Mothers, sick babies need more Ky. care

Bob Prichard, M.D., is chief medical officer of St. Elizabeth Healthcare.
Bob Prichard, M.D., is chief medical officer of St. Elizabeth Healthcare.

At issue | April 19 Herald-Leader editorial "Preemie decision needs thought; expansion may diminish care"

The editorial got it exactly right when it stated, "what's at stake is an important policy concern for all of Kentucky and a potentially harmful precedent for preemies." The problem is that the newspaper supported the very side that would do the least to help Kentucky mothers and their babies.

St. Elizabeth Healthcare, headquartered in Northern Kentucky, is seeking state approval to offer Level III (a) neonatal intensive care services which will improve the health of premature infants born to Northern Kentucky moms and save the lives of some of those preemies.

Premature babies need to be near the best possible care, and their mothers need to be with them. This is consistent with the national Guidelines for Perinatal Care (6th edition), drafted jointly by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Right now, virtually all Level III services in Kentucky are in Lexington and Louisville. We don't think that's enough to serve an entire state. Transporting mothers in pre-term labor or babies that are born prematurely or with serious conditions increases risks.

Better geographic distribution will enhance access to care for mothers and their babies. The Kentucky Hospital Association agrees, which is why it issued recommendations to the Cabinet for Health and Family Services in 2010 to update the NICU guidelines in the State Health Plan and provide for regional distribution of NICU services.

St. Elizabeth is going through the certificate of need process for its Edgewood facility. That is being opposed by the University of Kentucky, despite the fact it, "... wouldn't take any business away from UK," as the editorial says."

Interestingly, Cincinnati Children's Hospital, with the third-best neonatology program in the country, supports St. Elizabeth's certificate of need efforts because Children's officials know it is better for patients if Level III (a) services are offered in Northern Kentucky.

Currently, preemies have to be transported from Northern Kentucky to Cincinnati in specially equipped vehicles. This transport presents palpable risks to the preemies. If those risks can be eliminated, we will save the lives of some babies and improve outcomes for countless others. That is the opinion not just of St. Elizabeth but of some of the world's leading neonatologists who have testified in favor of St. Elizabeth's proposal.

There is no "harmful precedent" at stake, as the Herald-Leader editorial suggests. Other state hospitals interested in providing Level III (a) NICU services would have to go through the same certificate of need process. If they are successful, it will be on their own merits, not because of St. Elizabeth.

Kentuckians should want their babies born in the Bluegrass state. Because of limited access to Level III (a) NICU services, several thousand women have their babies in Ohio, Indiana, Tennessee, Missouri and Virginia.

In 2010, more than 700 Northern Kentucky mothers had their babies in Ohio because the level of care they needed was provided there. In many of these cases, mothers were separated from their babies for extended periods of times because of lack of access to adequate public or private transportation.

It is disappointing that the University of Kentucky is spending taxpayers' money to challenge a health care service that will only serve Northern Kentucky.

So, we ask, why? We're talking about the lives of babies who need the best care possible.

St. Elizabeth will deliver nearly 5,000 babies in 2011; leading neonatologists have indicated they know of very few programs in the U.S. that birth 5,000 babies a year without offering the higher level of neonatal care.

We are a major health care system serving 500,000 people, that has been recognized as one of America's 50 Best Hospitals by HealthGrades for five consecutive years and is designated a Magnet hospital for nursing excellence.

We remain steadfast in our commitment to winning approval for a Level III (a) NICU. That is the logical next component for our obstetrics service, and we know we can team with Cincinnati Children's to offer the very best Level III (a) care for our community, our patients, and our mothers in need.

That is our mission. That is what we should all strive to do.

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