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This hospital was established in March 2010 by relocating and integrating the Tokyo Metropolitan Kiyose Pediatric Hospital, the Tokyo Metropolitan Hachioji Children's Hospital, the Tokyo Metropolitan Umegaoka Hospital (Psychiatry), and the Fuchu Hospital Department of Pediatrics to the Tama Medical Campus in Fuchu. In addition to 359 beds in Body Ward, there are 202 beds in Mind Ward. In addition to 359 beds in Body Ward, there are 202 beds in Mind Ward. Also, the characteristics of the hospital are: i) it is located in a single structure with the Tokyo Metropolitan Tama Medical Center, and ii) it is close to the Neurological Hospital, Department of Pediatrics, Tokyo Metropolitan Fuchu Medical Center for the Disabled in the medical campus. In establishing this hospital, five management philosophies were created, which is our mission to execute them.
1. The pediatric medical hub in Tokyo
It consists of the following pillars: emergency medical care, advanced medical care, perinatal care, and clinical research.
As North America type ER, we accept all patients, evaluate the urgency with triage, and provide treatment mainly at the Emergency and Critical Care Department and the General Medicine Department. ER patients number approximately 100 people/day, including about one patient who is hospitalized at PICU (pediatric intensive care unit). Only a few percent among every 100 patients require emergency care; however, it is the pediatric care where severe cases may be included in those who complain the most common symptoms. In the ER ward, 10 beds are available for cases requiring follow-up observation, and 20 PICU beds are for severe cases managed by the intensive care department. Severe patients may be transported using a doctor car with our dispatched transport team. Transportation under the ECMO system (extracorporeal membrane type artificial lung) is one of our advantages.
In specialized medical care, we are focusing on refractory cancer treatment in particular as a pediatric cancer-hub hospital. Other than this, we deal with many cases, including kidney transplantation, congenital tracheal stenosis, ankylosis, cleft lip and cleft, hypospadias, cranium, congenital anomalies of the face, hip joints, congenital malformations of limbs, etc. Furthermore, we have medical teams consisting of different professions; which is also our strength.
In our perinatal care service, in collaboration with the Tama General Medical Center, we launch more than 300 doctor cars for newborns a year for delivery of emergency newborns in the local obstetrics and gynecology department. We will also strengthen fetal diagnosis team and promote collaboration with the local obstetrics and gynecology department.
A team of the Clinical Research Support Center, established in the Clinical Research Department, supports and promotes clinical research for each department.
2. Medical services that integrate “mind” and “body”
Our hospital is characterized by having 202 psychiatric beds and the medical team at "Mind Ward." The "Mind Ward" also deals with increasing number of severe cases, children of the low age group. To cope with these challenges, we have introduced the triage system, improved individual rooms, etc. “mind” and “body” are inseparable from each other. After treatment of the body, mind support is often required in the process of growth. Even in such a case, experts of "mind" and the liaison team will intervene from the early stage, where the mind and body experts will cooperate for treatment.
3. Medical care according to the growth of children
From childhood to birth to childhood, puberty, adulthood, --- we will continue to provide medical care with the growth of children. In particular, treatment is necessary even after pubescence for such cases as chronic diseases in childhood under a grant-in-aid program, intractable disease, cancer patients in AYA generation (Adolescent and Young Adult generation). In our transitional nursing outpatient clinic, we will start with a self-support program in the process of growing, and continue to provide medical treatment in collaboration with the Tokyo Metropolitan Tama Medical Center and neurological hospitals.
4. Child-centered medical care
Our "Pediatric Patient Bill of Rights" stipulates that children of any age "have rights to be informed and participate in medical care" and our teams ensure informed consent depending on their age, assent (gain approval), preparation (information beforehand to young children). Besides, although the life-saving rate has improved due to highly specialized medical care, unfortunately, we cannot always improve the quality of life. Through our multi-occupational palliative care support team, we are helping to alleviate physical and psychological pains and improve the quality of family life. Also, aggressive treatment may be inappropriate for some patients. We value the process of discussion with family members about the best treatment for the patient.
5. Medical services created together with the society
We believe that medical care for children with growth and development should be coordinated not only by hospitals, but also by administrative organizations and local communities, including schools, welfare facilities, municipalities, and public health centers. In our "Child and Family Support Department," doctors, nurses, psychotherapists, SW, nursery teachers, etc. are working on teams as soon as possible to leave the hospital and return to an early social reunion. This time, we have established a home care department in response to an increase in medical care children. We want to enhance collaboration with regional medical institutions further, visit medical treatment, municipalities, public health centers, special support schools and so on.
For better pediatric medicine, we will work towards a hospital with staff, teamwork well, smiling. We appreciate your continued support and cooperation.
April 1, 2018
Seiichi Hirobe
Director, Tokyo Metropolitan Children’s Medical Center