Perinatal Transport and Outreach Education

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Perinatal Transport and Outreach Education

• Renee Domanico, MD
• Ann Dacey, RN, BSN, CLS

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2006 Key Informant Survey

• 2006 Blueprint To Improve West Virginia Perinatal
  Health

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Perinatal health care providers who were
surveyed strongly recommended a more organized
system of perinatal care in West Virginia
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Perinatal Transport and Outreach Education
Committee

• 2007 West Virginia Perinatal Partnership

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Committee Directives

• Investigate and draft report related to
  improving the infrastructure of perinatal
  consultation, emergency transport, and outreach
  education
• History of Perinatal Transport System in WV
• Current situation of WV Statewide perinatal
  system.
• Input on what WV Key Informants say about how to
  improve the system.

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Complete Committee Report

• Available at website
• www.wvperinatal.org

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Two Surveys of Non-Tertiary Hospitals in West
Virginia

• Perinatal Transport Survey
• 71 Responded
• Perinatal Outreach Education Survey
• 75 Responded

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Key Survey Findings

• 70 of hospitals were not always able to get sick
  babies transported to NICUs
• 80 of hospitals stated they were not always able
  to transport high-risk mothers

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Key Survey Findings

• 90 of hospitals agreed that making a single call
  to a Transport Call Center would be desirable.
• 90 of hospitals agreed that, even if there was a
  Transport Call Center, physicians needing
  immediate consultation with tertiary physicians
  should be accommodated quickly.

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Key Survey Findings

• 62 of hospitals reported that the most common
  reason given for declined infant transports was
  lack of beds at the tertiary care center
• 38 of the hospitals reported that infant
  transports were sometimes declined due to lack of
  an available transport team

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Key Survey Findings

• 46 of hospitals reported they never received
  assistance in finding an alternative bed for a
  high-risk mother from the tertiary center that
  declined the transport
• 40 of hospitals reported they never received
  assistance

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13 Committee Recommendations

• In handouts

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Recommendation 13

• Plans for a perinatal transport summit, inviting
  all stakeholders to discuss implementation of the
  above recommendations, should be made for
  sometime early in 2008.

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Recommendation 2

• West Virginia should investigate the
  implementation of a single call system for
  perinatal transport.

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Characteristics of a Single Call Center

• Daily knowledge of all NICU and high risk
  maternal beds (Bedboard) available in the West
  Virginia and surrounding states
• Ability to immediately connect referring
  physicians with the appropriate neonatal or
  obstetrical specialists for consultation and care
  recommendations while awaiting transports

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Characteristics of a Single Call Center

• The ability to find available beds and arrange
  the transports of mothers or babies.
• The ability to (whenever possible) arrange
  transports to tertiary centers closest to the
  homes of mothers and babies.

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Until a Single Call Center is established

• A centrally maintained website with
  evidence-based guidelines for maternal-fetal and
  neonatal care including
• resuscitation, stabilization and transport
  guidelines for mothers and infants
• general care for mothers and infants
• development of these guidelines should take place
  in collaboration with perinatal care providers
  across West Virginia

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What information/links should we have on our
website?

• How to arrange a transport
• Checklists for maternal/infant transport
• Resuscitation, stabilization and transport
  guidelines for mothers and infants
• General care guidelines for mothers and infants
• Daily Bedboard?

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www.wvperinatal.org
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Perinatal Outreach Education and Guideline
Development for Website
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Recommendation 11

• West Virginia should establish an organized
  perinatal outreach education program coordinated
  by each of the three Level III Perinatal
  facilities for each of their referral hospitals.
  State funding for an office and a coordinator for
  these activities in each level III perinatal
  center is vital as well as reimbursement for
  teaching time by healthcare professionals.

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Recommendation 11

• Special attention and support should be given to
  those hospitals that deliver less than 750 babies
  per year. Results of the outreach education
  survey should be taken into consideration when
  scheduling these programs. All birthing hospitals
  should be offered a yearly review of the
  following programs

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Recommendation 12

• A special outreach education program should be
  developed for staff at those hospitals that have
  agreed to take babies back for convalescent care
  after NICU admissions

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Perinatal Outreach Education and Guideline
Development for Website
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Arkansas ANGELS Program

• http//www.uams.edu/angels/

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University of Washington NICU-WEB

• http//depts.washington.edu/nicuweb/NICU-WEB/trans
  1.stm

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California Maternal and Neonatal Bed Availability

• http//www.perinatal.org/california_perinatal_disp
  atch_center_bed_availability.asp?rsocal

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Ongoing Committees Formed

• Perinatal Education and Guideline development for
  website
• Developing a single call system for transport
• Guidelines for Reverse Transport
• Interstate Hospital Transport Relations
• Administrative and Reimbursement Issues/Finding
  Funding for perinatal Transport and Outreach
  Education

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Committee Meetings

• By WebEx no travel involved
• Conference call and web for sharing documents
• Possibility of Wiki website in the plans
• Password protected
• A website or similar online resource which allows
  users to add and edit content collectively