Scott Radcliff, of Hasenstab Architects, leads a brainstorming session.
Last month, Akron Children’s announced that it would dedicate a floor in its new building to high-risk deliveries – a milestone in the hospital’s 123-year history.
This has long been a dream of hospital leaders like President and CEO Bill Considine, as well as the doctors who head up the hospital’s maternal fetal medicine and fetal treatment centers and neonatal intensive care unit.
Now comes the work to make this dream a reality.
Dr. Anand Kantak has long supported the plan to bring high-risk deliveries to Akron Children’s as the ideal family-centered care.
The first steps in planning the new space, which will be on the 4th floor of the medical building already under construction, took place Aug. 5 and 6.
A team of about 20 doctors, nurses, architects, administrators and Lean Six Sigma experts participated in a kaizen (Japanese word for “rapid improvement”) to give key stakeholders a say in how the space is designed.
A high-risk OB patient also participated the first day.
“Delivering babies on our campus may be uncharted territory for us, yet the doctors and nurses in this room have a collective 182 years of experience delivering babies at other hospitals,” said Lisa Aurilio, vice president for patient services and chief nursing officer.
Chief Nursing Officer Lisa Aurilio has also participated in kaizens for the ER and NICU.
The plan is to deliver approximately 100 babies per year when prenatal diagnosis determines the baby to be at risk and in need of immediate medical intervention by pediatric surgeons or other specialists upon birth.
This would include babies with congenital heart and neural tube defects, diaphragmatic hernias, and abnormalities that may affect the airway.
The team began by creating a vision statement for the new center. This was done by participants writing responses to prompts like, “I see…”, “I hear…”, “I think…” and “I feel….”
The input of the team members suggest they want to create an environment that’s inviting, comfortable and focused on the highest quality of care.
Each team member was given 5 blue and 5 red dots to place on photos of the interiors of other birthing centers across the country. The exercise indicated the team is partial to soft rather than bright colors.
“They steered away from primary colors and starkness in favor of wood tones, a spa-like feel and interiors that convey home and comfort,” said Sherry Valentine, a project leader for Akron Children’s Mark A. Watson Center for Operations Excellence.
Sherry Valentine, Lean Six Sigma deployment leader, facilitates a group session.
Other activities focused on issues of patient experience and staff work flows.
They looked at the proximity of operating rooms to patient rooms, how many steps doctors and nurses have to walk, storage space, the size and comfort level of the patient rooms, and the various “points of entry” for patients.
While most of these deliveries will be scheduled through maternal fetal medicine, the team also has to plan for the unexpected, including patients arriving via transport, 911 ambulance arrivals, and even the occasional “walk-in” mother-to-be in labor.
Jennie Evans, a registered nurse and medical planner with HKS Architects, offers insight.
The team will make key decisions for the public/shared spaces, such as the waiting rooms, 3 ORs for C-sections, and 6 labor/delivery/recovery/postpartum rooms, which must also flexible enough to become 2 intensive care rooms and an isolation room, if needed.
Several participants talked about how the team “gelled” instantly and how they feel privileged to have a role in a history-making venture for Akron Children’s.
Drs. Melissa Mancuso and Stephen Crane are two of Akron Children’s high-risk obstetricians.
“We are all very invested in this,” said Dr. Stephen Crane, director of maternal fetal medicine. “We have dreamed about this for years. It’s the right thing to do for our patients.”
Dr. Melissa Mancuso, co-director of the fetal treatment center, says the ability to perform high-risk deliveries will, over time, enable Akron Children’s to offer new treatment options, such as laser therapy for twin-to-twin transfusion syndrome, ex utero intrapartum treatment (EXIT) procedure, fetal therapy for cardiac conduction abnormalities and in utero release of amniotic bands.
“Of course the best reason for doing this is it keeps moms with their babies and keeps families together under one [hospital] roof. You can’t put a value on that,” said Dr. Mancuso.
That’s not to say the process will be easy.
“The most challenging aspect of this for our hospital is thinking beyond babies and children as patients,” said Aurilio. “Now mothers will be our patients as well, and that has implications for everything we do from insurance contracts to medical coding to laboratory procedures.”
