Dozens of babies are born without complications each day in Utah hospitals. But whether the parents and these healthy infants are ready to set out on their own after just hours or a couple of days in the hospital is a question doctors, nurses and others are pondering.
What can be done to "better launch" families was the subject of the daylong Paul Ensign Vision Conference at the University of Utah Friday.The conference was held in honor of the late Dr. Paul Ensign, a longtime pediatrician who wanted to have a global impact on child health by improving medical practice and policy. He was an early proponent of well-baby care.
Dozens of health-care professionals, parents and others gathered to assess not only how well the professionals who surround a birth get families off to a good start, but to make concrete recommendations about ways to improve. Those recommendations will be presented to hospital staffs and written up in a local medical bulletin in hopes that needed changes will be made.
The length of hospital stays has been at the heart of recent concerns, nationally and locally.
A federal law that took effect Jan. 1 generally ended the practice of "drive-by deliveries" by mandating a 48-hour stay for newborns and their mothers following a routine delivery. A Caesarean birth can require up to 96 hours. Both have some exceptions, including where patient and doctor agree that the duo are ready to go home.
In that 48 to 96 hours, doctors and nurses try to reassure and educate families, assess the health of mother and child and generally make certain that everything's OK.
That may not be enough, according to Dr. George Durham II, pediatrician and division chief of Community Pediatrics at the University of Utah and chairman of the Ensign conference.
Before participants got down to drafting recommendations, Durham listed his own concerns about prenatal-to-postnatal care as it's practiced today. He's particularly frustrated that "many newborns have no medical home," meaning there's no close contact with a pediatrician or clinic or other setting a family automatically turns to when a child is ill or when there are questions.
He also sees communication problems between obstetrics and pediatrics communities. "That kind of interaction is not happening as we divide into our third-party payer camps . . . We have not had a seamless hand-off from prenatal to postnatal care."
Besides improving communication between health-care providers, Durham also wants improved communication between doctors and parents - particularly where there's a language barrier. While Utah has been characterized by outsiders as a "white bread, bland community," his own experiences have shown that Utah is "increasingly multicultural, with multiple languages."
Sometimes, he said, if the other language isn't Spanish, doctors must search for interpreters or simply give up on real communication with parents.
Participants also planned to discuss ways to help families who choose to breast-feed succeed. And they hope to improve immunization rates.
Because it's a huge topic, said Reba Keele, conference facilitator, the conference was based on a set of basic assumptions: That hospital stays should be tailored to the individual mother/baby couplet; that newborns should have an identified doctor for regular care before they leave the hospital; that breast-feeding is "optimal," and that education is an essential part of newborn care.