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Huggins responds to questions on maternity unit aftermath

September 24, 2009
WOLFEBORO — In the interest of clarifying what will happen after Huggins Hospital closes its maternity unit at the end of this month, this reporter gathered questions from interested readers and passed them along. Chris Strong, Vice President of Marketing and Development at Huggins, researched and gathered the answers from hospital staff members and provided the Granite State News with answers in a concise format.

The following is a lightly-edited transcription of the statement and answers provided by Strong, whose willingness to address these questions on behalf of the hospital is greatly appreciated:

To better understand what preparations have been made to ensure as smooth a transition as possible for our community I think it may be helpful and comforting to our community to understand what is already in place for our local services and providers.

When an individual in the community calls 911 for medical assistance, an Emergency Medical Service (EMS) ambulance will respond with Emergency Medical Technicians (EMTs) who are licensed through the State of New Hampshire to provide life-saving medical care in the pre-hospital setting. There are three levels of licensed providers: EMT-Basic, EMT-Intermediate, and the Paramedic, all providing different levels of care based on the skills and medications they are trained to utilize. The highest level of care is provided by the Paramedic who is trained in advanced life support skills including advanced airway management, advanced cardiac care, as well as care of the pregnant woman and newborn.

All EMTs are trained in the appropriate way to manage either the pregnant female or assist with delivery of a baby. Most services in this area do not have paramedics on their service so in October 2007 Huggins Hospital started a new service, the Paramedic Intercept Program, as a mechanism to get the higher level of care out to our community. When requested, these paramedics will respond out to any scene in a specially equipped vehicle with the advanced equipment and medications to manage any critical patient. They will then ride in the ambulance with the patient assisting the EMTs providing care while en route to the hospital. The hospital paramedics are all certified in Neonatal Resuscitation.

In response to your specific questions:

1. Since by definition any child born in Wolfeboro after Sept. 30 will be delivered on an emergency basis, have Emergency Room staff received training in emergency deliveries?

In June 2009, the staff of Huggins Hospital emergency department, nursing leadership, and physicians met with Barbara Fildes, RN BSN CNM, an assistant professor at Dartmouth Hitchcock Medical Center (DHMC) and one of the most knowledgeable leaders in New England about organizing obstetrical and neonatal delivery systems. The group discussed the experiences learned from the closing of the four other maternity units in New Hampshire hospitals and how to best organize safe transport and delivery of women in labor from the Wolfeboro area.

In the event that a baby must be delivered at Huggins Hospital, the emergency department staff have all received NRP (certified Neonatal Resuscitation Program) training to assist in the delivery. The Huggins Hospital Emergency Department staff will also participate in the annual OB Emergency and Delivery Training Program with Franklin Hospital on Oct. 20.

2. Have Lakeside Ambulance and the fire-rescue departments in Wakefield, Brookfield, Tuftonboro, Ossipee, Wolfeboro, New Durham and Alton received any special training?

In October 2007, Huggins Hospital started the Paramedic Intercept Program staffed with paramedics who are highly trained in advanced life support skills to respond to emergencies and provide care in advance of the ambulance. The paramedics in the program also ride in the ambulance with the patient to assist the emergency medical technicians (EMT) enroute to the hospital. The paramedics with Huggins Hospital's Paramedic Intercept Program are all certified in neonatal resuscitation.

In August 2009, Huggins Hospital sponsored additional training for all of the area emergency medical service providers to review the care and delivery of a newborn. Barbara Fildes, RN BSN CNM, taught an interactive class where the EMTs could actually practice deliveries on a life-like mannequin.

3. Have arrangements been made for Wolfeboro Gyn to refer pregnant patients to obstetricians at hospitals that still have maternity units (Memorial, Concord, Wentworth Douglas, Frisbie, and Lakes Region General)?

Unlike the other hospitals in New Hampshire that have closed their maternity units within a few months of the announcement, Huggins Hospital made the announcement six months in advance of the closing to give patients time to make other arrangements. The staff at Wolfeboro OB/GYN have provided and continue to provide patients with the names and contact information of other obstetrical providers in the region.

4. Has Wolfeboro Pediatrics made arrangements with these same obstetricians for intake of babies from Wolfeboro area mothers?

The providers at Wolfeboro Pediatrics, Dr. Michael Matos, Dr. Harley Heath and Deborah Stone, APRN already accept infants born at other hospitals and will continue to welcome babies and children to the practice. The providers at Wolfeboro Pediatrics are all very well respected and highly regarded by the communities served by Huggins Hospital as well as the obstetricians throughout the area. We believe that most parents will continue to choose Wolfeboro Pediatrics, which is conveniently located for families in this area and is a highly regarded practice.

5. Has Huggins received any information from hospitals such as Weeks in Lancaster and Upper Connecticut Valley in Colebrook that did close units on issues that arose following closing and what was done to deal with them?

Yes, the staff at Huggins Hospital has been in touch with Weeks, Franklin, New London Hospital, and Upper Connecticut Valley Hospital and would like to thank them for providing resources and support during this time. In addition, many thanks to Barbara Fildes, RN BSN CNM, from Dartmouth-Hitchcock Medical Center, who has helped the four other hospitals that have closed their maternity units and shared their experiences with the Huggins Hospital staff - all of which helped shape recommendations for our planning and protocol processes.

Huggins Hospital takes its mission to provide quality health care services and promote well being in the communities we serve very seriously. The staffs of both the Huggins Hospital Emergency Department and our Paramedic Intercept Program have taken the time since the maternity unit closing announcement to plan and complete the necessary training and organize the essential equipment. Our highly experienced Emergency Department and Paramedic Staff are prepared to handle traumas, injuries, illnesses and complex issues that may arise. When possible, emergency patients are quickly transported to traumas centers or, in this case, maternity units. When transport is not an option, emergencies are handled by the very capable Emergency Department staff at Huggins Hospital.

Martin Lord & Osman
Varney Smith
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