Perinatal Transport and Outreach Education

1. Perinatal Transport and Outreach Education Renee Domanico, MD Ann Dacey, RN, BSN, CLS

2. 2006 Key Informant Survey 2006 Blueprint To Improve West Virginia Perinatal Health

3. Perinatal health care providers who were surveyed strongly recommended a more organized system of perinatal care in West Virginia

4. Perinatal Transport and Outreach Education Committee 2007 West Virginia Perinatal Partnership

5. 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.

6. Complete Committee Report Available at website: www.wvperinatal.org

7. Two Surveys of Non-Tertiary Hospitals in West Virginia Perinatal Transport Survey 71% Responded Perinatal Outreach Education Survey 75% Responded

8. 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

9. 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.

10. 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

11. 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

12. 13 Committee Recommendations In handouts

13. 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.

14. Recommendation #2 West Virginia should investigate the implementation of a single call system for perinatal transport.

15. 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

16. 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.

17. 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

18. 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?

19. www.wvperinatal.org

20. Perinatal Outreach Education and Guideline Development for Website

21. 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.

22. 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:

23. 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

24. Perinatal Outreach Education and Guideline Development for Website

25. Arkansas ANGELS Program http://www.uams.edu/angels/

26. University of Washington NICU-WEB http://depts.washington.edu/nicuweb/NICU-WEB/trans1.stm

27. California Maternal and Neonatal Bed Availability http://www.perinatal.org/california_perinatal_dispatch_center_bed_availability.asp?r=socal

28. 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

29. 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