Partners in success
Our first step in any potential hospital partnership is to listen. For too long, hospitals with low obstetric volumes have been neglected and offered inadequate staffing options for newborn care. We offer hospitals a “menu” of options to choose from that best fit their needs. We then develop a customized program together to meet or exceed your unique goals and objectives.
Hospitals with Special Care Nursery/Level 2 NICU designation should be capable of managing infants from 32 weeks gestation and above but in practice, they are often unable to do so. In many instances, this is due to the challenges of organizing adequate in-house coverage. In other cases coverage by per diem neonatologists may result in a conflict of interest as they transfer infants to their primary hospitals. Typically, there have been three staffing options for Special Care Nurseries; community-based pediatricians, pediatric hospitalists, or a community neonatologist. Naturally, each arrangement has its strengths and weaknesses.
Hospital
Advantage
Some of the benefits of this model of care include:
-
Improved patient/family safety and satisfaction through the immediate availability of specialists in the management of their newborns.
-
Prevent the loss of obstetric and delivery volume by encouraging families to register their deliveries at hospitals that offer a higher level of newborn care.
-
Reduce the need for transport (which increases patient satisfaction and revenue).
-
Increase market share by reaching out to obstetricians who also deliver at competing hospitals where advanced newborn care is not available.
-
Provides neonatal nurse practitioners who have years of bedside experience and are not only aware of the newborns’ medical needs but the new mothers’ emotional needs as well
-
Foster the relationship with obstetric patients so that they choose the hospital for their other healthcare needs (and those of their families).
At Firstday, we establish and staff robust Level 2 NICUs by providing 24/7 in-house neonatal nurse practitioner care that is overseen by experienced, board-certified neonatologists using state of the art telemedicine. This staffing model provides the best of both worlds; the availability of practitioners skilled at newborn procedures and the immediate oversight by the neonatologists. Our physicians are licensed and credentialed at your facility and are ready to review results and place orders as well as document in your EMR. Every baby in your Special Care Nursery will be seen daily in conjunction with our neonatal nurse practitioner and neonatologist.
Neonatologists
Community hospitals may try to recruit a neonatologist to staff their Special Care Nursery but this can be challenging, particularly for isolated, rural hospitals where the low patient volume and acuity may not be clinically stimulating. Moreover, a neonatologist working alone will not be able to provide 365 days a year of in-house daytime coverage requiring hospital to pay for expensive locum tenens coverage
Pediatric Hospitalists
Although pediatric hospitalists provide more in-house coverage, similar they are unable to resolve many of the issues stated above. It is becoming increasingly difficult to find pediatricians with extensive NICU experience and competence in the procedures that are necessary in in order to operate a Special Care Nursery.
Community Pediatricians
Although hospital generally do not pay for this service, community pediatricians are unable to offer significant hours of in-house due to the nature of their office-based practice. Furthermore, due to residents work hour restrictions, general pediatricians coming out of training have limited NICU exposure and consequently, diminished expertise as well as confidence to manage Level 2 NICU babies.
Transfer to a Level 3 NICU is often the most expedient approach but it is disruptive to parental bonding and is not always medically indicated. Often, infants with mild disorders on neonatal transition are asymptomatic on arrival at the Level 3 NICU following a “therapeutic transport”.