mendment to SB1482, allows a free-standing children’s hospital, in a county with a population of 1,750,000 or more, to provide obstetrical services to healthy pregnant women with physician documentation indicating that the fetus has a fetal characteristic or condition diagnosed as high-risk or that the fetus may require at least one perinatal intervention. In short, a low-risk mother with a high risk baby.
Improving Outcomes for All of Florida’s Babies
Currently, children come from all 67 counties to Nicklaus Children's Hospital, formerly Miami Children's Hospital, via air or land transport to receive highly coordinated, life-saving interventions after birth. This would benefit ALL of Florida’s children who are already coming to NCH from hospitals statewide.
The Most Vulnerable Babies
High-risk deliveries make up approximately 1% of all births; therefore, NCH will be limiting labor and delivery to a 10-bed unit based on national benchmarks.
This amendment looks to provide services to healthy moms with high-risk babies. Pre-existing illnesses and conditions include structural abnormalities of the digestive, central nervous and cardiovascular systems and disorders of genetic malformations and skeletal dysplasia and acute metabolic emergencies.
Where Do These Babies Come From?
While some hospitals may say that they are equipped to provide the necessary and often immediate life-saving care to these babies, it is all too often that they have turned to us to provide the necessary specialized care for these children.
In 2012, 196 babies with pre-existing fetal conditions came to Nicklaus Children's Hospital, formerly Miami Children's Hospital, for life-saving interventions.
Babies born at various delivery centers can take over an hour to be transported and stabilized and delays in care can often be the difference between having a child who is a healthy child or one who may suffer a neurological deficit or worse yet, die.
Family Centered Care Options Promoting Safety And Better Outcomes
In addition to transportation stress, the separation of the child and mother creates a significant amount of anxiety for families. Providing this service allows the mother and child to stay together at a very critical time in development.
These deliveries are pre planned with a predetermined diagnosis by a consulting obstetrician, who will work with a coordinated care team comprised of all necessary adult and child specialists and subspecialists.
Pre planned deliveries using the coordinated care approach will reduce instances of emergency situations, allow for enhanced safety and provide the mother and babies with the best possible outcome.
NCH is committed to providing mothers with the same standards of care as other hospitals providing such services and will ensure the quality of services are in line with Joint Commission and other regulatory standards. The amendment specifically requires NCH to comply with guidelines and voluntary review for the Quality of Care Program of the American College of Obstetricians and Gynecologists and meet the obstetrical department requirements in Florida Administrative Code 59A-3.2085(8).
Meeting Our Community's Needs
Current Florida law does not provide a clear path via the certificate of need process to create a high-risk obstetrical unit. The Agency for Health Care Administration has indicated that the only current path would be for Nicklaus Children's to become an adult hospital, which goes against the hospital’s 64-year mission of providing hope to children and families. Similar to legislation passed in 2009 to enable a small population of adults suffering from previously undetected congenital cardiac anomalies to receive care through Nicklaus Children's Heart Program, Nicklaus Children's seeks the opportunity to provide a unique population of expectant mothers with a choice.
The Children’s Hospital of Philadelphia Center for Fetal Diagnostics & Treatment opened an eight-bed Special Delivery Unit in 2008 and has delivered more than 1000 babies diagnosed with complex conditions requiring immediate intervention.