When Jennifer and Ashton Hall first learned they were expecting rare identical triplets, they were told Jennifer would need specialized care throughout her high-risk pregnancy to increase their babies’ chances for survival. Based on their doctor’s recommendation, they traveled halfway around the world from their home in London, England, to be treated by Dr. Giancarlo Mari, the Medical Director of the High-Risk Obstetrics Program at Regional One Health. You can read more about their incredible journey on page 10.
“Regional One Health is the only hospital in downtown Memphis that takes care of the mother throughout the pregnancy and beyond — from the first pregnancy test to the Neonatal Intensive Care Unit (NICU), all the way to pediatrics after the baby goes home,” says Tammie Ritchey, Vice President of Development. “There is no other place in our area to get this level of care for both mothers and babies. We’re working hard to decrease the infant mortality rate in this community, and we’re beating benchmarks across the nation with our integrated teams from the High-Risk Obstetrics Program and the Neonatal Intensive Care Unit.”
Every Child Deserves a First Birthday
In a city where the infant mortality rate rivals that of many underdeveloped countries, Memphis continues to grapple with the number of babies who do not live to see a first birthday. The infant mortality rate is a healthcare index tracked around the world, and it is widely considered the most important measure of a community’s health. Because the majority of childhood deaths occur during the first year of life, once the baby makes it past this milestone, he or she has a much better chance of reaching adulthood.
In 2003, the infant mortality rate in Shelby County was 14.9 per 1,000 live births, more than double the infant mortality rate in the United States at that time. The doctors at Regional One Health rallied together and committed to finding a path to improving this reality.
“Today,” Dr. Ramasubbareddy Dhanireddy, Medical Director of the Sheldon B. Korones Newborn Center, says, “premature babies have a 95 percent chance of going home to live healthy lives.” In fact, the infant mortality rate in Shelby County has declined a staggering 35 percent since 2003, and in 2011, for the first time in history, the infant mortality rate in Shelby County dropped below 10 per 1,000 live births.
“Much of that decline,” Dr. Dhanireddy says, “came from Regional One Health’s multidisciplinary, collaborative approach to caring for high-risk mothers and babies. This innovative approach, developed by the doctors at Regional One Health, occurs when professionals from a range of disciplines with different but complementary skills, knowledge and experience work together to deliver comprehensive care that provides the best outcome for patients. It is well documented and accepted that multidisciplinary care is a best practice for treatment planning and care.”
Regional One Health provides social workers for each family to help connect new parents to community resources. Social workers and doctors work together to provide information and guidance on how to navigate this crisis in the parents’ lives. “After all,” Dr. Dhanireddy says, “many parents feel as though their lives have stopped. Everything in the world is revolving around their new baby.”
A Multidisciplinary, Collaborative Approach
Dr. Dhanireddy knows that the NICU wouldn’t be as successful without the multidisciplinary, collaborative approach at Regional One Health. “Our philosophy at Regional One Health is that the baby and the family are at the center of the universe,” he says.
“WE ARE ALL HERE TO PROVIDE THE BEST POSSIBLE CARE FOR THE BABY AND THE FAMILY, AND THE MOST IMPORTANT THING WE CAN DO IS TO WORK AS A TEAM. THERE’S NO SINGLE PERSON OR SINGLE GROUP OF PEOPLE RESPONSIBLE FOR THE HEALTH OF THESE BABIES; THE WHOLE TEAM IS COMPLEMENTING ONE ANOTHER’S SKILLS.”
At Regional One Health, the High-Risk Obstetrics Program is in constant communication with the NICU, so they can work together to provide seamless care for these critically ill and premature infants. Twice a day these two teams get together to exchange information about the progress of high-risk pregnancies, so that both teams know the plan going forward. In the delivery room, members of each team are available to care for the baby right away. This coordination of care and communication is crucially important since every second counts from the time the umbilical cord is cut. Coordinated interventions by an expert team during the first hour of the baby’s life can dramatically increase the survival rates and improve long-term outcomes for these newborns.
“Having a strong partnership between the High-Risk Obstetrics Program and the NICU is the key to reaching better outcomes for these high-risk mothers and newborns,” says Dr. Mari. “Having one good doctor is not enough, and having only the NICU alone or a strong maternal-fetal medicine team by itself is not enough.”
What makes the difference for these newborns and their mothers is having the High-Risk Obstetrics Program, the maternal-fetal medicine team, and the NICU working together as one. Just like the expert musicians in an orchestra, doctors at Regional One Health must pay attention to the smallest details about each high-risk infant to time each birth perfectly.
» To find out why ever minute matters read The Future at Risk: Part 2.