By Becky Wiese
The anticipation of a new baby is unlike anything else. The months of pregnancy provide an amazing perspective on life and the wonder of how all the various systems and parts of the body are knit together. It’s a special, and sometimes overwhelming, process, even when it all goes as it should.
When complications arise, however, a level of stress is added to the mix. Complications for either the mother or the baby require extra medical care, monitoring, testing, and sometimes intervention, perhaps before (if the complications are pregnancy related), or after (if the baby has medical needs), the baby is born.
Advocate BroMenn Medical Center in Normal already provides care for complicated situations for moms by having an obstetrician on-site 24 hours a day, every day of the week. Beginning in early October, the addition of a full-time, on-site neonatologist — a pediatrician with extra training in caring for medical needs of babies from birth to a few months of age — will enable the hospital to offer families even better care.
“Adding a neonatologist on site continues the evolution of care we provide,” says Colleen Kannaday, President of Advocate BroMenn Medical Center. “This new service is also a matter of timing: The number of deliveries at BroMenn has increased over the years, and our volume is such that adding services will be helpful.”
Dr. Duane Stich, medical director of neonatalogy at Advocate Children’s Hospital, adds, “We’re helping create a stronger medical home for pregnant moms by expanding the capabilities of what the facility can care for in the Mother Baby Unit.”
Mother Baby Unit already prepared
Hospitals receive designations from the State of Illinois regarding the level of care they are prepared to provide. Several years ago, when BroMenn Medical Center constructed an extensive addition to the hospital, the Mother Baby unit was upgraded and built with the intent of pursuing a higher designation for the level of care provided. “We have been a Level II facility for many years. We hope to expand our designation to Level IIE,” explains Lori Harper, Director of Nursing Practice and Obstetrics.
A hospital with a Level I nursery can care for newborns who are healthy — sick or premature babies are transferred to a hospital that has trained staff and special equipment to care for the baby. A hospital with a Level II nursery can care for babies born as young as 32 weeks gestation (38-40 weeks is considered “full-term”), and a Level IIE can care for babies as young as 30 weeks gestation.
Initially, the neonatology services will be provided by doctors from Advocate Children’s Hospital in Chicago, who will rotate for several days at a time to provide on-site and on-call coverage 24/7 here in Bloomington-Normal.
“When we launch the program, the doctors from Advocate Children’s will provide coverage — the neonatologist won’t be a distant consultant — they’ll be here on site,” says Kannaday. “The plan is to add three full-time neonatologists who will not only serve the community full-time at the hospital, but will also be vibrant and active in the community as residents.”
The obstetrics unit itself requires very little in the way of equipment upgrades. The Special Care Nursery already includes state-of-the-art machines and monitors as a result of the upgrade four years ago.
The neonatologists may identify a few other things, but “we are well prepared already,” says Harper, referring to the specialized equipment needed to care for premature babies. “We’ll have an updated ventilator and new probes for the ultrasound machine, but the actual nursery is already well-equipped with isolettes, radiant warmers, and oxygen.”
Mother Baby Care throughout your stay
Many years ago, mothers labored and delivered in one room, spent some time in a recovery room, and then stayed in a “regular” hospital room (maybe with a roommate) until they were discharged. The baby often stayed in the nursery and was brought to mom by request.
“We provide a different model of care now,” explains Harper. “A mom who delivers a wellborn baby may never be separated from her baby during their hospital stay unless she requests it.”
The LDRP (Labor, Delivery, Recovery, Post-Partum) model of care means that everything takes place in the same room. The new rooms are larger, equipped with everything necessary for labor and delivery. They are comfortable, even hotel-like, and include a pull-out couch for a support person to stay in the room. If the baby is delivered by Cesarean section, mom is moved to an operating room in the OB unit just down the hall, and then goes back to her private room as soon as she’s recovered. Baby stays with her as much as possible.
“You can’t really come to the OB unit to see the babies in the nursery anymore — they are usually all in the room with mom,” says Harper.
Babies who have health concerns go to the Special Care Nursery, where they can be monitored with specialized equipment and increased nursing care, but mom is still close by.
One change that will be especially beneficial for families as a result of having a neonatologist on site is that the likelihood of staying together is much higher. “Women who had high-risk pregnancies were often forced to go elsewhere to deliver their baby, or the baby may have required transfer after birth,” explains Kannaday.
“Now, mom is here, her OB physician is here, the baby is here, and the neonatologist is here to care for the baby. When the babies are able to stay here, the family can stay in their own home and environment where they are most comfortable and familiar.”
Similarly, babies born prematurely in an emergency situation would likely need specialized care because their lungs may not be fully developed. Emergency deliveries often require mom to be a patient for a while to recover, while baby is transferred somewhere else due to medical needs. Now, especially if the main issue is respiratory in nature, these babies will be able to stay here.
Sometimes babies are diagnosed with problems in utero — before they are born. Many pediatricians do not have experience in treating the issues these babies have or develop soon after birth, so they are more comfortable with the baby receiving care where there is a neonatologist available to manage the case.
“Don’t get the wrong idea,” Harper is quick to explain. “Our pediatricians are well trained and want to care for our babies. It’s more a matter that the skills needed to care for these babies aren’t required as often, so they aren’t as comfortable with the care the baby needs. A neonatologist’s skill set is narrower and more finely-tuned for this population.”
Dr. Stich agrees, saying, “The facility is set up as a Level II, but without the physician component with the specialization and training, there’s a lot that’s outside the scope of practice and comfort level for a general pediatrician to take on with some premature babies. The pediatricians in the community have been doing a great job of providing special nursery-level care, but as the need for that service has increased, it’s now become more important that we have people who are specialized providing that type of care.”
The neonatologist provides care only in the hospital — they don’t hold office hours. When babies are ready to be discharged, they return to their pediatrician’s care.
“We will still have to transfer some babies to a Level III nursery,” says Harper. “Babies who need surgery or other specialists would be transferred.”
“What we can safely do, we will do,” says Kannaday. “Patient care and safety come first.”
Staff readiness for increased services
The ancillary staff and services are already in place to care for babies with special needs. Disciplines such as respiratory therapy, lab services, speech therapy, dietetics, social workers, and others will also see an increase in the needs for their services.
“My sense is that there is a level of excitement among the staff as there is an opportunity to sharpen their skills and focus on a population that we haven’t served before,” says Kannaday.
The special care nurses, who already have a strong base and good tenure as far as experience, have received additional training. Continuing education will include on-site training, classroom certification, additional training opportunities at Advocate Children’s Hospital, and teaching from the neonatologists themselves.
“The fact that we can grow, expand, add new services and expertise to benefit our patients show Advocate’s willingness to invest in Bloomington-Normal. It speaks to the benefit of being part of a large system,” says Kannaday.
The smallest members of our community will benefit the most.
Discover why twice as many families choose Advocate BroMenn Medical Center to have their baby. Private suites, a state-of-the-art birthing center, and 24/7 neonatology services will offer the highest level of newborn care in McLean County. We’d love for you to take a tour. Call 1-800-3-ADVOCATE, or visit us at advocatehealth.com/bromenn-ob to set up a visit and learn more.
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