Texas Children’s Pavilion for Women, a preeminent facility for women’s health and high-risk obstetrical and fetal care, was recently designated as a level IV maternal care facility, the highest level of care available. The designation followed a rigorous site visit conducted by the EMS/Trauma Systems Office of the Texas Department of State Health Services. A level IV maternal care facility provides comprehensive care for pregnant and postpartum patients, from those with low-risk conditions up to and including the most complex medical, surgical and/or obstetrical conditions that present a high-risk of maternal morbidity or mortality.
“This designation certifies that we offer the highest level of care for the most complex obstetric patients,” Dr. Christina Davidson, a maternal-fetal medicine specialist and chief quality officer at Texas Children’s Pavilion for Women, said. “It speaks to the expertise of our clinical teams and the processes we have in place to ensure high-quality care and the positive outcomes we strive for.”
With the overall goal of reducing infant and maternal morbidity and mortality in the United States, the designation comes as the result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. The intent of the legislation is to ensure both neonatal intensive care units (NICUs) and maternal care facilities have the resources and expertise to provide high-quality, specialized patient care that leads to the best outcomes for mothers and babies.
The NICU at Texas Children’s Hospital, the nation’s largest, housing 173 beds, was the first in Texas to be designated as a level IV NICU in April 2017.
Texas is one of the first states requiring maternal care facilities undergo a site visit to verify the level of care provided to patients meets the Maternal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement to receive Medicaid reimbursement for obstetrical care by Aug. 31, 2020.
“This designation is the fruit of the work we perform daily. It is recognition by the Department of State Health Services of Texas Children’s commitment and investment to maternal health,” Dr. Nan Ybarra, director of nursing for inpatient services at Texas Children’s Pavilion for Women, said. “With over 6,200 deliveries annually, we are committed to serving women in our community and partnering with community hospitals to strengthen their maternal care processes and programs – our singular goal is to improve outcomes for pregnant women across Texas and beyond.”
Texas Children’s announced in January it opened one of the nation’s few intensive care units dedicated solely to obstetrical critical care. It is the only four-bed maternal ICU in the country staffed 24/7 by both pulmonary critical care and maternal-fetal care teams embedded in a hospital’s labor and delivery unit. This maternal ICU offers a specialized, private space for high-risk expectant and postpartum mothers with conditions such as sepsis, peripartum bleeding, placenta accreta, maternal heart disease and other serious conditions.
The hospital also has a nationally known placenta accreta spectrum program, where a team of experts provide comprehensive, multidisciplinary care for women with this potentially life-threatening pregnancy complication that occurs in approximately 1 in 1,000 to 2,000 pregnancies.
Additionally, in 2017, Texas Children’s obstetrics service partnered with the hospital’s Kangaroo Crew to create the Maternal Transport Service, further bolstering its reputation as a primary referral site for patients with high-risk pregnancies. The team, consisting of a Kangaroo Crew nurse, labor and delivery nurse, respiratory therapist, and EMT, can provide specialty care to mothers while enroute to the Pavilion for Women, helping the hospital’s community partners transport their sickest patients for the most optimal outcomes for mothers and babies.
“It’s crucial for women, especially those experiencing a high-risk pregnancy, to be educated about the level of obstetrical care available in the facility in which they plan to deliver,” Dr. Michael Belfort, obstetrician/gynecologist-in-chief at Texas Children’s Pavilion for Women, said.