Butler converting eight pediatric beds to adult use

Citing a growing demand for adult inpatient services and a “fluctuating census” in children’s inpatient services, Butler Hospital said recently that it plans to close one of its pediatric units and convert the eight beds to adult use.
Butler’s sole ward for patients under age 13 will now be the 10-bed Children’s Intensive Treatment Unit, which provides acute, intensive stabilization treatment for children ages 3 to 18 with serious psychiatric and behavioral problems.
In addition, Butler will continue to serve adolescents ages 13 to 18 who need acute inpatient psychiatric care in the 14-bed Adolescent Unit.
However, the Children’s Treatment Unit, which serves patients ages 3 to 13 “who require immediate professional intervention, stabilization, evaluation and treatment for various psychiatric, mental health or behavioral health problems,” was scheduled to be phased out by Oct. 1.
The majority of Rhode Island children who are hospitalized with psychiatric problems do not go to Butler – which specializes in adults but serves patients of all ages – but rather to Bradley Hospital in East Providence, the nation’s oldest mental hospital for children.
That facility, which has 60 licensed beds for children and adolescents, is currently undergoing a $31.1 million expansion and renovation that will ensure all patients have private rooms and provide extra space for day and outpatient programs, but will not add extra inpatient beds.
And Butler’s experience in the last year suggests that even as parents and health care providers struggle to find mental-health resources for children in the community and other outpatient or intermediate settings, on the inpatient side Rhode Island now has a surplus.
Patricia Melaragno, director of marketing and public affairs for Butler, said the patient census for the two children’s units combined over the last year has averaged 11.3 – meaning that on the average day, a third of the beds went unused.
The census does fluctuate, Melaragno said, hitting its lowest points in the summer, but the demand for pediatric beds seldom matched the supply.
On the adult side, meanwhile, demand has been “consistently high,” she said, and Butler has been struggling to meet it.
The hospital’s annual report notes that in 2007, Butler – which has 117 licensed beds in its Providence facility, plus 29 within Kent Hospital – cared for an average of 136 inpatients per day, up 8 percent from 2006.
“We have had to turn patients away because we haven’t had a bed, and we also know that the community hospital emergency departments are just overflowing,” Melaragno said. “We know that that is a real crisis for the emergency departments, where they are ‘boarding’ patients for days until a bed opens up.”
Melaragno couldn’t say how many patients have been turned away, but she said “we do know it happens,” and she added that within Butler, patients are also affected by the shortage, staying in the assessment area for more than 24 hours because there are no beds available.
Reassigning the beds will take a few days, Melaragno said recently, and it will require changing how Butler uses some of its space. &#8226