LEBANON – Along with infants experiencing serious illnesses and surgical needs, the 30-bed Intensive Care Nursery (ICN) at Children’s Hospital at Dartmouth-Hitchcock (CHaD) located at Dartmouth-Hitchcock Medical Center, cares for premature babies who are stable and growing. While families receive tremendous support from the Neonatology staff, being in the ICN for days—or weeks—is stressful. Hope Grows at Home is a new program to help shorten hospital stays for preterm babies known as “feeders and growers.”

“We have 10 to 12 babies at home with tracheotomies or on ventilators, and realized if they can be home, why can’t the feeders and growers?” said Tyler K. Hartman, MD, Neonatology, CHaD. “We conducted more than 50 interviews of those ICN parents and discovered they wanted the same level of care they were receiving in the ICN—at home.”

Neonatology’s existing Transitional Long-Term Care Clinic provides special care to babies who leave the ICN but require home monitoring. Staffed by Hartman, Kate Richards, MSN, APRN, and Laura Cogswell, RN, nurse clinician, the team developed the Hope Grows at Home program as a Transitional Long-Term Care Clinic subset. It is modeled after similar programs at the University of Virginia Children’s Hospital, Duke University Hospital and Oregon Health & Science University Hospital.

With initial one-year support of the pilot program provided by the Susan and Richard Levi Health Care Delivery Incubator, the team enrolled its first patient on July 29, 2020, and has graduated 31 babies to date. “There have been zero adverse events, zero emergency room visits and zero readmissions,” said Richards. “It’s a unique opportunity for one team to manage ICN patients while helping parents take autonomy over the care of their baby’s health and nutrition.”

Eligibility for Hope Grows at Home includes passing sleep apnea (pausing in breathing) countdown, maintaining body temperature outside of incubation and taking some feeds by mouth. If families agree to participate they receive education about nasogastric tube placement, CPR, home feedings (by nasogastric tube and mouth) and monitor use.

After analyzing the data, it has also proven to save up to $500,000 annually by freeing beds for babies requiring more care. “Most importantly, is that outcomes for babies are markedly improved,” said Hartman.

For more information visit www.CHaDkids.org

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