(From the Winter 2013 issue of Everything Matters: In Patient Care)
Gail A. Bagwell, RN, MSN, CNS
Terri Long RN, MSN
Nationwide Children's Hospital (NCH) outreach programs began with the development of the Perinatal Outreach program in 1976. The Ohio Department of Health (ODH) established the Regional Perinatal Center program for the State of Ohio through funding from the Federal Title V Maternal Child Block Grant. The state was divided into six distinct regions based on population. Each region had a tertiary medical center(s) responsible for providing education to the hospitals, health departments and consumers in the region regarding best practices for the mother and newborn.In conjunction with The Ohio State University Medical Center (OSUMC), NCH provided this service as the tertiary referral centers to Perinatal Region IV continuously from 1976 until the dissolution of the Regional Perinatal System by ODH in 2010. NCH continues to provide Perinatal Outreach service to the hospital’s referral area. In addition, other programs have been modeled after the original Perinatal Outreach program including Pediatric and EMS Outreach programs. The main referral area for all the NCH outreach programs encompasses 42 counties in Northwestern, Western, Central and Southeastern Ohio, West Virginia and Kentucky.
Initially the Perinatal Outreach program was developed to help improve the care of women and babies as well as to decrease maternal and neonatal mortality and morbidity primarily through education of the health care professionals in the region. The program is now utilizing evidence-based data to guide recommendations for care. This is accomplished by monitoring system performances, by analyzing data, by facilitating the development of systems and by providing consultations. In addition, Outreach assists the hospitals in the referral area with policy and procedure development, education on the care of the ill neonate, implementation of national standards, facilitation of networking and serving as a liaison between ODH and the referral hospitals.
The Pediatric Outreach program started as an education-focused program. In addition to providing up-to-date information on the care of pediatric patients in hospitals and emergency rooms, the program now also coordinates Pediatric Advanced Life Support (PALS) programs, the coordination of pediatric workshops and preceptor training.
The quarterlyPerinatal Liaison Network meeting, begun in 1977, is the longest running Perinatal Outreach meeting. Meetings are held four times a year to disseminate information throughout the region in an open forum. The meetings consist of educational offerings, updates on new initiatives at NCH, discussion of Ohio Perinatal Quality Collaborative initiatives, data results, current literature review, and also provides an opportunity to work on projects together as a region to improve Perinatal Care. There is an annual “State of the Region” presentation and setting of goals for the coming year. In 2008, a new network of meetings for the Lactation Consultants of our referral area was developed. This group meets twice a year to discuss issues and share information in relationship to breast feeding the term and preterm neonate. A partial list of the perinatal and pediatric educational programs currently offered is listed in Table 1.
The liaison meeting format has been so successful in the region that the Pediatric Quarterly Regional Outreach Meeting developed from this program. The pediatric group learns about new pediatric topics based on the yearly needs assessment done with the pediatric units and ERs in the hospital’s referral area. Networking is done both at the meeting and electronically between scheduled meetings.
Educational program topics are provided to all referral hospitals by Perinatal and Pediatric Outreach. These didactic and skills practicum programs cover neonatal care, infant growth and development, perinatal/neonatal nutrition, Neonatal Resuscitation Program (NRP), PALS, pediatric skills, pediatric assessment and specific classes tailored to the needs of the regional hospital. In 2011, the Perinatal Outreach program provided 67 educational courses to 1,207 participants, two Level III assessments for Level II OB units that wished to elevate their status to a Level III and participated on many local, regional and state task forces and committees.
Perinatal Outreach also consults and offers expert guidance to the Ohio Perinatal Quality Collaborative, the Ohio Collaborative to Prevent Infant Mortality, the Ohio Partners for Birth Defect Prevention, the Franklin County Maternal Depression Task Force, the Franklin County Safe Sleep Task Force, the Council of Healthy Mothers and Babies Public Awareness Committee, the Franklin County Preconception Task Force, the Central Ohio Division of the March of Dimes Health Leadership Awards Committee, the Central Ohio Division of the March of Dimes Program Services Committee, the State Chapter of the March of Dimes Program Services Committee, the State Board of Directors for the Ohio Chapter of the March of Dimes and the Region IV Perinatal Education Consortium of Central and Southeastern Ohio.
Pediatric Outreach offered 113 educational programs with 1,000 participants in 2011. The educational programs included PALS classes, pediatric IV workshops, regional conferences and lunch and learns. The PALS program alone provided education at more than 16 locations with more than 100 classes in 2011. The PALS classes are offered at hospitals and at local and regional fire stations. Recently one of the PALS Coordinators attended training to become a State Certified Fire Instructor which allows the program to also grant fire credit to these fire station participants.
Through Pediatric Outreach, NCH partners with facilities to hold regional conferences. NCH brings pediatric experts to partner hospitals for half-day conferences or evening dinner conferences at a minimal cost. These regional conferences have proven to be very successful and popular in the NCH referral area. All regional facilities are invited to participate. Also offered to the region are lunch and learn sessions for nursing staff on topics such as shock and respiratory distress in the pediatric patient.
The Pediatric Outreach program also offers preceptorship and observations for all health care professionals in the region, state and, sometimes, even nationally. Preceptorships are offered in the areas of Neonatology, Nutrition, Interventional Radiology, GI, Rehabilitation Program and Pediatric Radiology. The Pediatric Outreach program manager coordinates with key personnel in the requested unit to set up the experiences. Pediatric Outreach also provides consultation in areas related to electronic medical records, policies and procedures, equipment and general care of the pediatric patient.
As health care continues to evolve and change, both the Perinatal and Pediatric Outreach programs will continue to improve the way programs are run and update educational offerings to NCH referral areas with the latest innovations in health care. As teleducation has evolved and more hospitals have the equipment to participate, NCH will be investigating ways to provide long-distance education without the employees of referral area always having to travel to Columbus for education.