There’s no place like home for tiny patients and their families

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Welcoming a new baby is a joyous event and Markham Stouffville Hospital is proud to share in approximately 3,100 births each year. After the excitement of a birth, the next big milestone is preparing to take the new baby home. For some families, however, this milestone can take a bit longer to reach. There are times when, despite a well-planned birth, a baby requires extra care – times when a baby is born prematurely or struggles to breathe at birth. At Markham Stouffville Hospital, the Level II Neonatal Intensive Care Unit (NICU) is ready to provide a more intensive level of care to these babies in need.

For parents, the experience of having a sick baby is frightening. The baby may need to be moved from the mother’s room to be cared for in the NICU by pediatricians and specially trained registered nurses, which causes a strenuous separation. Approximately 24 to 30 times per year, this separation can be made more difficult when babies require care beyond the NICU services at Markham Stouffville Hospital and need to be transferred to a downtown tertiary centre for a higher level of critical care. These infants are transferred out to receive the care they require by the Hospital for Sick Children transport team.

Whenever one of these transfers is necessary, health-care providers in Markham Stouffville Hospital’s NICU take every step possible to make the experience as stress-free as possible for the new parents.

“A decision to transfer a baby out of our hospital for care is always a difficult one,” says Joanne Mackenzie, Director of Maternal Child and Oncology Services at Markham Stouffville Hospital. “Parents are relieved that their child will get the level of care that they need but they are also stressed about their baby being moved to a hospital that is far from their home.”

The hospital has always worked closely with tertiary care centres to bring babies back to their community hospital, or “repatriate” them, once their condition has improved. About a year ago, the hospital was able to expand these efforts due to the addition of two more NICU bassinets. With 10 NICU bassinets in total, transfers back to Markham Stouffville Hospital can occur in a timely fashion without delays due to bassinet availability. To ensure timely transfer, the hospital calls the tertiary NICUs daily to receive updates on any infant’s forecast to return to Markham. In addition, the NICU has increased the scope of services to include umbilical line care, total parenteral nutrition and peripherally inserted central catheter (PICC) lines so that infants can return home to their community at the earliest possible time.

“The increased scope of services means that we can get more babies back to our hospital sooner,” says Mackenzie. “This means that babies are back in their community, closer to their parents and extended family and that overall the family will be experiencing less stress when visiting their baby.”

Repatriating neonates is a high priority for the hospital and the unit even has flexible staff scheduling patterns to ensure extra nurses are able to accommodate a transfer of a baby coming back to the hospital.

Together these strategies have proven to be successful and have resulted in a doubling in the number of babies being transferred back to Markham Stouffville Hospital. This trend is expected to increase over the next several years.

“At Markham Stouffville Hospital, we continually work to do our best to bring newborns, born in our facility, whose parents live in our community or our Local Health Integration Network, back to our hospital to continue with their care as soon as they are stabilized,” says Dr. Munesh Singh, Pediatric Hospitalist. “This allows mom, dad and family members to have their newborn close to the comforts of home for the remainder of their hospital stay.”

Families benefit greatly and are very appreciative of the hospital’s efforts to bring their babies back home. “Markham Stouffville Hospital is our hospital,” says Uday Mohan and Shetal Patel, parents of newborn Aesha Patel, born on April 23, 2011, nine weeks early, at Markham Stouffville Hospital by emergency caesarean section.

Aesha was transferred out to Sunnybrook Health Sciences Centre for critical care within 12 hours of birth and returned back to Markham Stouffville Hospital on June 3, 2011 at just 2.5 pounds. Aesha is doing very well and she is tolerating her feedings and slowly gaining weight.

Having Aesha back in the community and close to home has made a big difference to this family. “It is comforting to know she is here and there is a sense of security knowing we do not have to travel so far,” says Patel. “There is a sense of detachment when we have to travel to see our baby.”

The benefits of bringing a baby back to the community to receive treatment also has benefits that go beyond the local hospital, they benefit the health-care system as whole.

“Taking infants back to Markham to continue with their health-care needs ensures that a critical care bed in downtown Toronto is available for other infants who June need it, which reduces out-of-province transfers, or transfers to another city,” says Dr. Larry Pancer, Chief of Pediatrics at Markham Stouffville Hospital.