Texas Children’s becomes first in state to achieve Level IV NICU designation

We’ve all heard the saying, “Hard work pays off.”

That old adage certainly rings true for Texas Children’s Newborn Center leadership and staff. On April 7, Texas Children’s neonatal intensive care unit (NICU) became the first hospital in the state to achieve Level IV NICU designation by the Texas Department of State Health Services.

“As a Level IV NICU, our neonatal team has the resources and expertise to deliver the highest level of care available for premature and critically ill newborns,” said Texas Children’s Chief of Neonatology Dr. Gautham Suresh. “This designation helps ensure our neonates, who require highly specialized resources and 24/7 multidisciplinary care, are treated in the right level of NICU to achieve the most optimal outcomes.”

The designation process comes as a result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. Texas is one of the first states requiring NICUs to undergo a site visit to verify they meet the Neonatal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement in order to receive Medicaid reimbursement for neonatal services by September 1, 2018.

Reaching this milestone was no easy task. The process required tremendous collaboration among NICU leadership, staff and employees, as well as various support services that help the neonatal team care for these critically ill babies including pharmacy, respiratory, physical therapy, lactation, nutrition and social services.

“In June 2016, we started a weekly work group that included members from neonatology and various ancillary departments across the organization,” said Project Manager Sohail Azeem. “We led them through the Neonatal Level IV designation guidelines impacting each area and gathered all of the necessary materials and documentation to prepare for the 2-day site visit and for the application process that followed.”

Several key requirements for Level IV NICU designation included the development of a Quality Assessment and Performance Improvement (QAPI) committee and a program plan outlining the Newborn Center’s breadth and depth of services, policies, procedures and structure for prioritizing quality improvement initiatives. While the Newborn Center already had an active quality and safety program, it was incorporated into the QAPI program.

In addition to meeting these Level IV designation requirements, Texas Children’s also participated in a rigorous survey site visit conducted by the American Academy of Pediatrics NICU Verification Program in November 2016.

“The 2-day site visit included interviews with NICU nursing and physician leadership among others, as well as reviews of our policies, medical records and credentialing process,” said Newborn Center Director Heather Cherry. “Surveyors also toured all of our level NICUs and other hospital areas that support neonatal services.”

As the largest NICU in the nation, Texas Children’s is proud to receive this designation. As a Level IV NICU, Texas Children’s Newborn Center meets all level III capabilities plus has the ability to care for infants born earlier than 32 weeks gestation and weighing less than 1,500 grams, provide life support, perform advanced imaging including MRI and echocardiography and provide a full range of respiratory support, among many other criteria.

“A lot of hard work went into achieving our Level IV NICU designation and I am so proud that our teams pulled together,” said Newborn Center Vice President Judy Swanson. “This collaborative milestone solidifies our reputation in providing the highest level of neonatal care to our tiniest, most fragile patients and their families.”