COVID-19 safety guidelines and visitor regulations created challenges for discharging newborns, but Regional One Health staff stepped up to get healthy babies home with their families.

The team is using iPads to provide parents with the education they need to take their babies home.

The success of the project has also inspired them to expand the use of iPads to inform patients and keep extended families in touch with their newborns.

One of the most joyous events at any hospital is sending a newborn home with his or her family.

Regional One Health NICU Nurse Manager Kelley Smith, RN wasn’t about to let COVID-19 rob families of that milestone. When visitor restrictions and isolation requirements created barriers to a typical discharge, she innovated a curbside system where a family member or other authorized adult picks up the baby without setting foot inside the hospital.

Taking a newborn home from the hospital is an exciting milestone. When COVID-19 created challenges, Regional One Health employees found new ways to give families the joyful experience.

“We’re still sending the baby home – we’re just doing it outside,” she said. “The parents are very excited that we’re doing this. They just want their baby home!”

Alejandra Alvarez, Center for Innovation director, is celebrating employees like Smith who have tackled COVID-19 challenges by thinking outside the box.

“This is a creative way of adapting to provide an exceptional patient experience. This situation could have bogged them down, but they’re moving forward with what they need to do so babies aren’t away from their parents,” Alvarez said. “They’re working within the existing regulations and the reality of the situation to get these babies home.”

Smith explained the conundrum COVID-19 created. “If a mom tests positive, we not only isolate her, we isolate the baby in an incubator in the NICU, even if the baby is full-term and healthy. We haven’t had any babies test positive, but we need to take precautions for everyone’s safety.”

The babies are tested for the virus at 24 and 48 hours. If they test negative and are otherwise healthy, there’s no reason to keep them in the hospital and take a bed from another infant.

Smith started brainstorming discharge options that comply with Centers for Disease Control guidelines. She determined a curbside system with clear virtual communication about infant care and COVID-19 protection was best for the baby, parents and hospital.

One of the biggest hurdles was creating procedures for another adult to pick up the baby.

Under Regional One Health’s COVID-19 policies, the only visitors a baby can have are mom and dad. Since a COVID-19 positive mom must remain in isolation, the father is the only person who could enter the hospital to pick up the baby. However, if the mom and dad live together, the dad is considered exposed to the virus and barred from visiting.

When needed, the labor & delivery team is providing discharge education remotely via iPad. It’s been working so well that they plan to expand their use of the devices in the future.

“In those cases, we need to find someone other than mom or dad to take the baby home, and we need paperwork signed that mom agrees to let the baby leave with somebody else,” Smith said.

They also needed a way for the authorized adult to pick up the baby without coming inside the NICU, so they ask them to bring the baby’s car seat and leave it at the front desk: “Then, we just bring the baby down in the car seat and meet in the circular path by the newborn center,” Smith said. The discharge is, as always, overseen by a doctor, nurse and social worker.

Smith also found a way to give new parents the same education they would normally receive at discharge. She was already using an iPad and the hospital’s new telehealth platform to consult with parents and let them see their baby, so she knew it could also work for discharge.

“Mom is in isolation – she can’t come see her baby. Dad is the only person who can, and only if he tests negative,” she said. “It’s a tough situation, but parents are so excited to see their babies on the iPad. We do it during a feeding or diaper change so mom can see her baby awake.”

Giving discharge instructions via iPad has also worked well. “These moms never got to take care of their baby in the hospital, so it’s more important than ever that we provide education about breastfeeding, when to take the baby to the doctor, etc.,” she said. “With the iPad, we can do all that and see that she can feed her baby, burp her baby, change the diaper.”

Smith also uses the time to talk about protecting the baby from COVID-19.

“This is a creative way of adapting to provide an exceptional patient experience,” said Center for Innovation Director Alejandra Alvarez. “They’re working within existing regulations to get babies home.”

Fortunately, evidence indicates it is rare for babies to contract the virus. Still, nurses caution parents to minimize hands-on newborn care if they’ve tested positive and to have the baby stay in a different house or at least different room than a COVID-19 positive caretaker.

That said, Smith noted the CDC says a COVID-19 positive mom can breastfeed if she wears a mask and washes her hands thoroughly before touching the baby.

Overall, she said the process is working well, with 10-12 infants successfully sent home. While she is eager to return to regular discharges – “In person is always best,” she said – she plans to expand use of iPads to communicate with parents. She is looking into grants to buy more tablets and implementing new platforms so parents who don’t have iPhones can take part.

“Sometimes, parents aren’t available in-person during rounds due to work, transportation issues or other kids,” she said. “This is a great way to communicate and let them ask questions, no matter where they are. Since we’re already doing it, it’s a great time to think about expanding it.”

To support innovation at Regional One Health, visit Regional One Health Foundation at regionalonehealthfoundation.org.

When I was watching the Olympics, I thought a lot about time. Nothing highlights the importance of time quite like the Olympics, where so much comes down to seconds. Katie Ledecky just set a world record for the 800m freestyle; second place was nearly 12 seconds behind her. To most of us, what’s 12 seconds?

In the 100m dash, the difference between the gold medal and last place is usually less than half a second, yet that sliver of time will define a person for the rest of his or her life.

At the Regional One Health Center for Innovation, we talk as much about where innovation can happen as when it can happen. It’s not just about having something happen at the right time. It’s also about making the time.

We’ve all heard about the importance of seizing every moment of every day. My own mother and grandmother impressed this on me as a child. As we get older, time flies by faster. In the Olympics of our lives, it feels like every second matters more, especially as we layer marriage, children, career, community, and other life experiences.

Whether we are entrepreneurs or employees at a major company, in most cases our time is dictated by the environment around us.

When it comes to the work we do in innovation, we have to remember that true innovation can be born in just a single moment—if we just remember to take the time. I have heard people tell me they don’t have time to be innovative. They are too busy putting out the fires of day-to-day operations.

We have to remind ourselves to find the time. Take a moment of quiet, a moment of reflection, a moment to remove ourselves from the daily grind in order to make life better for us and the patients. Innovation happens because we are in that moment. We can’t spend all our time waiting for the right moment. We have to claim that time.

One of the key goals of the Regional One Health Center for Innovation is to find a way to better create a positive relationship between the patient and the provider. The best way to do this is to develop ways to improve communication.

Sometimes the best way to innovate is to create a new tool. Sometimes it’s a matter of first reorienting our thinking.

Sometimes it’s as simple as taking a breath.

There are hundreds of quotes about how breathing relates to life. I know it might sound a little silly to say that “breathing is the key to life,” but I can’t help but see the comparison between breathing and good communication between the patient and the provider.

We often have to be taught to breathe “well.” It’s something our bodies know how to to do, but we can forget about how to do it well in times of stress. Expectant parents take classes on breathing. Athletes talk about how important breathing is to good performance. When we feel mental stress, we have to remind ourselves to relax and breathe. We have to consciously focus our energies to it.

Communication is the same way. Hundreds of articles are written about better communication. Just because we know how to talk, or how to relay information, doesn’t know that we always know how to communicate well. It can also be easy to momentarily forget what we do know, as someone forgetting to take a breath.

When our bodies are under stress, we all can forget to breathe. When we’re sick, we can also fail to communicate our issues to our providers until it is too late. In fact, just the thought of communicating with providers can often bring on more stress.

How can we simplify communication between a patient and his or her provider? We need to develop innovative tools and processes that allow the providers and support staff to communicate as easily as taking a breath. The patient has to be able to receive information and communicate back to the provider in a way that’s as easy as breathing out.

How can the Center for Innovation learn to breathe better and easier?

Maybe we are overthinking it, making it harder than we should. Maybe we just need to step back and take a deep breath.

We launched the Regional One Health Center for Innovation website earlier this year, but this center has been in development for much longer. Creating the system identity of Regional One Health had been in the works for even longer. It can be hard to describe the amount of brainpower and manpower required to get something of this magnitude off the ground. It can be harder still to describe how inspiring it’s been to witness.

I came on as Executive Director of the Center for Innovation in June of 2015, and I’ve certainly been reflecting on my first year these past months.

Quite frankly, I’m not entirely sure I knew what I was getting myself into when I accepted the position. I knew a few things:

  • I had always admired Dr. Coopwood and Susan Cooper for their successes in Nashville.
  • Regional One Health was a new name.
  • There was a buzz in the air about the outpatient facility at Quince and Kirby.
shark tank

Winners of Regional One Health’s recent “Shark Tank” employee idea competition.

Even at the beginning, as a sort of outsider looking in, I witnessed innovation each and every day. It’s been a humbling experience to come to understand the number of people, from the executive team to environmental services, who have been so committed to making Regional One Health better. I saw the staff solving big and small problems with innovative solutions via technology, process, or staff realignment.

On our homepage we say, “It’s time for a transformation, to create the innovation we want to see, rather than waiting for it to come to us.” This has been the literal truth for this center from day one, for both Regional One Health and the Center for Innovation.

All of us here at the Regional One Health Center for Innovation are pumped up with the knowledge that Regional One Health is moving quickly in the right direction. I look for the Center to organize the campus and encourage staff to solve some of our bigger challenges and seek solutions from outside entrepreneurs in Memphis and the Mid-South.

This past year has blown me away, and this is only just the beginning.