21 / 32
V
irginia
C
apitol
C
onnections
, S
ummer
2017
21
I’d like you to think back to your
childhood for a moment, if you would.
If you’re like me, you probably had a
parent who stressed the importance of
a balanced breakfast each morning to
get you off to a good start for the day.
A similar principle applies in the world
of neonatal and perinatal care – in
short, giving babies a healthy start is an
important factor in influencing future
success and productivity throughout a
person’s life.
Getting mothers and babies the health care services they need
to make a strong start together is a key focus for members of
Virginia’s health care community engaged in perinatal, neonatal,
and pediatric care. While that never ends, Virginia has achieved
some encouraging results. For example, data released at the end
of 2016 showed the Commonwealth had achieved the lowest
early elective delivery (EED) rate in the nation. In recent years,
Virginia lowered its EED rate from 8 percent to 1.3 percent,
ranking the Commonwealth first in the nation in reducing
EEDs, according to federal Hospital Compare data. Virginia
previously had been ranked 24th in the nation on EED rate based
on Hospital Compare data released in 2014. Reducing EEDs
is important because research has shown that babies carried to
full term (after 39 weeks of gestational age) can improve birth
outcomes and have lasting positive effects on lifelong health.
Previously, conventional wisdom held that babies born between
37 and 39 weeks were generally as healthy as those carried to
full term. Alongside that came a trend toward early elective
deliveries. It is now known that babies are still developing in the
final weeks of gestation and that early deliveries which are not
medically necessary should be avoided. Virginia’s community
hospitals and health systems, the Virginia Hospital & Healthcare
Association’s (VHHA) Center for Healthcare Excellence, the
American College of Obstetricians and Gynecologists (ACOG),
the Medical Society of Virginia (MSV), the March of Dimes
(MOD), and other health care providers and stakeholders have
worked in recent years to reduce EEDs.
In addition to the focus on EEDs, health care providers in this
arena are also working to decrease primary, normal presentation
cesarean births, promote safe sleep environments, and a range of
other strategies to prevent prematurity and maternal and infant
morbidity and mortality.
Yet another challenge providers are confronting is the effect
the ongoing opioid crisis is having on mothers and babies. In
Virginia, opioid-related fatalities have become the leading
cause of accidental deaths, overtaking car crashes to earn that
ignominious distinction. And while we often associate this health
crisis with the adult population, it is also impacting very young
patients. Many babies born to mothers with an opioid addiction
can experience withdrawal symptoms due to a drug exposure
Hospital and Healthcare Association
By Joan Williamson, RN, MN, CPHQ, CPPS • Virginia Patient Safety Organization Director • Virginia Hospital & Healthcare Association
in the womb. This condition is called neonatal abstinence
syndrome, or NAS. Babies born with NAS can be prone to
involuntary behaviors atypical in infanthood such as reduced
quality and length of sleep following a feeding; increased muscle
tone, tremors, and convulsions; respiratory-related issues such as
sweating, frequent yawning, and sneezing; and gastrointestinal
issues such as excessive sucking, poor feeding, vomiting, and
loose stools. Often, these symptoms are relatively short-lived.
However, some research suggests that this condition could have
longer lasting effects on children’s development.
And unfortunately, the prevalence of NAS is growing. Data
shows the number of infants diagnosed with NAS quadrupled
from 2012-2016. Last year, more than 770 Virginia newborns,
out of nearly 96,000, were diagnosed with NAS. In other
words, 1 percent of Virginia babies born in 2016 exhibited NAS
symptoms.
In an effort to combat this public health challenge,
members of Virginia’s hospital community have joined with
VHHA, MOD, and ACOG to launch the Virginia Neonatal
Perinatal Collaborative (VNPC) to focus on improving birth
health for mothers and babies in the Commonwealth. VNPC is
initially prioritizing improvements in care for pregnant women
diagnosed with substance use disorders and infants impacted
by NAS. That work is being supported by the Virginia General
Assembly. During the 2017 legislative session, Delegate Chris
Stolle, an obstetrician-gynecologist from Virginia Beach,
successfully patroned House Joint Resolution 745 to raise
awareness for efforts to improve birth health by designating
the first week of July as Substance-Exposed Infant Awareness
Week in the Commonwealth of Virginia. That resolution was
part of a package of legislation introduced to address Virginia’s
opioid crisis. And Senator Siobhan Dunnavant, an obstetrician-
gynecologist from Henrico County, helped secure in the new
fiscal year state budget cycle that began July 1 funding to
support the establishment of VNPC.
The VNPC was formally launched at a State Capitol news
conference in late July featuring representatives from Carilion
Roanoke Memorial Hospital, Children’s Hospital of Richmond
at VCU, HCA Virginia Health System, Riverside Health System,
University of Virginia Health System and UVA Children’s
Hospital, and VCU Health System. These are just a few of
the stakeholders engaged with the Virginia Neonatal Perinatal
Collaborative, which exists to ensure that every mother has
the best possible perinatal care, and every infant cared for in
Virginia has the best possible start to life. We believe in an
evidence-based, data-driven collaborative process that involves
care providers for women, infants, and families, as well as state
and local leaders. We believe that working together now will
create a stronger, healthier Virginia in the future.
Wow! I think this is a perceptive observation. Personally, I would
rather read a short poem saying this kind of thing then listening to hours
of babbling from television commentators and personalities.
Language has power. We all still value it, but time is at a premium,
and we don’t want our time wasted. Finding ways to make each word
count as it tries to communicate an idea, a thought, a feeling, a whim is
important to all of us. Try poetry. You might be surprised at what you
can do.
Continued from previous page
V
V