Clinical Programs
Program for Fetal Concerns:
A new program that incorporates expertise from at least seven different departments has been created to care for unborn and newborn babies with abnormalities and educate and assist their families. The Program for Fetal Concerns, a joint program of Obstetrics and Gynecology and Pediatrics, was created by the Medical College of Wisconsin, Children's Hospital of Wisconsin and Froedtert Hospital. It is the first program of its kind in Wisconsin.
While some program services have always been provided, 50 families have received the program's comprehensive care since September 5th. Assistance begins with prenatal diagnosis of an abnormality, and continues for one year after delivery.
Thomas R. Wigton, MD, Associate Professor of Obstetrics and Gynecology, and Steven R. Leuthner, MD, Assistant Professor of Pediatrics and Bioethics, are co-directors, and Emilie Lamberg Jones, RN, BSW, Clinical Nurse Specialist is the program coordinator.
Making the program successful is the effective interaction of the many departments and services involved. This includes: Perinatology, Neonatology, Genetics, General Surgery, Cardiology and Cardio thoracic Surgery, Nephrology and Urology, Neurology and Neurosurgery, Orthopedic Surgery, the Cleft Lip and Palate Center, as well as the Palliative Care Service, the Infant Death Center and Chaplains' Services at CHW.
The purpose of the program is to provide a more comprehensive service for families who have concerns for their fetus, particularly when there is a prenatal diagnosis of a fetal anomaly. The strength of the program is in the effective interaction of the various specialties in giving the women and families complete information and an understanding of what the problem means for them and their future child. They meet with the specialists who will care for their child after birth and tour the facilities where they will receive care. This allows for more informed decision-making on all aspects of care from delivery to neonatal care, as well as supportive care and reduced anxiety for families.
The program is expected to generate referrals from throughout Wisconsin and the Midwest. Families can come for the highly specialized care and service it provides, or to get a second opinion.
We hope that this program offers physicians a resource in helping them help their patients seek out up-to-date information on what a diagnosis means, and what are the current subspecialty abilities for the newborn. It will offer one-stop shopping in the sense that one phone call from a physician or patient provides access to all services at MCW, Froedtert and the Medical College. Jones coordinates the rest, providing information, consultations, and support for the families and feedback to the referring physician.
In addition to the extensive medical expertise available to babies diagnosed with birth defects, the Program for Fetal Concerns offers a variety of services to their parents:
- Education on the abnormality
- Education on the birthing problems that may arise
- Education on the additional care the child may need
- Meetings with the providers who will care for their child after birth
- Help with decision-making
- Financial counseling
- Tours of the birthing center and NICU/PICU should their infant need care there
- Emotional support and grief counseling
The program, housed in Obstetrics and Gynecology, is funded by the two hospitals and the MCW Department of Pediatrics. A toll free phone number and web site are in development in order to provide families with greater access to information and program services. Plans are being made to expand services to the areas of prevention, including preconception planning and toxicology.
For more information on the program, please call Jones at 805-4776 or contact by email at ejones@mcw.edu.
Waukegan:
There are two Neonatologists who run the Neonatology Services at the two Level II Nurseries in Waukegan, IL. Provena St. Therese Medical Center Nursery is composed of 34 nursery beds, and Victory Memorial Hospital is composed of 20 nursery beds. There are approximately 2500 deliveries per year at both hospitals, and there are approximately 720 neonatology consultations per year. The duties of the two Neonatologists are centered toward patient care, teaching, and administration. They attend high-risk deliveries for newborn resuscitation, assist primary physicians in the stabilization of newborns, and provide consultations for any problems related to newborns. Teaching is generally directed toward nursing and allied ancillary services personnel. Periodic in-service lectures and case reviews are given. They are responsible for training the respiratory therapy and nursing staff in newborn resuscitation, oxygen therapy, short-term ventilator therapy, care of IVs, PICC lines, and stabilization of newborns prior to transfer. Their administrative duties include developing policies and procedures specifying the scope and conduct of patient care in Neonatology.
Waukesha Memorial Hospital NICU:
Waukesha County's only Level III Neonatal Intensive Care Unit is at Waukesha Memorial Hospital to care for babies as early as necessary, even those weighing less than a pound. The hospital works closely with Medical College of Wisconsin neonatologists, physicians with expertise in the care of premature and sick infants. The neonatologist is on call around-the-clock to respond quickly to any problems that may arise during or after delivery. Neonatal nurse practitioners and respiratory therapists are also available 24 hours a day.
Waukesha Memorial is the first NICU in southeastern Wisconsin to make available Tele-echocardiography - a blend of technological and human expertise available to its tiny patients, sometimes weighing a pound or less. A tiny baby, born weeks premature, is suspected of having a heart problem. Time is critical. A staff of medical experts surrounds the infant's bassinet, including a pediatric cardiologist in attendance at Children's Hospital of Wisconsin via two-way imaging on television screens. A technician gently moves a wand again and again across the infant's tiny chest, transmitting computer images of the walnut-sized heart miles away to the remote expert's location for instant evaluation. No surgery is required and the child feels no discomfort. The process is accomplished live via teleconferencing technology. Simultaneously, the computerized echocardiography machine transmits sonar images of the beating heart and its blood flow via modem to the pediatric cardiologist for expert interpretation. This technology shaves critical hours off of diagnosis time - there is no time spent transporting studies and waiting for reports. Another advantage is that the test is right the first time. Tele-echocardiography allows for accurate assessment of the infant's condition and monitors the progress of the medical treatment in closing the passage.
The NICU, along with over 300 other NICU's, participates in Vermont Oxford, an international database that reports survival rates and clinical outcomes of premature babies less than 1500 grams (32 weeks). This database compares Waukesha Memorial clinical outcomes with that of other NICU's in the country.
Through ProHealth Care, Inc., the system formed by Waukesha Memorial and Oconomowoc Memorial hospitals, Oconomowoc Memorial, too, offers a seamless and immediate newborn transport system to ensure that infants get the extraordinary neonatal care they need at a facility that is close to home. Waukesha Memorial's Neonatal Transport Service is available twenty-four hours a day, seven days a week. Your call requesting transport is directed to a neonatologist who will mobilize the team required to meet the specific needs of the infant being transported to the Birthing Center's Neonatal Intensive Care Nursery. Members of the transport team include qualified personnel. The neonatologist will be in close communication with the referring physician and transport team throughout the transport process. Infants are transported to Waukesha Memorial by a specially equipped ambulance.