARCH MISSION IS TO BE THE LEADING SOURCE OF RESEARCH AND DISCOVERY. WE ARE THE LEADER IN DISCOVERY AND INNOVATION THAT IS DRAMATICALLY ADVANCING NOT ONLY PEDIATRIC CARE BUT ADULT CARE AS WELL. WE HAVE THE WORLD'S LARGEST PEDIATRIC RESEARCH PROGRAM FOR MANY REASONS. THE MOST IMPORTANT REASON IS OUR FOCUS ON OUR PATIENTS. WE ARE CONSTANTLY EVOLVING CARE AND CARING FOR INCREASINGLY COMPLEX PATIENTS. EVERY CHILD WHO WALKS THROUGH OUR DOORS TEACHES US SOMETHING. IN FY2023, BOSTON CHILDREN'S WAS #1 IN NATIONAL INSTITUTES OF HEALTH FUNDING FOR ALL U.S. CHILDREN'S HOSPITALS, AND #4 IN FUNDING AMONG ALL INDEPENDENT HOSPITALS. MORE THAN 3,000 BASIC, CLINICAL, AND TRANSLATIONAL RESEARCH EMPLOYEES WORK IN OUR DEDICATED FACILITIES, WHICH TOTAL SOME 1 MILLION SQUARE FEET OF SPACE.OUR MORE THAN 1,100 INVESTIGATORS INCLUDE 13 MEMBERS OF THE NATIONAL ACADEMY OF SCIENCES, 28 MEMBERS OF THE NATIONAL ACADEMY OF MEDICINE, 23 FELLOWS OF THE AMERICAN ACADEMY OF ARTS AND SCIENCES, 13 FELLOWS OF THE AMERICAN ACADEMY FOR THE ADVANCEMENT OF SCIENCES, 12 CURRENT MEMBERS AND 13 ALUMNI OF THE HOWARD HUGHES MEDICAL INSTITUTE. TWENTY-SEVEN FACULTY ARE MEMBERS OF THE AMERICAN ASSOCIATION OF PHYSICIANS AND 47 ARE MEMBERS OF THE AMERICAN SOCIETY OF CLINICAL INVESTIGATION. OVER THE YEARS, FOUR BOSTON CHILDREN'S INVESTIGATORS HAVE WON THE NOBEL PRIZE AND SIX HAVE WON THE NEARLY EQUALLY PRESTIGIOUS LASKER AWARD.OUR INVESTIGATORS ARE HARVARD MEDICAL SCHOOL FACULTY - BASIC SCIENTISTS, CLINICAL RESEARCHERS AND EPIDEMIOLOGISTS - WHO ARE ACCELERATING THE PACE OF MEDICAL DISCOVERY FROM BRAINSTORM TO BENCH TO BEDSIDE. OUR RESEARCHERS WERE THE FIRST TO DEVELOP 10 NEW DISEASE-BASED STEM CELL LINES BY REPROGRAMMING ADULT STEM CELLS THAT CAN BE USED TO STUDY TREATMENTS FOR DISEASES RANGING FROM PARKINSON'S TO DIABETES. HERE ARE JUST A FEW RESEARCH SUCCESS STORIES FROM 2023:- A LONG-AWAITED GENE THERAPY FOR SICKLE CELL DISEASE WITH DEEP ROOTS AT BOSTON CHILDREN'S HOSPITAL AND DANA-FARBER CANCER INSTITUTE WAS APPROVED BY THE FOOD AND DRUG ADMINISTRATION (FDA). IT IS ALSO THE FIRST THERAPY USING CRISPR GENE EDITING TO GAIN FDA APPROVAL FOR ANY CONDITION.- BOSTON CHILDREN'S GENE THERAPY PROGRAM, IN CLOSE COLLABORATION WITH THE LEUKODYSTROPHY CLINIC AT MASSACHUSETTS GENERAL HOSPITAL, INFUSED THE FIRST PATIENT EVER TO RECEIVE SKYSONA GENE THERAPY OUTSIDE OF A CLINICAL TRIAL.- A TEAM OF SPECIALISTS FROM BOSTON CHILDREN'S AND BRIGHAM AND WOMEN'S HOSPITAL PERFORMED A FIRST-OF-ITS-KIND INTERVENTION FOR A RARE, LIFE-THREATENING TYPE OF BLOOD VESSEL ANOMALY CALLED A VEIN OF GALEN MALFORMATION (VOGM) - PERFORMED IN UTERO. THE ULTRASOUND-GUIDED EMBOLIZATION INVOLVED DEPLOYING TINY METAL COILS INTO THE AFFECTED VEIN VIA A MICROCATHETER INSERTED THROUGH A NEEDLE THAT WE GUIDED THROUGH THE MOTHER'S ABDOMEN AND INTO THE FETUS'S BRAIN.- BOSTON CHILDREN'S RESEARCHERS ARE INVESTIGATING A CELL OR GENE THERAPY APPROACH TO CYSTIC FIBROSIS, TARGETING A CELL TYPE THAT'S ONLY RECENTLY BEEN DISCOVERED.- RESEARCHERS IN BOSTON CHILDREN'S DEPARTMENT OF UROLOGY ARE DEVELOPING A NEW APPROACH TO TREATING CLOSTRIDIUM DIFFICILE (C. DIFF) INTESTINAL INFECTIONS TARGETING THE INFLAMMATION, NOT THE BACTERIA.- OUR CARDIAC SURGEONS ARE USING 3D MODELING TO IMPROVE SURGICAL PLANNING BY REVEALING DETAILS OF PATIENTS' HEARTS.- SCIENTISTS IN OUR COMPUTATIONAL HEALTH INFORMATICS PROGRAM HAVE FOUND TELLTALE MARKERS OF ANXIETY IN ELECTROENCEPHALOGRAMS (EEGS), EVEN IN EARLY CHILDHOOD.- SPORTS MEDICINE RESEARCHERS AT BOSTON CHILDREN'S MAY HAVE FOUND A NEW PATHWAY FOR PREVENTING AND TREATING MEDIAL TIBIAL STRESS SYNDROME (SHIN SPLINTS) IN YOUNG ATHLETES BY FOCUSING ON THE MUSCLES OF THE FEET.

TEACHING: BOSTON CHILDREN'S IS COMMITTED TO PROVIDING HIGH QUALITY CONTINUING EDUCATION FOR PEDIATRIC PROVIDERS AND SPECIALISTS THROUGHOUT THE WORLD. AS THE PRIMARY PEDIATRIC TEACHING AFFILIATE OF HARVARD MEDICAL SCHOOL, OUR MORE THAN 2,000 ATTENDING PHYSICIANS AND RESEARCHERS ARE ON THE CLINICAL FRONTIER OF EFFECTIVELY UNDERSTANDING AND TREATING MANY PEDIATRIC DISEASES AND DISORDERS.WE ARE PROUD TO BE THE PRIMARY TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, AND OUR NURSING DEPARTMENT PARTNERS WITH 27 SCHOOLS OF NURSING THROUGHOUT MASSACHUSETTS AND NEW ENGLAND. WE ARE HOME TO THE LARGEST AND MOST COMPETITIVE TRAINING PROGRAM IN PEDIATRICS, SEEDING THE WORLD WITH THE NEXT GENERATIONS OF SCIENTISTS, INNOVATORS AND CAREGIVERS.WE OFFER MORE THAN 70 TRAINING PROGRAMS (44 ARE ACCREDITED - MORE THAN ANY OTHER FREESTANDING CHILDREN'S HOSPITAL). WE HOST OVER 500 BOSTON CHILDREN'S-BASED RESIDENTS AND CLINICAL FELLOWS ANNUALLY, SELECTED FOR THEIR POTENTIAL LEADERSHIP IN THEIR RESPECTIVE FIELDS AND THEIR COMMITMENT TO ADVANCING THE FRONTIERS OF PEDIATRIC CARE. A 24-YEAR ANALYSIS OF RESIDENTS WHO HAVE GRADUATED FROM OUR DEPARTMENT OF MEDICINE FOUND THAT ROUGHLY 40% GO ON TO BECOME LEADERS IN ACADEMIC MEDICINE, FILLING POSITIONS SUCH AS DEANS, CHAIRS AND PROGRAM HEADS ACROSS THE COUNTRY. MORE THAN ONE THIRD OF THE CHIEFS OF PEDIATRIC DEPARTMENTS ACROSS THE COUNTRY TRAINED AT BOSTON CHILDREN'S. OUR SIMULATION PROGRAM, IMMERSIVE DESIGN SYSTEMS, IS THE FIRST HOSPITAL-BASED SIMULATOR PROGRAM AT A TEACHING HOSPITAL IN NEW ENGLAND. OUR GOAL IS TO MAKE "PRACTICE PRIOR TO GAME TIME" PART OF HEALTHCARE ROUTINE, OFFERING A FULLY INTEGRATED QUALITY ASSURANCE AND IMPROVEMENT RESOURCE, PREPARATION AND TESTING ENVIRONMENT FOR HOSPITALS. BOSTON CHILDREN'S OFFERS THE ONLY TRAINING PROGRAMS IN NEW ENGLAND FOR ADOLESCENT MEDICINE, CONGENITAL CARDIAC SURGERY, AND NEURODEVELOPMENTAL DISABILITIES; AND THE ONLY TRAINING PROGRAMS IN MASSACHUSETTS FOR ADOLESCENT MEDICINE, CONGENITAL CARDIAC SURGERY, NEURODEVELOPMENTAL DISABILITIES, PEDIATRIC CARDIOLOGY, PEDIATRIC HEMATOLOGY/ONCOLOGY, PEDIATRIC NEPHROLOGY, PEDIATRIC ORTHOPEDICS, PEDIATRIC PATHOLOGY, AND PEDIATRIC SURGERY.