CHILDRENS HOSPITAL CORPORATION
300 Longwood Avenue, Boston, MA 02115 www.childrenshospital.org

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Organizations Filed Purposes: Boston Children's Hospital is the nation's premier pediatric hospital and research enterprise. We serve as the community hospital for the children of Boston; provide specialty pediatric care throughout the region; and offer access to innovative, lifesaving care to children across the world facing rare and complex conditions. Our vision is to build on our legacy of discovery and innovation to harness our powerful combination of life-changing care and world-changing research to drive the breakthroughs that advance and improve the health and well-being of children everywhere. Our four-part mission is to provide access to safe, high quality, compassionate and innovative clinical care to children; research new cures and treatments for diseases and methods of care delivery; train the next generation of pediatric caregivers; and improve the health and well-being of children, with a special emphasis on helping the children of Boston grow and learn in safe, healthy environments.

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. Our team has a deep commitment to setting the bar for quality and safety and exceeding the expectations of our patients and their families for service, undertaking significant investments in each of these areas.In FY2019, Boston Children's saw more than 670,000 outpatient visits, 61,000 emergency department visits, 23,000 inpatient or observation stays, and 29,000 inpatient or day surgeries. Our inpatient case mix index was 2.26 and the average length of stay was 5.8 days. Of the bedded cases, more than 16.8% (CMI > 2.00) can be qualified as clinically complex. Of these patients, approximately 35% (patients on Medicaid/Medicare) are considered low income.BCH 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. BCH is the single largest provider of care to children enrolled in the Medicaid program, caring for approximately 30% of all pediatric Medicaid patients statewide, including many of the sickest children in the state. BCH also provides clinical care for the largest number of uninsured children in the state. While the numbers are not finalized, we're projecting a Medicaid loss over $120M for FY19. In FY18 (the most recent complete year we have), for our Massachusetts patients, 39.4% of our gross patient service revenue (GPSR) was from Medicaid, including carved out behavioral health programs and the Children's Medical Security Plan.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.BCH 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.We've attempted to manage these trends by delivering care in lower cost settings including community hospitals that we help support, and by transitioning inpatient care to multi-specialty outpatient settings where possible. We've built care teams that work effectively across disciplines. We've strived to create a more welcoming and family-centered environment for children & families on the Longwood campus. We need to do more.Recognizing the difficulties that community-based hospitals face in providing specialized pediatric care (which requires significant investments in staff, equipment & training), BCH has formed partnerships with community hospitals throughout eastern Massachusetts, including Beverly Hospital, Winchester Hospital, Charlton Memorial in Fall River, Milford Regional, St. Luke's in New Bedford, Tobey Hospital in Wareham & South Shore Hospital. We've also expanded partnerships with Barbara Bush Hospital at Maine Medical Center and Hasbro Children's Hospital in Providence, RI. Additionally, our physicians see patients at Massachusetts General Hospital. With approximately 100 physicians serving those community hospitals, we enhance the community's-and the state's-ability to provide access to emergency, neonatal, inpatient & outpatient specialty services for children. BCH also operates satellite facilities in Lexington, North Dartmouth, Peabody & Waltham where we offer specialized care in cardiology, gastroenterology, neurology, respiratory diseases, diabetes, orthopedic surgery, urology, behavioral health and other specialties, as well as Martha Eliot Health Center, our community health center in Jamaica Plain. In addition, our physicians offer outpatient services at our Physician Office Locations in Brockton, Milford, Norwood & Weymouth. The Pediatric Physicians Organization at Children's consists of more than 300 physicians and 100 nurse practitioners and physician assistants across Massachusetts who work in close collaboration with Boston Children's. Additionally, our BCH Physicians partnership is a multi-specialty, pediatric practice with strong medical and academic roots, whose more than 276 physicians serve families in 57 locations throughout New York's Metropolitan Area, the Hudson Valley, Connecticut and New Jersey.Each year, BCH improves the quality of the clinical care it provides by recruiting talented staff, investing in cutting-edge equipment and technology, undertaking safety & quality initiatives, supporting community health programs and ensuring that our facilities make the care process easier & more comfortable for all the patients & families we serve. For example:Focus on Quality and Safety: At BCH, a dedication to quality & patient safety is embedded in everything we do. We continuously measure & track our performance in order to improve the care we provide. We believe measurement is essential for providing world-class care. If we don't track how we're doing, we can't identify areas of care that need improvement. And we can't identify high-performing areas that could serve as a model throughout BCH & the health care industry as a whole. By closely watching our quality & safety outcomes, we push ourselves to get better every day & raise the standard of care everywhere. We are committed to transparency in our efforts to constantly improve quality & safety, and clinical departments at BCH publish information on both in their own sections of our website.We value the insights of parents, patients & families when it comes to quality and safety. Parents know their child best, and they often have excellent ideas about how care can be improved. Adult family members, and children who are old enough, are encouraged to voice their observations, opinions or concerns to members of the care team. Doctors, nurses, researchers & administrators throughout BCH are continually exploring new ways of improving the quality of care we provide. Whenever possible, we share our successes & breakthroughs with the wider world, so that other health care professionals can learn from our experience and join us in raising the standard of care for children everywhere.In addition, BCH is engaged in an ongoing enterprise-wide commitment, extending to all staff as well as patients and families, to be a High Reliability Organization, one where ZERO preventable harm will occur to any patient, family member or team member. Foster innovation: Through the work of the Innovation and Digital Health Accelerator, BCH reinforces a commitment to, and investment in pediatric innovation. We are combining our data, clinical expertise, and health care technology development experience, with leading worldwide industry partners - including start-ups - to transform health care. Through the IDHA, we continue to make significant investments in the area of digital and technology-driven care. We know that the patient's journey is going to be not only more personalized as it comes to their care, but clearly more digital.Some of our ongoing projects include:- Circulation, which leverages on-demand transportation services to ease the burden of non-emergency medical transportation- Mightier, which uses the power of video games to help kids 6-14 struggling with anxiety and controlling emotions build emotional strength and resilience- An Early Literacy Screening App that can effectively screen for early signs of literacy challenges in only 30 minutes and link to risk-specific evidence-based responses for screening- Mindlight Medical, a brain-based diagnostic service that leverages EEG data to provide risk assessment & monitoring services for autism in infants as early as 3-6 months.

RESEARCH: Boston Children's is dedicated to enhancing the wellbeing of children and families by leading research and innovation around child health issues, and by seeking new approaches to the prevention, diagnosis and treatment of childhood and adult diseases.We have the world's largest pediatric research program-more the 1 million square feet of dedicated research space-for many reasons. The most important reason is our focus on our patients. We are constantly evolving care, and caring for increasingly complex patients - patients with congenital heart conditions, childhood cancers, complex neurological and neurosurgical conditions, and more. Research occurs in every clinical department, and our advancement of basic research helps us to advance the understanding of disease, but also model the diseases we see in pediatrics. In FY2019, Boston Children's received a total of $410M in research funding-federal (NIH, etc.), non-federal direct and indirect. We are the 5th largest NIH funding recipient of all hospitals in the U.S. and received 16%+ more NIH funding secured than any other pediatric hospital. Our funding amount has a multiplier effect, serving as a magnet for medical education, research and corporate investments.Boston Children's research faculty and trainees in 2019 produced over 3,000 publications.Our investigators hold numerous prestigious honors and awards, including many "research firsts." In our laboratories and clinics, hundreds of scientists seek to identify the factors that contribute to both childhood and adult diseases and to develop effective treatments for them. 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. Clinicians and researchers at Boston Children's work with colleagues throughout the medical community to translate basic science research into applications for clinical care. These projects frequently have applications that go beyond pediatrics to impact adult care as well. In FY2019 alone, we disclosed 153 inventions, received 269 patents, executed 54 licensing agreements and 24 sponsored research agreements, and formed six startup companies to help bring our innovations to the patient bedside. Our research specialties include:- Research-driven discovery science platforms- Established collaborations focused on childhood diseases- World-leading, disease-specific expertise- Therapeutic trials experience- Comprehensive understanding of regulatory landscapes- Top-level genetics and genomics research infrastructure- Deeply phenotyped disease cohorts- World-class informatics

Teaching: 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 word with the next generations of scientists, innovators and caregivers.We offer more than 70 Training Programs (41 are accredited - more than any other freestanding children's hospital), and host nearly 500 BCH-based residents and clinical fellows annually. These men and women are selected for their potential leadership in their respective fields and their commitment to advancing the frontiers of pediatric care. In fact, 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. Over a third of the chiefs of pediatric departments across the country trained at Boston Children's. Boston Children's has trained approximately 20% of the practicing pediatric cardiology specialists in the U.S., and 42 of those trainees have been pediatric cardiology division chiefs.We train individuals throughout all areas of the care continuum, including medical students, interns, residents, fellows, nursing students and community pediatricians. We provide continuing professional education for all of our clinical staff.Our Department of Continuing Medical Education enables clinicians around the world to tap into Boston Children's expertise. We were the first pediatric hospital to receive joint accreditation, Our Simulation Program 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. Our groundbreaking programs in simulation technology, 3D printing, advanced genomic testing, and other areas allow us to bring new techniques to medicine that are unique to our institution - many of them specialized for the care of the smallest babies.We are the only pediatric hospital to offer certification for physicians in use of robotic equipment, helping surgeons develop and perfect new robotic procedures and surgical techniques. We offer the only Pediatric Addiction Medicine program 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 offers the only programs in New England for 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.

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