When Cambridge Health Alliance decided to shut down Cambridge Hospital’s pediatric unit in 2009, longtime pediatric nurse Donna Kelly-Williams said she was alarmed at how easy it was for the hospital system to close her unit.


In the following decade, Kelly-Williams — now the president of the state’s nurses union — says she has witnessed the same pattern repeat itself. Hospitals decide which services are no longer profitable, she explained, then begin to limit resources to those units: not hiring nurses or limiting the number beds, for example. She said the hospitals then tell the Department of Public Health that they intend to close a unit; the DPH declares those units “necessary” to the region, yet the hospitals close the unit anyway.

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