Moms want to direct their maternity care, and hospitals are listening

Bells-and-whistles maternity services emerge as big marketing tool

A generation ago, mothers-to-be entered the hospital with little information and very little say in how the birth of their children would proceed. The care they received was designed to meet the needs of doctors and nurses, not families.

But over the last 30 years, things have changed dramatically. Maternity units boast beds or sleeper chairs for dads. There are refrigerators in the rooms and special celebratory meals for new parents. At the Rose Medical Center in Denver, one premier part of the labor ward includes private chefs for patients.

Hospitals are going all out to cater to new moms, and use their maternity services as a big selling point for their facilities.

One of the places where this trend is most evident is Northside Hospital in Atlanta. A 450-bed community hospital, it had 13,500 deliveries last year. The hospital is in the midst of a $36 million renovation that will include a women’s center (for more on women’s centers, see related story, p. 51) with 36 labor/delivery/recover (LDR) rooms and 108 private post-partum rooms.

Consumers want high-tech/high-touch facilities

According to Eileen Hayes, CHE, director of planning at the hospital, the additional facilities are just one marketing tool for the maternity services.

"First, we serve very well-educated consumers, and they want facilities that are high tech and high touch," she explains. "But patients also don’t want to be treated like they are sick. They want an environment that acknowledges that."

The new rooms have many of the family care center concepts that are popular in major hospitals — from places for dads or partners to sleep, to more home-like décor. Northside has also provided new moms with some options that other hospitals don’t.

"A lot of places like the rooming-in concept and encourage the moms to keep their babies with them," says Hayes. "But there is no nursery for them to send their baby to if they want some rest."

Having a nursery also helps to accommodate pediatricians, who can examine all the babies at the same time.

Another part of the program is to have a low patient-to-nurse ratio, which Hayes says will be at 5:1 when the new facility is completed.

The high-tech part of the program includes a special care nursery that has more space for the family at the bedside and more privacy.

"Some people call us a baby factory because we deliver so many babies," she says. "But we try to focus on one-to-one care. And, so far, our patient satisfaction scores show we are doing a good job."

Patient satisfaction surveys’ design helped

The project, which started in 1990 as a way to build on Northside’s bread-and-butter maternity business, was designed around comments and suggestions from patient satisfaction surveys and focus groups, as well as on the clinical aspects of care that physicians and nurses demanded. Nursing staff, in particular, have been directly involved in the process, explains Hayes. Getting their input from the start helped them buy-in to changes and become some of the biggest cheerleaders of the project. Over 130 people from the 3,000 member staff at the hospital were involved.

There have been some glitches, however. The construction of the five-floor, 150,000-square-foot facility caused a parking nightmare. Hayes went to management with an unusual request: valet parking for patients for the duration of construction. Although there was a cost associated with it, by her third approach to management she convinced the holders of the purse strings that providing this service would help to alleviate the problems that patients — particularly moms in labor — would face in getting where they needed to go.

The payback for the millions spent will be loyal customers, Hayes says. "Women are health care decision makers; if we can provide high-quality service to them when they have a baby, then we keep them for a lifetime. They will send their children and husbands here."

Smaller markets, same trends

Salinas, CA, located on the central coast, is a much smaller market than Atlanta. But there too, the trend toward patient-centered maternity care is evident.

Natividad Medical Center, which had just under 1,500 deliveries in 1998, completed a move to a new facility in February. The 163 beds include eight labor/delivery/recover/post-partum (LDRP) rooms, and capacity for 16 more mothers in the infant unit. There are also 15 beds in neonatal intensive care.

The hospital, associated with the University of California-San Francisco residency program in family practice, also has a level-two nursery, which treats seriously ill babies.

Here, too, staff proudly talk about the elements of care they have developed with mothers in mind. Shirley Algire, RN, assistant director of nursing, points to the three physicians on duty at all times. "That means no waiting," she says.

Virginia Matthews, RN, MBA, assistant hospital administrator of nursing services, likes to talk about the affiliated family center which provides day care services for patients’ children, and access to ancillary services, such as the Women, Infants, and Children’s (WIC) program. "It’s a real one-stop shop."

Algire says that just putting in a rocking chair and new décor won’t cut it any more with knowledgeable patients.

"That’s all old hat. What patients want — and what they asked for when we started our building program — is LDRPs. We only planned to have three or four, but then we decided to convert all our rooms."

Matthews says just having a new facility is an improvement, offering increased space, greater comfort, and more privacy.

"Our gut feeling, even this early, is that it has improved patient satisfaction," she says.

The decisions on what to include in a new maternity wing were made, as at Northside, with the assistance of patient satisfaction surveys and focus groups. Natividad also looked at past patient complaints to see what was missing from the facilities, and keeps abreast of what other local hospitals are doing through peer networking.

"We have to stay abreast of what is going on in the industry and in the community," says Matthews.

Even in a hospital with limited funds, she adds there is a strong argument to be made for making some of these expensive changes.

"It keeps us state-of-the-art, current, and competitive," says Matthews. "The fact that we are a teaching hospital may make it a little easier for us to sell the idea to management. But we still have to make a case for the changes with a good business plan."

So far, the new maternity program is working well. Open for just four months, the number of births at the center is already up from 120 per month last year to 129 in its first month of operation.

Cherie Stock, director of marketing and public relations, has marketed the new services using television, newspapers, and health forums. Like her peers at Northside, she sees the emphasis of catering to women as part of a larger trend that acknowledges their greater role in making health care decisions.

Stock sees that trend continuing. "You have all these baby boomer women hitting menopause at the same time. That makes them talk about hormone replacement therapy. You have women talking about wellness issues and breast cancer. Women are hungry for more information and demanding more from their care. We aren’t our mothers. We will be influencing what is a hot topic in health care and what is not for a long time to come."