The Johns Hopkins All Children’s Maternal, Fetal & Neonatal Institute seeks to improve outcomes for newborns through collaborative approaches to value-based care, beginning with the high-risk expectant mother, continuing through delivery and neonatal intensive care unit (NICU) admission, and extending beyond discharge.
“The collaboration between our obstetrics and gynecology, perinatology and neonatology providers and staff allows for a coordinated approach to care for both high-risk moms and babies from pre-pregnancy, through hospitalization, to follow-up outpatient care—with the quality and outcomes you’d expect from a Johns Hopkins organization,” explains Chris Snyder, institute senior director.
For The Kids, the Johns Hopkins All Children’s Foundation’s donor magazine, recently visited with Suzanne Icely, M.D., medical director of the division of obstetrics and gynecology, and Jose Prieto, M.D., medical director of the division of maternal fetal medicine, about how they offer the highest levels of care to parent and child.
What are the benefits of the institute for patients?
Icely: From an OB-GYN perspective we offer a continuum of care for women that stretches from adolescence through motherhood and even into her menopausal years. The institute supports all facets of a woman’s health care journey with a special emphasis on that critical nine months before and immediately after the birth of her child. The institute allows for an unencumbered focus on research, education and innovation particularly when compared to other health care systems.
Can you explain the “institute model of care”?
Prieto: The benefit for our patients is our ability to guide the mother—especially the high-risk mother—from gynecology to fetal life to neonatal life through our continuum of care, which Dr. Icely mentioned. For cases that involve advanced maternal age, patients with chronic illness, diabetes, hypertension, patients who did not have access to high-quality care and fetuses with anomalies, it’s all right here—one-stop shopping. Our early care dovetails into our NICU and guides the mother and child through the Johns Hopkins All Children’s level of innovative care, which often isn’t available in other hospitals locally or internationally.
What is happening in the institute right now that excites you?
Icely: Working with institute director Dr. Prabhu Parimi is a dream for physicians. He is a true physician’s advocate and is very supportive when we have research or educational initiatives we want to pursue. It benefits every one of our patients to be in an environment that encourages research and education. These are exciting times. We are adding physicians and fellows, people are beginning to understand the significance of the Johns Hopkins name and what it means for superior care, and we are really growing strong.
You mention international care. How is the institute growing this area?
Prieto: We provide international outreach to countries such as Guatemala in Central America. I visit every year to speak at medical conferences to provide information on the Johns Hopkins All Children’s model. I also network with OB-GYNs and neonatologists about the services we offer, which leads to multiple referrals of high-risk pregnancies. In fact, we have a family arriving in a few weeks for a fetal transfusion for Rh disease, which is when the mother’s blood is incompatible with the fetus’ blood. The treatment isn’t available in their country, so we can offer them a chance to avoid the risks of premature birth and possibly losing the child by treating this disease in the womb. We are helping and possibly saving children internationally who otherwise might not have had a chance.
What should our donors know?
Icely: One of the most impressive things about being part of the Johns Hopkins family is that we are pharma-free. Being pharma-free is a trend in this country, and it tends to take hold in academic institutions first. In our clinics, pharmaceutical representatives may not offer free samples or gifts to physicians. Decisions involving which medication to place a patient on are made based on the scientific literature without the pressure or biases of these companies. We are able to act in the best interests of our patients. We can focus on patient advocacy without being beholden to anyone.
Another trend happening in women’s care is midwifery. Even as obstetricians, we are really supportive of our midwife colleagues because we see the advantages this form of care offers for low-risk pregnancies. The institute offers this service and we see it expanding because our families are asking for it.
Prieto: I host a monthly multidisciplinary conference on campus that is literally standing room only. We present our top cases to our fellow neonatologists, neurosurgeons, cardiologists, geneticists, nurses, ultrasound technicians and other specialists who want to attend. We review the findings and formulate a plan of care that we can then take to the parents. Our pediatric subspecialists can’t get enough of these prenatal evaluations because they allow them to prepare sooner. The whole purpose is to bring everyone on board as early as possible in order to improve outcomes. In fact, we keep a Clinical and Outcomes Evaluation Dashboard because we are interested in tracking not only short-term, but long-term outcomes that follow the child into adulthood.
It isn’t just survival, but quality of life for both the mother and child that we strive for, and I think that goes for the entire Johns Hopkins All Children’s family. It’s about using every tool we have and every innovation we can come up with to provide the highest level of care to our local, national and international patients.
This story first appeared in For the Kids. Visit HopkinsAllChildrens.org/MFNI to learn more about the Johns Hopkins All Children’s Maternal, Fetal & Neonatal Institute.