Tom Doyle’s Post

    Having researched the “business” of maternal healthcare and the conversion of medical care to business for decades I have come to some conclusions based on the literature. Maternal health is the only field of medicine in which mortality rates have risen, rather than falling as a result of medical progress. This is because “medical progress” cannot solve the problem and is, in fact, the problem. Designating pregnancy as a medical issue and developing interventions which were not medically necessary has led to the high mortality and morbidity rates. When organizing an international conference on these issues, two physicians told me that “the most dangerous place to have a baby in the U.S. is in a hospital with an obstetrician”. This has occurred for no other reason than money. The maternity ward was long considered the “cash cow” of hospitals. Procedures that allowed higher billing such as c-sections, inductions, etc. grew as hospitals (and obstetricians) sought to increase profit as did maternal mortality. Evidence of this can be seen with the increase of maternal health deserts. As insurance companies, Medicaid, etc. started refusing to pay higher costs for unnecessary interventions, some .hospitals are eliminating maternity care SOLUTIONS: Obstetricians: while an Important part of the system, obstetrics is the only field of medicine in which the obstetrician is both the primary care individual and specialist. Obstetricians need to be considered specialists who care for at-risk women who have health issues that could affect outcome. Primary care should be done by midwives as in the Nordic and other countries which have the lowest maternal mortality rates in the world. Doctors are trained to “cure/treat” and pregnancy for not-at-risk women does not need to be cured or treated. Birth location: the very culture of a hospital is curing/treating which means intervention in a problem. Birth needs to be taken out of hospitals into free-standing birth centers operated by midwives where women and families can experience a more home-like and relaxing atmosphere. Birth centers, of course, should have the ability to consult with an obstetrician or transfer patients when unexpected issues arise, but these are rare. 

Testing for pre-eclampsia - the neverending story I joined Roche in 2011, as a (relatively) fresh-faced International Product Manager, with responsibility for the portfolio of tests related to Pregnancy Care. I had  always been inspired by the idea of bringing medical innovations to the people who need them and I was so excited to have landed my dream job in such an important area of diagnostics. One of the new products I was responsible for was our blood test for pre-eclampsia - a condition affecting up to one in ten pregnancies which, if left untreated, can be fatal for both mother and baby. This blood test had just been launched in Europe but it hadn’t been widely adopted due to limited clinical evidence. My first years in the role were completely focused on building the evidence base which was needed to make the case for it to be adopted by healthcare systems across the world. Fast forward to 2023 and I joined Roche Diagnostics UK & Ireland as Director of Marketing - another dream job!  As a mother myself now, I completely understand the mixed up feelings of excitement and anxiety that come with being pregnant and giving birth - and how much you rely on the tests and checks that can tell you that everything is ok - or if something isn’t right. In the same year, my cousin's wife had a seizure and emergency delivery due to pre-eclampsia. She was sedated during the delivery and in ICU for the first days of her new baby’s life. This made one of the happiest moments of their lives, a really frightening experience. Thankfully, she recovered completely after some weeks and they are all happy and healthy, but that doesn’t mean that pre-eclampsia hasn’t had a lasting impact on all their lives. In other words, over the last ten years or so, my own personal experience has only strengthened my already sound belief in the clinical case for pre-eclampsia testing. And one of the many reasons I was excited to join the UK team was because I knew some really great work had been done to roll the test out across NHS maternity units in England. But I recently heard the frustrating news, that 12 months since the publication of Scottish Health Technology guidance which said PlGF testing improves outcomes and drives cost savings - not one of the Health Boards in Scotland has introduced it. Knowing where my career in Roche started, somebody asked me how I feel about that, and the honest answer is very sad. How can it be, more than 13 years after this test was launched, that a woman in Carlisle with pre-eclampsia symptoms will have access to a quick and easy blood test and all the benefits of an early diagnosis - but a woman 30 miles up the road in Dumfries, won’t? The good news is that our commitment is as strong as it was 13 years ago and by working with amazing organisations like Action on Pre-Eclampsia we are continuing to do all we can to get these tests to everyone who needs them. #WomensHealth #MaternalHealth #Healthcare #Pregnancy

One of Our Food & Freezer Bags saves a life... 💪❤️ "The premature babies saved by 20p freezer bags" the remarkable story of two premature babies, born two years apart, and their life-saving journey is recounted. The main events of the story centre around the births of Willow and Zach, born prematurely. The mother Emma was rushed to the neonatal intensive care unit at King's Mill Hospital, near Mansfield, Nottinghamshire.. Willow was born at just 23 weeks gestation, weighing a mere 1lb 8oz, while her younger brother Zach arrived prematurely two years later, also weighing a fragile 1lb 8oz. Key players in the story include the medical team at the hospital, led by consultant neonatologist Dr. Andrew Weeks, who devised the ground breaking technique of using freezer bags to create a makeshift incubator for the babies. Facing the challenge of keeping these extremely premature infants warm and stable, Dr. Weeks and his team turned to this unconventional solution with remarkable results. The implications of this innovative approach are profound, as it represents a low-cost, readily available method for providing critical care to premature infants in resource-limited settings. By utilizing simple freezer bags to create a warm and protective environment, hospitals around the world could potentially save countless lives and reduce the risk of complications associated with premature birth. The article highlights the challenges faced by premature infants, who are particularly vulnerable to hypothermia and other complications due to their underdeveloped immune systems and delicate physiology. Traditional methods of providing warmth and support, such as expensive incubators, may not always be readily available, especially in low-resource settings or during emergencies. In response to this challenge, Dr. Weeks and his team devised a creative solution that leveraged the accessibility and affordability of freezer bags to create a makeshift incubator. By placing the babies inside the bags and filling them with warm water, the medical team was able to replicate the protective environment of the womb, helping to stabilize their body temperature and improve their chances of survival. The article also highlights the incredible resilience and strength of Willow and Zach, who defied the odds and overcame numerous obstacles during their time in the neonatal intensive care unit (NICU). Despite facing significant health challenges and spending several months in hospital, both eventually grew stronger and healthier, thanks to the dedication and expertise of the medical team. Overall, the story of Willow and Zach serves as a powerful reminder of the importance of innovation, resourcefulness, and compassionate care in the field of neonatal medicine. By thinking outside the box and utilizing simple, cost-effective solutions, hospitals can provide life-saving support to premature infants and improve outcomes for some of the most vulnerable patients in their care.

Recently on Healthcare Upside Down, I had the privilege of describing the enormous challenges facing children’s hospitals and why it will take a strategic, system-level approach to overcome them. Integrating care across the full healthcare continuum is not only feasible, it is essential. Here’s a recap. #healthcareupsidedown #HCUpsidedown #pediatrics

Every tenth baby is born preterm, which is defined as the birth before 37 weeks of pregnancy. According to the World Health Organization, prematurity is an urgent public health issue, as it often results in various health challenges for these babies and causes emotional strain on their families. The families face the complex and uncertain medical needs of the newborns while enduring the emotional burdens associated with extended hospital stays and ongoing healthcare support.    Today is #WorldPrematurityDay – a day of global significance dedicated to raising awareness, advocating for change, promoting research, and supporting premature babies and their families. Unfortunately, preterm babies’ survival rates are highly dependent on where they are born. On this day, it is critical to call out this gap and incite change to enable the best possible healthcare for them - no matter where in the world they are born.    I am proud that at Fresenius, we are advancing care for this vulnerable patient group at every stage:   • Most #premature babies can be saved by high-quality medical care before, during, and after birth. For example, at 26 German locations of our Helios Kliniken GmbH clinics, preterm babies receive special medical care, nine of which offer the highest level of care (Perinatal Center Level 1) for babies born before the 29th week of pregnancy. More than 400 premature babies were born this year in our hospitals of Helios. The network of Quirónsalud also comprises specialized neonatology departments and advanced medical care for preterm infants and their families. A great achievement of the teams! • Specialists in prenatal medicine, obstetrics, neonatology, and pediatric surgery, as well as specially trained pediatric nurses, ensure the best possible care of the preterm babies. In addition to respiratory support, premature babies often need help with feeding. Since their digestive system is not yet developed enough, many of the little patients receive nutrition via infusions. Fresenius Kabi has developed sip and tube feeds for enteral nutrition, as well as supplements that are specially adapted to premature infants’ needs. • As premature babies require a higher nutrient intake than mature babies, parenteral nutrition is particularly important to support normal growth and development. The sight of the tubes might cause concern for the parents, but these tubes are vital for the little fighters because they provide everything the babies need.  World Prematurity Day provides us with an opportunity to underscore our commitment to serving the most vulnerable in society and discuss how we can positively impact the lives of patients. We aim to offer patients and healthcare providers the best treatment options.    Let’s celebrate the little heroes today and reflect on their incredible resilience, hope, and strength. And let’s thank the pediatric staff for their incredible support.  #PreemiesMatter #AdvancingPatientCare #FutureFresenius  

Palliative care, pediatric end-of-life care, and end-of-life doula services are at the forefront of hospices' minds as they diversify their care in 2024. This strategic move may indicate future trends in the industry and provide insight into how hospices are evolving to meet the needs of their patients and families. #hospicecare #palliativecare #endoflifecare #pediatriccare #EOLD #healthcareindustry #trends

What’s the TL;DR on IBCLCs? International Board Certified Lactation Consultants (IBCLCs) are, simply put, the gold standard in lactation care. 🏅 The Lactation Network works exclusively with IBCLCs, the highest accredited healthcare professionals specializing in lactation. What does this certification mean? While lactation educators can offer education and support, only IBCLCs have completed the rigorous training to become internationally recognized lactation experts. IBCLC certification programs require 2-5+ years, and candidates must complete: ➡️ 90 hours of lactation-specific education ➡️ 300-1,000 hands-on hours of clinical training ➡️ Recertification every five years to maintain accreditation What does an IBCLC do? Your IBCLC can assist with *all* your lactation needs, from helping you design a workday pumping schedule and storage plan to finding the best breastfeeding position for you. IBCLCs work in various settings, providing care at home, hospitals, birth centers, and via virtual visits. IBCLCs can also help with common lactation challenges, like low milk supply, nipple pain, and conditions like mastitis and plugged ducts. It’s always the right time to get the care you deserve. From prenatal consultations to breastfeeding baby #3, our nationwide network of IBCLCs is here to provide expert, compassionate care. Request a consultation to receive personalized, insurance-covered care from an IBCLC. 🤍

Had the pleasure of working with the team that produced this study; it was an identifiable gap by the amazing diabetic educator, and was later reviewed and researched. I know programs have worked had grown from there, today I have found out CQU has had some of the first Bachelor of Midwifery graduates to enter the CGM for type 1 and GDB program at Mater Hospital. How full circle translation to practice can be! https://lnkd.in/g4DwKFmR

Our work has studied the integration of an International Board Certified Lactation Consultant (IBCLC) into the #primarycare setting, yet many communities have limited IBCLC availability. If you are in a community with limited availability, or you do not already have an #IBCLC on staff, translating our team-based model into your practice setting raises questions about what type of #lactationsupport to provide. We know that #breastfeeding support improves outcomes and that there are a number of ways to provide support. There is not a one-size-fits-all solution. So how can you find the solutions that will work for YOUR practice? In primary care clinics we need to start at the very basic level with health care providers being knowledgeable and supportive. Once we have that foundation, we can determine our next steps toward collaboration. Check out my latest blog post to learn from my experience about what the most effective next steps could be for your practice: https://lnkd.in/g_CD_ZpW Please share with your community and encourage others to join the discussion, because this is how we can move the needle toward improved lactation support for all! Thank you for all you do to support breastfeeding families. ~ Ann M. Witt, MD, FABM, IBCLC Founder Breastfeeding Medicine & Primary Care Education

This week, the National Perinatal Information Center is discussing #newborn falls. There is excellent #missedcare research in Labor and Delivery and #NICU settings. Missed care research has shown that one of the most frequently missed care items is patient education. However, there is currently no missed care research in #postpartum care settings. It would be logical to then hypothesize that missed education may occur in postpartum care settings as well, which could include missed opportunities for newborn fall education. What other potential missed care items occur in the immediate #postpartum period? And how can we ensure education surrounding the prevention of #newbornfalls is on the list? Be sure to check out the 2023 white paper developed by NPIC and supported by a generous unrestricted educational grant by GE HealthCare Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) National Association of Neonatal Nurses (NANN) Synova Associates LLC Kelley Franklin Joint Commission Karen P. Becker, PhD, BC-NNP Heidi E. Morin, MSN, MBA, RN, FABC Nancy Travis, MS, RN, CPN, C-ONQS, FAWHONN Luann Jones, DNP, RN, NE-BC Rachel Sheehan Gail Bagwell DNP, APRN, CNS, FAAN Rachael Zastrow Michele Kulhanek, MSN, RNC Heather DiCioccio, DNP, RNC-MNN, C-ONQS https://lnkd.in/eiBAnbYs