The award-winning Children’s Mercy Transport team has partnered with the Elizabeth J. Ferrell Fetal Health Center to provide safe and specialized transport for pregnant women needing immediate access to a higher level of care. This new service provides an invaluable resource for our region to ensure immediate transportation is offered, to the best place of care, for both mom and unborn baby.
Hear from Sherry McCool, RRT-NPS, MHA, CMTE and Melanie Foltz, MSN, RN, on the benefits it will offer our region.
Maternal Fetal Transport: Ensuring the Best Care for Expecting Mothers
Featured Speaker:
Sherry McCool RRT-NPS, MHA, CMTE is the Director of Critical Care Transport at Children’s Mercy Kansas City. McCool has over 20 years of experience in Neonatal and Pediatric Transport and an extensive background in safety, communications, flight and ground operations. In 2012, she received the CMH Excellence in Leadership Award. McCool received her Cerner Certificate in Healthcare Leadership from the UMKC Bloch School of Management and holds a Certificate in Advanced Quality and Safety Training.
Sherry McCool, RRT-NPS, Melanie Foltz, MSN
Melanie Foltz, MSN RN, has more than 15 years of experience in the field of high-risk obstetrics. She earned a Bachelor’s of Science in Nursing at Kansas University and a Master’s of Science in Nursing at the University of Phoenix. Foltz currently serves as the Director of Fetal Health Services at the Elizabeth J. Ferrell Fetal Health Center at Children’s Mercy Kansas City.Sherry McCool RRT-NPS, MHA, CMTE is the Director of Critical Care Transport at Children’s Mercy Kansas City. McCool has over 20 years of experience in Neonatal and Pediatric Transport and an extensive background in safety, communications, flight and ground operations. In 2012, she received the CMH Excellence in Leadership Award. McCool received her Cerner Certificate in Healthcare Leadership from the UMKC Bloch School of Management and holds a Certificate in Advanced Quality and Safety Training.
Transcription:
Maternal Fetal Transport: Ensuring the Best Care for Expecting Mothers
Dr. Michael Smith (Host): Our topic, today is, “Maternal-Fetal Transport: Ensuring the Best Care for Expecting Mothers.” I have two guests today. I have Melanie Fultz. She has 15 years in the field of high-risk obstetrics, and she’s also the director of the Fetal Health Services at the Elizabeth J. Ferrell Fetal Health Center at Children’s Mercy Kansas City. And then I also have Sherry McCool. She’s the director of Critical Care Transport at Children’s Mercy Kansas City. Melanie, Sherry, welcome to the show.
Sherry McCool (Guest): Hello.
Melanie Foltz (Guest): Thank you.
Dr. Smith: So why don’t we start with this – I’m going to ask you, Sherry, to start us off a little bit. Tell us a little bit about the history of needing this type of transport team at Children’s Mercy.
Sherry: Yeah, so to give you a little bit of background on how the talk started with this, almost two to three years ago we started talking about having the ability to provide transport for a mother that needs to get to a higher level of care to deliver her baby. As we know, the best incubator, per se, for a baby, is actually a mom. Our transport team has been in existence since the early 70s and is a very robust neonatal and pediatric team with 13 ambulances, a helicopter, a plane and a jet, very robust. We really had all of the pieces when we started talking about this, and it made a perfect fit with our fetal health center and having the clinical expertise within Children’s Mercy from our maternal-fetal physicians to our OB nurses -- to actually just bring them to the transport team, start training them to transport logistics, and adding their clinical piece to our already complex transport program and to be able to provide a service that currently doesn’t exist today in the community.
Dr. Smith: So what exactly is the program, then? Tell us a little bit about how makes up the team, what type of backgrounds do they have, and certifications?
Sherry: Currently, our transport team is a critical care pediatric nurse and neonatal nurse – they’re both cross trained – and a respiratory therapist, EMT, and paramedic. What we’re going to do with the maternal team is we’ll actually be bringing a high-risk OB trained transport nurse onto our existing configuration. With that, our medical control – our people that will be guiding us when we’re out in the field, is going to be maternal-fetal physicians here a Children’s Mercy. It’s really providing a different level of care than has been out there providing care to mom because we’re actually taking OB-trained, experienced individuals out into the field to care for these patients.
One of the things we require is a robust experience, multiple years experience of high-risk OB before they can be on our team. The nurses from the Fetal Health Center at Children’s have been actually riding and training with our transport team for about a year, getting that experience and really making this program one that’s going to be really good for moms and getting them to where they need to go.
Dr. Smith: Obviously high-risk pregnancies are identified pretty early on, so when does your team actually start talking with the physician -- or the health care practitioner, and the mom, and the family? How early does this all begin?
Sherry: I think anytime a mom is going into preterm labor, or maybe has pre-eclampsia and that mom maybe is two-hours away from Kansas City and presents to an ED or presents to her provider and what they determined is that facility there does not have the capabilities to either care for a preterm infant or care for mom because they don’t have those extended OB services. They would call and talk to our maternal-fetal physician, and we would launch a transport team to them. One of the things that’s really great about this combination is that not only are we adding that high-risk OB nurse, we’re also – if we get to a patient and find that maybe they’re too progressed in preterm labor, we have our neonatal team that can assist with the baby if they are born at that facility and provide that high level of care to the infant. That’s the overall goal and meeting the goal of what Children’s Mercy always does is making sure we provide the best care to the infant, whether that’s transporting mom or actually standing by and taking care of the baby as needed.
Dr. Smith: Melanie, I noticed that you are working with the Fetal Health Center at Children’s Mercy Kansas City. I think it’s the Elizabeth J. Ferrell Fetal Health Center. Tell us a little bit about that center and your role in working with the transport team.
Sherry: The Fetal Health Center is a fairly new program at Children’s Mercy Hospital. It is about seven years old for outpatient services and six years old for inpatient services. The Fetal Health Center was established to really help our moms that know that their newborn will end up in our intensive care unit. We have one of the highest level intensive care units within the region – a level four NICU is what a lot of people call that. That being said, we see these families that have known fetal differences that will need treatment immediately after birth – possibly treatment from our surgeons, possibly treatment from a neonatal standpoint.
We see these moms referred to us with a fetal difference and see them on an outpatient basis. We do ultrasound testing -- what we’d call an integrated consult to educate mom on what to expect – and another layer of that service is should they need our intensive care services after delivery they can deliver within our program. We are one of a few free-standing pediatric hospitals that provide labor and delivery postpartum services within the walls of the hospital. That ultimately is so that we can keep mom and baby together instead of having a baby ship out via transport or other means, to an intensive care nursery while mom is at another hospital.
Dr. Smith: I see here, Melanie, that the Children’s Mercy transport team is award-winning. Can you tell us a little bit about the awards that you guys have won?
Melanie: I can defer that to Sherry, but there are several awards that she has actually – she can speak very well to --
Dr. Smith: Okay, Sherry?
Melanie: And from a transport standpoint.
Dr. Smith: Sure, okay.
Sherry: Yeah, I can talk a little bit about those. Our transport team – currently, we’re doing around 5,600 transports annually and the awards we have won over the last, probably ten years, our -- the Association of Air Medical Services and the big, really critical care transport association in the country – we have won multiple awards. One of those has been the Critical Care Ground Provider of the Year. We’ve won that award, and that is not just in pediatric neonatal, that is within all transport programs across the country. We also were awarded the Fixed Wing and Transport Program of the Year, the Overall Transport Program of the Year, and most recently we were named the Neonatal/Pediatric Transport Team of the Year. We’re very proud that we have a very well-rounded expertise and those awards are based off of safety and protocol, care and quality provided to patients, so we’re really proud of those awards and the things that we’ve accomplished.
Dr. Smith: Right. I want to end by asking both of you the same question, and we’ll just start with Melanie. Where do you see this going, Melanie? What’s your vision for this type of program? Are there some new innovations that can be utilized in the transport care of a mom? What do you think?
Melanie: Most certainly, a maternal transport program in tandem with our pediatric, neonatal transport program is an innovation in itself. It is becoming seen as a great standard of care for programs that have a transport fleet such as the one we have at Children’s Mercy Hospital. Our goal for the program, and beginning this innovation is to ensure that we provide specialized, quality care for the high-risk maternal patients versus calling a local EMS service. They are providing quality care, but to have a maternal-fetal medicine physician or perinatologist present to help manage that patient with a high-risk OB nurse is definitely an added layer of specialized care for these moms. So really, that goal is to increase our quality of care for that mom. Also, another piece of this puzzle is to keep mom and baby together versus having a baby deliver and having to transport a baby out and be able to get that mom to a center that they can keep them together.
Our true goal and our future goal is to increase our visibility in the community as a quality provider for the high-risk obstetric transport and to continue to gather data and evaluate how we are doing and continue to improve.
Dr. Smith: Sherry, what about you? Where would you like to see this program go?
Sherry: Yeah, I really think we see some pockets nationally where people are beginning to recognize that this is – in the transport industry, high-risk OB and actually having high-risk OB clinicians take care of the mom is really something that has not taken hold yet. It’s really not become the norm. What I see is, really, we’re in a unique situation in that Children’s actually has the services of the Fetal Health Center here. I really do see this as being something that is going to really improve the care to mom and baby and something I think that we can see maybe becoming – something that’s more of a standard of care nationally, and possibly we’ll be able to improve the quality, of course to our patients, but then also to set and be the standard for other programs who want to look at this in their community that don’t currently have these resources.
Dr. Smith: Melanie and Sherry, I want to thank you guys for the work that you’re doing. It really is quite amazing, and you guys have obviously come together and put together a great program that will continue to grow. I wish you the best of luck for it and thank you, for coming on the show today. You’re listening to Transformational Pediatrics with Children’s Mercy, Kansas City. For more information, you can go to ChildrensMercy.org, that’s ChildrensMercy.org. I’m Dr. Mike Smith. Thanks for listening.
Maternal Fetal Transport: Ensuring the Best Care for Expecting Mothers
Dr. Michael Smith (Host): Our topic, today is, “Maternal-Fetal Transport: Ensuring the Best Care for Expecting Mothers.” I have two guests today. I have Melanie Fultz. She has 15 years in the field of high-risk obstetrics, and she’s also the director of the Fetal Health Services at the Elizabeth J. Ferrell Fetal Health Center at Children’s Mercy Kansas City. And then I also have Sherry McCool. She’s the director of Critical Care Transport at Children’s Mercy Kansas City. Melanie, Sherry, welcome to the show.
Sherry McCool (Guest): Hello.
Melanie Foltz (Guest): Thank you.
Dr. Smith: So why don’t we start with this – I’m going to ask you, Sherry, to start us off a little bit. Tell us a little bit about the history of needing this type of transport team at Children’s Mercy.
Sherry: Yeah, so to give you a little bit of background on how the talk started with this, almost two to three years ago we started talking about having the ability to provide transport for a mother that needs to get to a higher level of care to deliver her baby. As we know, the best incubator, per se, for a baby, is actually a mom. Our transport team has been in existence since the early 70s and is a very robust neonatal and pediatric team with 13 ambulances, a helicopter, a plane and a jet, very robust. We really had all of the pieces when we started talking about this, and it made a perfect fit with our fetal health center and having the clinical expertise within Children’s Mercy from our maternal-fetal physicians to our OB nurses -- to actually just bring them to the transport team, start training them to transport logistics, and adding their clinical piece to our already complex transport program and to be able to provide a service that currently doesn’t exist today in the community.
Dr. Smith: So what exactly is the program, then? Tell us a little bit about how makes up the team, what type of backgrounds do they have, and certifications?
Sherry: Currently, our transport team is a critical care pediatric nurse and neonatal nurse – they’re both cross trained – and a respiratory therapist, EMT, and paramedic. What we’re going to do with the maternal team is we’ll actually be bringing a high-risk OB trained transport nurse onto our existing configuration. With that, our medical control – our people that will be guiding us when we’re out in the field, is going to be maternal-fetal physicians here a Children’s Mercy. It’s really providing a different level of care than has been out there providing care to mom because we’re actually taking OB-trained, experienced individuals out into the field to care for these patients.
One of the things we require is a robust experience, multiple years experience of high-risk OB before they can be on our team. The nurses from the Fetal Health Center at Children’s have been actually riding and training with our transport team for about a year, getting that experience and really making this program one that’s going to be really good for moms and getting them to where they need to go.
Dr. Smith: Obviously high-risk pregnancies are identified pretty early on, so when does your team actually start talking with the physician -- or the health care practitioner, and the mom, and the family? How early does this all begin?
Sherry: I think anytime a mom is going into preterm labor, or maybe has pre-eclampsia and that mom maybe is two-hours away from Kansas City and presents to an ED or presents to her provider and what they determined is that facility there does not have the capabilities to either care for a preterm infant or care for mom because they don’t have those extended OB services. They would call and talk to our maternal-fetal physician, and we would launch a transport team to them. One of the things that’s really great about this combination is that not only are we adding that high-risk OB nurse, we’re also – if we get to a patient and find that maybe they’re too progressed in preterm labor, we have our neonatal team that can assist with the baby if they are born at that facility and provide that high level of care to the infant. That’s the overall goal and meeting the goal of what Children’s Mercy always does is making sure we provide the best care to the infant, whether that’s transporting mom or actually standing by and taking care of the baby as needed.
Dr. Smith: Melanie, I noticed that you are working with the Fetal Health Center at Children’s Mercy Kansas City. I think it’s the Elizabeth J. Ferrell Fetal Health Center. Tell us a little bit about that center and your role in working with the transport team.
Sherry: The Fetal Health Center is a fairly new program at Children’s Mercy Hospital. It is about seven years old for outpatient services and six years old for inpatient services. The Fetal Health Center was established to really help our moms that know that their newborn will end up in our intensive care unit. We have one of the highest level intensive care units within the region – a level four NICU is what a lot of people call that. That being said, we see these families that have known fetal differences that will need treatment immediately after birth – possibly treatment from our surgeons, possibly treatment from a neonatal standpoint.
We see these moms referred to us with a fetal difference and see them on an outpatient basis. We do ultrasound testing -- what we’d call an integrated consult to educate mom on what to expect – and another layer of that service is should they need our intensive care services after delivery they can deliver within our program. We are one of a few free-standing pediatric hospitals that provide labor and delivery postpartum services within the walls of the hospital. That ultimately is so that we can keep mom and baby together instead of having a baby ship out via transport or other means, to an intensive care nursery while mom is at another hospital.
Dr. Smith: I see here, Melanie, that the Children’s Mercy transport team is award-winning. Can you tell us a little bit about the awards that you guys have won?
Melanie: I can defer that to Sherry, but there are several awards that she has actually – she can speak very well to --
Dr. Smith: Okay, Sherry?
Melanie: And from a transport standpoint.
Dr. Smith: Sure, okay.
Sherry: Yeah, I can talk a little bit about those. Our transport team – currently, we’re doing around 5,600 transports annually and the awards we have won over the last, probably ten years, our -- the Association of Air Medical Services and the big, really critical care transport association in the country – we have won multiple awards. One of those has been the Critical Care Ground Provider of the Year. We’ve won that award, and that is not just in pediatric neonatal, that is within all transport programs across the country. We also were awarded the Fixed Wing and Transport Program of the Year, the Overall Transport Program of the Year, and most recently we were named the Neonatal/Pediatric Transport Team of the Year. We’re very proud that we have a very well-rounded expertise and those awards are based off of safety and protocol, care and quality provided to patients, so we’re really proud of those awards and the things that we’ve accomplished.
Dr. Smith: Right. I want to end by asking both of you the same question, and we’ll just start with Melanie. Where do you see this going, Melanie? What’s your vision for this type of program? Are there some new innovations that can be utilized in the transport care of a mom? What do you think?
Melanie: Most certainly, a maternal transport program in tandem with our pediatric, neonatal transport program is an innovation in itself. It is becoming seen as a great standard of care for programs that have a transport fleet such as the one we have at Children’s Mercy Hospital. Our goal for the program, and beginning this innovation is to ensure that we provide specialized, quality care for the high-risk maternal patients versus calling a local EMS service. They are providing quality care, but to have a maternal-fetal medicine physician or perinatologist present to help manage that patient with a high-risk OB nurse is definitely an added layer of specialized care for these moms. So really, that goal is to increase our quality of care for that mom. Also, another piece of this puzzle is to keep mom and baby together versus having a baby deliver and having to transport a baby out and be able to get that mom to a center that they can keep them together.
Our true goal and our future goal is to increase our visibility in the community as a quality provider for the high-risk obstetric transport and to continue to gather data and evaluate how we are doing and continue to improve.
Dr. Smith: Sherry, what about you? Where would you like to see this program go?
Sherry: Yeah, I really think we see some pockets nationally where people are beginning to recognize that this is – in the transport industry, high-risk OB and actually having high-risk OB clinicians take care of the mom is really something that has not taken hold yet. It’s really not become the norm. What I see is, really, we’re in a unique situation in that Children’s actually has the services of the Fetal Health Center here. I really do see this as being something that is going to really improve the care to mom and baby and something I think that we can see maybe becoming – something that’s more of a standard of care nationally, and possibly we’ll be able to improve the quality, of course to our patients, but then also to set and be the standard for other programs who want to look at this in their community that don’t currently have these resources.
Dr. Smith: Melanie and Sherry, I want to thank you guys for the work that you’re doing. It really is quite amazing, and you guys have obviously come together and put together a great program that will continue to grow. I wish you the best of luck for it and thank you, for coming on the show today. You’re listening to Transformational Pediatrics with Children’s Mercy, Kansas City. For more information, you can go to ChildrensMercy.org, that’s ChildrensMercy.org. I’m Dr. Mike Smith. Thanks for listening.