THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Wednesday, February 7, 1996 TAG: 9602070003
SECTION: FRONT PAGE: A10 EDITION: FINAL
TYPE: Letter
LENGTH: Medium: 52 lines
Regarding ``Treat mothers right'' (editorial, Jan. 17) which deals with discharging new mothers from the hospital within 24 hours for an uncomplicated birth and the desire for a mandatory extra day in the hospital: Providing another day in the hospital for a childbirth does not solve problems on a long-term basis for new mothers and fathers.
Virginia's Department of Medical Assistance Services (Medicaid) implemented a pilot program, ``Home Tomorrow,'' in which new mothers who receive Medicaid are sent home within 24 hours after giving birth and receive a required follow-up home visit by a nurse within 24 to 48 hours after discharge from the hospital. Only mothers who have routine deliveries and experience no complications are eligible for the program.
Virginia has always used clinical criteria as the basis for discharge of the mother and infant, rather than the clock. The guidelines are from Standards for Obstetric-Gynecologic Services (American College of Obstetricians and Gynecologists) and Guidelines for Perinatal Care (The American Academy for Pediatrics). If within 24 hours, either the mother or infant does not meet the criteria, the patient stays until the criteria are met. On the home visit, the registered nurse has the option of scheduling a second visit for the following day if the nurse has concerns about the well-being of either patient.
The results from the 5-year-old ``Home Tomorrow'' program have been very positive. Patients have been satisfied; they actually feel they get more individual attention than they do in the hospital. Mothers get time to review information they learned in the hospital and ask questions that have arisen since taking their baby home. Evaluation of the program includes comparisons of patient outcomes, quality of care, patient satisfaction and cost.
Virginia Baptist, part of the pilot program, had a satisfactory rating from 99.9 percent of the patients in the program. Fairfax Hospital found that the number of readmissions were not significantly higher after the program than they were before the program was implemented. Fairfax's data are important - the hospital is the nation's second leading hospital in number of deliveries.
``Home Tomorrow'' demonstrates that earlier discharge combined with one-on-one patient education can be done with positive results for patients. Creating a mandatory length of stay for mothers or any other patients is not the answer.
BARBARA S. BROWN, R.N.
Richmond, Jan. 23, 1996 by CNB