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Birthing Centers Blossom

Joe Cantlupe, for HealthLeaders Media, March 13, 2012
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Birthing centers are sprouting in cities and suburbs as hospitals seek to attain ROI by outdistancing their healthcare neighbors. It's no easy task.

The Buffalo (MN) Hospital, a 45-staffed-bed facility, has incrementally expanded its birthing center since the 1990s as it kept tabs on its growing population base. After making modest adjustments in the 1990s, it built a new floor devoted to a birthing center, essentially doubling its size and added amenities, such as comforting artwork, music, Internet access, TVs, and 24-hour meal service. The Allina Hospitals and Clinics, Buffalo Hospital's parent company, made it a priority by investing $6.1 million, while the Buffalo Hospital Foundation has raised $850,000 so far toward a total of $7.1 million in improvements.

Not only does Buffalo Hospital want to continue to provide comfort to families, but it also wants to be competitive. Gretchen Frederick, RN, director of patient care at the hospital, counts off the nearby hospital facilities opening birthing centers: one 40 minutes away, another 9 minutes away, and a third 15 miles away.

Several years ago, Buffalo expanded its amenities to respond to patient needs, and surveys indicate high patient satisfaction, she says.

Over the past year, Buffalo had 626 births, which was a record year, and projects at least 700 for 2012. The hospital had projected 1,000 births for 2013, but Frederick believes that goal may not be reached. Still, the hospital is contemplating improvements to the birthing center for increased ROI, as it waits out the "ebb and flow" of population growth, which has slowed in the area, Frederick says.

Buffalo is in the planning stages of adding to its labor-delivery and C-section suites to meet continued demand, she says. An important element is the demographics of the area itself, which could give Buffalo an advantage. Buffalo is located 30 minutes northwest of the Minneapolis-St. Paul metropolitan area and has a population of 15,543. In 2009, the city reported that the population increased more than 42% from 2000.

"We are continuing to look at the business case for improvement," says Frederick. "We're actually the fastest population growth area in [Wright County] for young families. You focus on what your market bears."

Success key No. 2:  Better communications

Officials of Regions Hospital, a 425-staffed-bed facility in St. Paul, MN, looked to improve the clinical aspects of their care by establishing standardized protocols to monitor births and improve communication with patients.

In one of the protocols, the hospital established a bundling strategy to properly account for materials used in vaginal deliveries.

The hospital's program has significantly increased compliance with recommended care over time, says Julie Larson, MS, RN, director of nursing at the Regions Hospital birthing center.

A standard process includes guiding clinicians in response to information gathered during fetal heart rate monitoring, ensuring proper notification protocols involving physicians or midwives, and empowering nurses to activate a surgical team when a cesarean might be needed, according to a report Larson wrote for the AHRQ's innovation program.

"We want to focus on the communication strategies," she says. "We can't go on assumptions about what a person is thinking, even though we may be facing that person. We need to be on the same page and need to express our thoughts in those critical moments. We have just minutes to make a critical decision, and in a caesarean birth, that will affect the outcome of the baby in the future."

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