Neonatal Hotline Telephone Network

PEDIATRICS ◽  
1979 ◽  
Vol 64 (4) ◽  
pp. 419-424
Author(s):  
Paul H. Perlstein ◽  
Neil K. Edwards ◽  
James M. Sutherland
Keyword(s):  
Intensive Care ◽  
Community Hospital ◽  
Care Center ◽  
Care Facility ◽  
Telephone Network ◽  
Community Hospitals ◽  
Newborn Intensive Care

By simplifying the process by which telephone contacts are made, improved communications were established between a university-affiliated newborn intensive care center and some of the community hospital nurseries that it serves as a regional resource. Initiation of the improved system of communications was associated with a significant improvement in the survival of infants transferred from the community hospitals to the regional care facility.

scholarly journals Completeness of Prenatal Records in Community Hospital Charts

2018 ◽  
Author(s):  
Nedra W ◽  
Laura B. Strange ◽  
Sara M. Kennedy ◽  
Katrina D. Burson ◽  
Gina L. Kilpatrick
Keyword(s):  
Intensive Care ◽  
Medical Care ◽  
Medical Records ◽  
Laboratory Tests ◽  
Community Hospital ◽  
Medical Condition ◽  
Medical Conditions ◽  
Community Hospitals ◽  
Newborn Intensive Care ◽  
Common Laboratory

We describe the completeness of prenatal data in maternal delivery records and the prevalence of selected medical conditions and complications among patients delivering at community hospitals around Atlanta, Georgia. Medical charts for 199 maternal-infant dyads (99 infants in normal newborn nurseries and 104 infants in newborn intensive care nurseries) were identified by medical records staff at 9 hospitals and abstracted on site. Ninety-eight percent of hospital charts included prenatal records, but over 20 percent were missing results for common laboratory tests and prenatal procedures. Forty-nine percent of women had a pre-existing medical condition, 64 percent had a prenatal complication, and 63 percent had a labor or delivery complication. Missing prenatal information limits the usefulness of these records for research and may result in unnecessary tests or procedures or inappropriate medical care.

Back Transporting Infants From Neonatal Intensive Care Units to Community Hospitals for Recovery Care: Effect on Total Hospital Charges

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 22-26
Author(s):  
Ciaran S. Phibbs ◽  
Lynn Mortensen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Small Sample ◽  
Hospital Charges ◽  
Neonatal Intensive Care Units ◽  
Community Hospitals

Many neonates are referred to neonatal intensive care units (NICUs) for specialized care far from their parents' residence. This distance can add to the stress of the parents and reduce the contact of the parents with their newborn. Small studies have found that back transporting these neonates to hospitals closer to their homes is safe and cost-effective. Despite these findings, the reluctance of many insurers to pay for back transports prevents or delays many back transports. Insurers may not consider the findings of the previous studies to be conclusive, given that the comparisons were between small numbers of neonates back transported and neonates who remained in tertiary care, and the potential for differences in severity of illness between the groups is significant. In this study the effect on hospital charges of back transports was examined by comparing the charges for care in community hospitals with what these charges would have been in a tertiary care center. The advantage of this method is that it avoids case-mix differences between the groups and thus minimizes the potential for small-sample bias. Data were collected for all back transports from a NICU to non-tertiary care centers (n = 90) for a 9-month period. We were able to obtain the itemized bills for the care at community hospitals for 42 of these patients. Each bill was recalculated using the charges for the NICU to determine potential for savings. The average charges for recovery care were about $6200 lower at the community hospital than they would have been at the NICU. When the charges for the back transport are subtracted (mean = $1603), the average net savings are $4,600. These savings are even larger ($6163) for neonates who stayed at the community hospital for more than 7 days.

Back Transport of Neonates: Improved Efficiency of Tertiary Nursery Bed Utilization

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 918-922 ◽  
Author(s):  
August L. Jung ◽  
Carl L. Bose
Keyword(s):  
Intensive Care ◽  
Community Hospitals ◽  
Oxygen Supplementation ◽  
Newborn Intensive Care Unit ◽  
Level Ii ◽  
Hospital Beds ◽  
Critically Ill Neonates ◽  
Newborn Intensive Care ◽  
Level I ◽  
Full Occupancy

Neonatal back transport is defined as the return of previously critically ill neonates from Level III newborn intensive care units to Level II and Level I nurseries for intermediate and/or convalescing care. During 1980, 172 infants (65% of eligible infants) were back transported from a Level III nursery to both Level I and Level II community hospitals. Infants who were returned to Level II hospitals tended to be smaller at the time of transfer, were less frequently nipple fed, and more frequently required oxygen supplementation compared with infants returned to Level I hospitals. Back transport permitted physicians to defer 3,892 days of hospitalization for these infants to community hospitals, an equivalent savings of approximately ten hospital beds at full occupancy. This resulted in a 44% reduction in the need for services in the newborn intensive care unit. Back transport is an efficient means of dealing with overcrowding of Level III nurseries.

Percutaneous Insertion of Silastic Central Venous Catheters in Newborn Infants

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 484-486 ◽  
Author(s):  
Jack L. Dolcourt ◽  
Carl L. Bose
Keyword(s):  
Intensive Care ◽  
Care Center ◽  
Newborn Infants ◽  
Central Venous Catheters ◽  
Effective Alternative ◽  
Basilic Vein ◽  
Central Venous ◽  
Newborn Intensive Care ◽  
Outside Diameter ◽  
Percutaneous Insertion

Percutaneous insertion of a very narrow (0.635-mm outside diameter) Silastic catheter for delivery of central hyperalimentation was performed on infants in the Newborn Intensive Care Center. Insertion of the catheter into the external jugular or basilic vein was successful in 15/17 (88%) infants, including four weighing less than 1,000 gm. Catheters remained in place for 446 patient-days (mean 24.8 ± 15.9 days). Culture-proven infection, thrombophlebitis, or caval obstruction did not occur. Percutaneously placed central Silastic catheters proved to be a safe and effective alternative to surgically placed catheters.

Neonatal Back Transport: Clinical Outcomes

PEDIATRICS ◽  
1988 ◽  
Vol 82 (6) ◽  
pp. 845-851
Author(s):  
Terese M. Lynch ◽  
August L. Jung ◽  
Carl L. Bose
Keyword(s):  
Intensive Care ◽  
Weight Gain ◽  
Hospital Care ◽  
Community Hospital ◽  
Supplemental Oxygen ◽  
Community Hospitals ◽  
Care Givers ◽  
Appropriate Care ◽  
Tertiary Center ◽  
Clinical Problems

The convalescent course of 55 infants transported from a Level III hospital back to the community hospitals from which they were originally transported was compared with the course of 58 infants who convalesced in the tertiary center nurseries. The events in their prenatal course and acute neonatal course were similar, thus making comparisons of their convalescent course possible. Weight gain was greater among the transported infants for infants with birth weights ≥2,000 g and comparable if birth weight was <2,000 g. Transported infants received fewer transfusions than their nontransported counterparts. Tolerance of feedings, the occurrence of apnea and bradycardia, and use and discontinuance of supplemental oxygen were similar in both groups. Major new health problems occurred in 27% of all subjects, 20% of transported infants and 32% of nontransported infants. Readmission to the tertiary center or a change in status to more intensive care in the tertiary center occurred in 10% of all infants, 7% of transported and 14% of nontransported infants. It was concluded that convalescing infants often presented new clinical problems, in similar numbers and severity whether convalescing in the tertiary center or after back transport to community hospitals. Community hospital care givers were considered alert to these new problems and to have provided appropriate care, including retransfer to the tertiary center when necessary.

The changing role of GP clinicians working in community hospitals.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696713
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Helen Tucker ◽  
Angela Ellis-Paine ◽  
Jon Glasby
Keyword(s):  
Medical Care ◽  
Local Community ◽  
Community Hospital ◽  
Clinical Care ◽  
Hospital Setting ◽  
Community Hospitals ◽  
Recruitment Challenges ◽  
Acute Hospitals ◽  
Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

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