The first-ever center in the United States dedicated exclusively to improving safety for pregnant women and babies has been established through grants from The Gordon and Betty Moore Foundation and Joe Kiani/Masimo Corporation to the March of Dimes in collaboration with McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and Children’s Memorial Hermann Hospital.
The first March of Dimes Perinatal Safety Center (PSC) is an innovative concept designed to serve as a blueprint for industry-leading patient safety initiatives that can be applied at hospitals across the nation.
“The March of Dimes is proud to initiate this project that helps fulfill our goal to give every baby a healthy start in life,” says Stacey D. Stewart, president of the March of Dimes. “And it’s fitting that we partner with institutions in the Texas Medical Center, where more than 25,000 babies are delivered each year.” She noted that Sabrina Midkiff, a member of the March of Dimes National Volunteer Council and a local resident, had spearheaded the effort to create the PSC.
“This gift will expand upon efforts at UTHealth and Children’s Memorial Hermann Hospital to establish a preeminent culture of safety in maternal and infant health care, through the development of a national model devoted to mothers and babies that can be replicated throughout the country,” says Paul E. Jarris, M.D., senior vice president for Mission Impact and chief medical officer for the March of Dimes.
The grant will support the development of evidence-based techniques and training to improve patient safety during pregnancy, labor, delivery, postnatal care and transition to home life. The PSC will also focus on ways to create, teach and assess safety culture among hospitals, especially as pertains to perinatal care.
“This is a tremendous opportunity for us and all those involved in the care of mothers and babies. Although having babies in hospitals is routine in this country, we understand that there are unnecessary risks when we enter a complex healthcare system. Patient safety has to be our No. 1 priority,” says KuoJen Tsao, M.D., lead investigator for the PSC; the Children's Fund, Inc. Distinguished Professor in Pediatric Surgery at McGovern Medical School; and co-director of The Fetal Center at Children’s Memorial Hermann Hospital. “The PSC, in partnership with the March of Dimes, will serve as a framework for healthcare institutions to tackle key safety issues in caring for pregnant mothers and their babies.”
Dr. Tsao is the chair of the American Pediatric Surgical Association Quality and Safety Committee. He is the vice-chair of Quality and Safety for the Department of Pediatric Surgery at McGovern Medical School and led an initiative at Children’s Memorial Hermann Hospital that focused on establishing a culture of safety and the use of a surgical safety checklist his team created for its needs. He has been funded by the National Institutes of Health for research into safety for neonatal surgery and has led trials in resident education in patient safety. He will now take this expertise and translate it into the PSC goals.
He noted that as an international leader in maternal-infant research and initiatives, the March of Dimes is uniquely qualified to launch the PSC initiative. “And Children’s Memorial Hermann Hospital and UTHealth are two strong collaborators with outstanding reputations for providing high-quality care centered around patient safety. Together, the organizations make for a natural yet powerful partnership,” said Dr. Tsao.
McGovern Medical School at UTHealth is the only institution in the state and one of just nine centers in the entire United States to be members of both the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Neonatal Research Network and the Maternal-Fetal Medicine Unit Network.
Children’s Memorial Hermann Hospital, a Magnet®-designated hospital that has received the prestigious international Baby-Friendly® recognition, also recently received official designation from the Texas Department of State Health Services (DSHS) as a Level IV Neonatal Intensive Care Unit (NICU), the most advanced distinction available. Level IV designation recognizes the capability of a multidisciplinary team of healthcare professionals, including McGovern Medical School neonatal physicians, to care for the most critically ill babies and mothers. The hospital is one of only four facilities in the state to carry the accreditation.
With funding from the grants, the March of Dimes PSC will focus on improving four clinical problem areas:
- Improving the use of antenatal corticosteroids (ACS) for impending premature births. Treatment of women at risk of premature birth with a single course of corticosteroids to improve the infant’s lung function has been shown to decrease the risk of newborn death by about 30 percent. The team will use Children’s Memorial Hermann Hospital’s success in administering the full National Institutes of Health-recommended ACS course to all at-risk pregnant women between 24 and 34 weeks of gestation as a model. Recommendations will be included in a perinatal toolkit created to spread the use of established best practices to clinicians and organizations across the country.
- Maximizing maternal immunization for flu and pertussis (whooping cough) to provide protection against vaccine-preventable diseases in pregnant women, fetuses and newborns. According to the Centers for Disease Control and Prevention, changes in the immune system, heart and lungs during pregnancy make pregnant women more prone to severe illness, hospitalization and even death from flu. Pregnant women with flu also have a greater chance of premature labor and delivery. New research, including a 2016 study published in Clinical Infectious Diseases, has linked a higher risk of stillborn birth in mothers who were not vaccinated for flu. Maternal vaccination can help prevent more infant hospitalizations and deaths from pertussis by providing passive immunity to the child. The PSC will focus on the optimal timing of maternal vaccination and increasing flu and pertussis rates. The perinatal toolkits will include ways to help obstetrical care providers integrate immunizations into their routine practice.
- Optimizing the transition of mother and baby to home. In its statement on the hospital discharge of high-risk newborns, the American Academy of Pediatrics says infants born preterm with low birth weight who require neonatal intensive care have a much higher rate of hospital readmission and death during the first year after birth compared with health babies born at term. According to research cited in a 2012 study in the journal Perinatal and Neonatal Nursing, up to 27 percent of healthy preterm infants were readmitted to the hospital and up to 50 percent of high-risk infants who had spent time in the NICU had to be re-hospitalized. Even late-term premature infants – born between 34 and 36 weeks gestation – were readmitted to the hospital twice as often in the first year of life compared to full-term infants, according to a 2009 study in Pediatrics. The grant will support the development and feasibility of an educational smartphone app, including testing by a multidisciplinary team of parents, nurses, doctors and software engineers. The app will serve as a platform for designing future technologies to aid parents in the care of high-risk infants and children.
- Reducing early elective (medically unnecessary) deliveries before 39 weeks of pregnancy. Elective early delivery puts mother and baby at significant risk. Babies born between 37 and 39 weeks are at increased risk for admission into neonatal intensive care units (NICU), respiratory failure or distress, sepsis, feeding difficulties, jaundice, hypoglycemia, hypothermia, delayed brain development and death. The new center will focus on increasing awareness of the dangers of early elective deliveries through physician and patient education.
Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in The UT System and the U.S. Gulf Coast region, UTHealth is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing and public health and the John P. and Kathrine G. McGovern Medical School. UTHealth includes The University of Texas Harris County Psychiatric Center and a growing network of clinics throughout the region. The university’s primary teaching hospitals include Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital. For more information, visit www.uth.edu.
About Memorial Hermann
A fully integrated health system with more than 250 care delivery sites throughout the greater Houston area, including a nationally acclaimed Accountable Care Organization, Memorial Hermann is committed to delivering safe, high-quality, patient-centered care and offers world-class clinical expertise, innovation and cutting-edge technology to all patients, including its Health Plan members. The system, with its exceptional affiliated medical staff and more than 25,000 employees, provides compassionate, superior service while advancing health in Southeast Texas. Learn more about Memorial Hermann Health System.