|Ocala, FL -
April 23, 2012|
Munroe Regional Medical Center is indefinitely delaying its plans for a $1 million, Level 2 neonatal intensive care unit and a separate mother-and-child Couplet Care Model project. The move came after some local pediatricians complained to hospital administration the Couplet Care Model could put patients at risk, that plans were rushed and that the hospital didn't involve doctors enough during development of the program.
Munroe Regional had publicly rolled out a plan in March to shift to the Couplet Care Model, in which mother and newborn are kept in the same maternity room and only minimally separated. Under the proposed program, hospital nurses who once had provided care to either mother or baby would have taken care of both in the same room. The plan was then to convert the hospital's nursery into a Level 2 neonatal ICU.
Because the Couplet Care Model project is on hold, the neonatal ICU project is as well.
Eleven area pediatricians said in an April 3 letter to hospital president and CEO Steve Purves that they would give up their medical privileges at Munroe unless the project was put on hold.
The pediatricians wrote that the scheduled changes were "unacceptable and pose significant risks to the safety of our patients, and that we are unwilling to accept them in the format and time frame that has been established by the administration."
In the nearly three-page letter, the doctors wrote they weren't invited to have a role in the change of how care would be provided, although they were "assuming the risks for that care" to patients.
They went on to write: "We were effectively blindsided by the advanced stage, late June launch date, and covert planning of the Couplet Care project."
The pediatricians wrote that "unless the launch of the Couplet Care project is postponed until we have sufficient time to adequately address our concerns, make appropriate adjustments and ensure the ongoing high level of competency currently in place in the in the newborn nursery, each of the undersigned resigns his/her privileges on the medical staff of the MRMC effective June 25, 2012."
The pediatricians also said they were concerned that the Couplet Care rooms wouldn't have adequate lighting to examine babies, that nurses would be asked to work in areas outside their field of expertise, and that the program would begin during the busiest time of the year for baby deliveries.
The new program, they wrote, also created logistical problems getting access to patient records and staff during physician rounds.
The letter was signed by the following doctors: Slyvester Ajufo, Cheryl J. Hawk, Paul C. Logas, Sukhbir Nijher, Yves-Lande Pierre, Stephanie S. Harrell, Susan F. Kerns, Kenneth H. Morse, Christopher Okonkwo, Humeraa Qamar and Jose Velez-Borras.
In an April 13 letter to the pediatricians, Purves said that based on the pediatricians' concerns, the plans were "on hold indefinitely."
Purves wrote to the pediatricians, in part, "let me say that we value your opinion and your input and despite significant effort on everyone's part, it is perfectly clear that more work needs to be done in order to secure your support of this change in Munroe."
In his letter, Purves invited the pediatricians to meet with him to better plan strategies for servicing Marion County's pediatric needs.
The purpose of the Level 2 neonatal ICU was to provide care for babies with moderate illness following their delivery. It would also have allowed families with ill babies that had been delivered elsewhere to return to the area continuing to receive level two care.
In an April 17 letter, Purves let hospital board members and other administration members know of his decision.
Purves told the Star-Banner he didn't yet have additional communications with the pediatricians who wrote the letter, but was planning to meet with them about the importance of the projects.
"You need their support," he told the Star-Banner, adding later, "We still believe it's very important in the community and we hope we can move forward with it."