June 30, 2020 at 4:37 p.m.
Adjusting focus
With birthing services no longer being offered, hospital is focusing on pre- and post-natal care
Adjusting focus
Beginning Wednesday, Jay County’s hospital will no longer offer birthing service.
Instead, it will shift to a focus on prenatal and post-natal health.
IU Health Jay announced two weeks ago its plans to stop delivering babies at the facility effective Wednesday. A new maternal and infant care services program is being implemented.
“Ninety percent of what we do to help women through their pregnancy, we will continue to do,” said Dr. Mark Haggenjos, a family care physician who provides obstetrics services at IU Health Jay. “It’s just that small section … the actual delivery process, that Jay County will not be involved in …”
Jon Vanator, president of IU Health Jay, acknowledged that it’s disappointing to not be able to provide birthing services locally, but “our directive to ourselves is, ‘Let’s crush it on that 90 percent,’” he said. “We owe it to the community to really knock it out of the park.”
The new program will feature the addition of a manager, advanced provider and nurse navigator in addition to Haggenjos and any other doctors who would provide obstetrics services. A $400,000 grant from Indiana State Department of health is being used to fund those positions.
Julie Teeter, previously the clinical nurse manager of IU Health Jay’s mother-baby unit, recently accepted the role of manager. She will lead the effort to enhance pre-natal and post-natal care in Jay County and across IU Health’s east-central region.
The hospital’s goal is to hire a certified nurse midwife as the advanced provider who would be part of the IU Health Ball Memorial Hospital’s Voss Center for women and work out of one of IU Health Jay’s clinics. That individual would help provide service to pre- and post-natal patients along with Haggenjos and any other local providers that would offer those services.
A nurse navigator would be assigned to each patient to help facilitate care and make sure that specific standards are being met during each trimester.
The overall goal is to help reach more mothers and children, as currently 35 percent of Jay County mothers do not seek prenatal care.
“Our goal is to keep care as local as we can,” said Teeter. “We want to be able to drive those numbers down because that’s what’s going to decrease mortality rates.”
Statewide health indicators for mothers and newborns do not compare well to the rest of the nation, and the numbers are even worse in Jay County and the surrounding region.
The county’s infant mortality rate is 12.3 percent, well above the state average of 7.2 percent according to the most recent IU Health Jay Community Needs Assessment.
The data show that 8.7 percent of Jay County babies have a low birthweight, also well above the state average, and that 20.5 percent of Jay County mothers smoked during pregnancy.
“We really think we’ve got a chance to move the needle on some of those stats,” said Vanator. “A lot of those stats aren’t about who’s delivering babies or not … but having access and getting out in front of young mothers, young parents to be, and making sure they understand the importance of taking care of themselves.”
“We can still be a part of their story,” added Teeter. “We can be there in the very beginning when they get a positive pregnancy test. …
“We would be there to guide them all the way through pregnancy and then additionally all the way through that first year of life.”
The hospital’s obstetrics program was a key subject during the lead-up to Jay County Hospital’s integration into IU Health on March 1, 2018.
As part of the integration agreement, IU Health agreed to keep the obstetrics program in place as long as it had two doctors who perform childbirth services, including cesarean sections, on staff. It also agreed to spend at least three years recruiting qualified replacements before considering and changes to the program.
Since then, the hospital has lost obstetrics providers Dr. Kristy Mount and Dr. Andrew Stevens, leaving only Haggenjos offering OB services.
Vanator said the hospital has worked to recruit physicians in the area of obstetrics and will continue to do so, but thus far the efforts have been unsuccessful.
“We’ve never turned off the recruiting switch,” he said. “We’re still trying. It was almost by default that we had to go this direction that we’re going. It’s not from lack of trying. And we’ll continue to do that.”
“The general trend in rural America is that you do not have all of the services you’d like to have,” said Haggenjos. “OB services is one of the ones that has taken the biggest hit …"
In building the new program, IU Health Jay looked to other communities that have found themselves in similar situations.
Specifically, the staff looked at studies from rural Wisconsin and Minnesota to get an idea of what lessons physicians there have learned about what did and didn’t work in their communities. They’ve also been in contact with the Richard Lugar Rural Health Center in Terre Haute that runs a similar program and talked with nurse navigators in the Fort Wayne area.
In the new program, expectant mothers will still start with prenatal care at IU Health Jay with Haggenjos, the new advanced provider and any other physician that would offer those services. They will be connected immediately with a nurse navigator to coordinate visits, with most happening at IU Health Jay. (More complex cases would be shifted to IU Health Ball, as was already the case.)
When getting closer to delivery — typically around 36 weeks — they would be introduced to physicians at IU Health Ball to begin the transition for the birthing process. At that point, weekly doctor visits could remain at Jay or shift to Ball, depending on the patient’s preferences and needs.
Patients would go directly to IU Health Ball when in labor, although IU Health Jay would still be available to stabilize them in emergencies.
Mothers would then return to their providers at IU Health Jay for follow-ups, postpartum exams and other care through the first year of their child’s life.
Beyond those steps, IU Health Jay’s new program will also seek to connect with members of the community long before pregnancy. Through reproductive and overall health education, partnerships with local organizations and other outreach efforts, the staff hopes to make those connections.
“If we can engage with future parents ... about all manners of things that are going to improve the likelihoods of them raising a healthy, successful family, that’s the area that we want to grow,” said Vanator. “We’ve got to start meeting people before they’ve got a twinkle in their eye. It’s really about prenatal care not just being when you’re pregnant.”
Instead, it will shift to a focus on prenatal and post-natal health.
IU Health Jay announced two weeks ago its plans to stop delivering babies at the facility effective Wednesday. A new maternal and infant care services program is being implemented.
“Ninety percent of what we do to help women through their pregnancy, we will continue to do,” said Dr. Mark Haggenjos, a family care physician who provides obstetrics services at IU Health Jay. “It’s just that small section … the actual delivery process, that Jay County will not be involved in …”
Jon Vanator, president of IU Health Jay, acknowledged that it’s disappointing to not be able to provide birthing services locally, but “our directive to ourselves is, ‘Let’s crush it on that 90 percent,’” he said. “We owe it to the community to really knock it out of the park.”
The new program will feature the addition of a manager, advanced provider and nurse navigator in addition to Haggenjos and any other doctors who would provide obstetrics services. A $400,000 grant from Indiana State Department of health is being used to fund those positions.
Julie Teeter, previously the clinical nurse manager of IU Health Jay’s mother-baby unit, recently accepted the role of manager. She will lead the effort to enhance pre-natal and post-natal care in Jay County and across IU Health’s east-central region.
The hospital’s goal is to hire a certified nurse midwife as the advanced provider who would be part of the IU Health Ball Memorial Hospital’s Voss Center for women and work out of one of IU Health Jay’s clinics. That individual would help provide service to pre- and post-natal patients along with Haggenjos and any other local providers that would offer those services.
A nurse navigator would be assigned to each patient to help facilitate care and make sure that specific standards are being met during each trimester.
The overall goal is to help reach more mothers and children, as currently 35 percent of Jay County mothers do not seek prenatal care.
“Our goal is to keep care as local as we can,” said Teeter. “We want to be able to drive those numbers down because that’s what’s going to decrease mortality rates.”
Statewide health indicators for mothers and newborns do not compare well to the rest of the nation, and the numbers are even worse in Jay County and the surrounding region.
The county’s infant mortality rate is 12.3 percent, well above the state average of 7.2 percent according to the most recent IU Health Jay Community Needs Assessment.
The data show that 8.7 percent of Jay County babies have a low birthweight, also well above the state average, and that 20.5 percent of Jay County mothers smoked during pregnancy.
“We really think we’ve got a chance to move the needle on some of those stats,” said Vanator. “A lot of those stats aren’t about who’s delivering babies or not … but having access and getting out in front of young mothers, young parents to be, and making sure they understand the importance of taking care of themselves.”
“We can still be a part of their story,” added Teeter. “We can be there in the very beginning when they get a positive pregnancy test. …
“We would be there to guide them all the way through pregnancy and then additionally all the way through that first year of life.”
The hospital’s obstetrics program was a key subject during the lead-up to Jay County Hospital’s integration into IU Health on March 1, 2018.
As part of the integration agreement, IU Health agreed to keep the obstetrics program in place as long as it had two doctors who perform childbirth services, including cesarean sections, on staff. It also agreed to spend at least three years recruiting qualified replacements before considering and changes to the program.
Since then, the hospital has lost obstetrics providers Dr. Kristy Mount and Dr. Andrew Stevens, leaving only Haggenjos offering OB services.
Vanator said the hospital has worked to recruit physicians in the area of obstetrics and will continue to do so, but thus far the efforts have been unsuccessful.
“We’ve never turned off the recruiting switch,” he said. “We’re still trying. It was almost by default that we had to go this direction that we’re going. It’s not from lack of trying. And we’ll continue to do that.”
“The general trend in rural America is that you do not have all of the services you’d like to have,” said Haggenjos. “OB services is one of the ones that has taken the biggest hit …"
In building the new program, IU Health Jay looked to other communities that have found themselves in similar situations.
Specifically, the staff looked at studies from rural Wisconsin and Minnesota to get an idea of what lessons physicians there have learned about what did and didn’t work in their communities. They’ve also been in contact with the Richard Lugar Rural Health Center in Terre Haute that runs a similar program and talked with nurse navigators in the Fort Wayne area.
In the new program, expectant mothers will still start with prenatal care at IU Health Jay with Haggenjos, the new advanced provider and any other physician that would offer those services. They will be connected immediately with a nurse navigator to coordinate visits, with most happening at IU Health Jay. (More complex cases would be shifted to IU Health Ball, as was already the case.)
When getting closer to delivery — typically around 36 weeks — they would be introduced to physicians at IU Health Ball to begin the transition for the birthing process. At that point, weekly doctor visits could remain at Jay or shift to Ball, depending on the patient’s preferences and needs.
Patients would go directly to IU Health Ball when in labor, although IU Health Jay would still be available to stabilize them in emergencies.
Mothers would then return to their providers at IU Health Jay for follow-ups, postpartum exams and other care through the first year of their child’s life.
Beyond those steps, IU Health Jay’s new program will also seek to connect with members of the community long before pregnancy. Through reproductive and overall health education, partnerships with local organizations and other outreach efforts, the staff hopes to make those connections.
“If we can engage with future parents ... about all manners of things that are going to improve the likelihoods of them raising a healthy, successful family, that’s the area that we want to grow,” said Vanator. “We’ve got to start meeting people before they’ve got a twinkle in their eye. It’s really about prenatal care not just being when you’re pregnant.”
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