The smallest patients: the neonatal unit and couplet care

1981–2019 · BOUNDARY — MEMORIAL HOSPITAL, SOUTH BEND · ROW 5

No neonatal unit has ever stood in the CDP, because no hospital has; the unit that takes this ground's smallest patients stands at Memorial Hospital of South Bend, and its founding and its care-model first both date: Beacon's own state-recognition release of 2 December 2019 states the founding plainly — "Since its inception in 1981, the NICU has consistently met similar Level III requirements established by the American Academy of Pediatrics" — and states the first in the same breath: the unit "was the first in the country to offer couplet care, which enables families to stay with their babies in private patient rooms for the duration of their stay." Both statements print at the strength of their source, the system's own record, offered to and accepted by the state in a certification announcement; no independent national registry of couplet-care firsts was reached, and the claim is not upgraded beyond its source.

The model, as the design and clinical record describes it, reverses the old geography of the NICU: instead of the baby in a ward and the mother — herself still a patient — in a postpartum room floors away, couplet care rooms carry two headwalls, one for the infant's bed and one for the mother's, staffed by nurses cross-validated in both postpartum and neonatal skills. The new Beacon Children's Hospital, which began welcoming patients in early May 2017 at 95,000 square feet — more than tripling the previous children's facilities inside Memorial — was built around the model: 39 NICU beds in single-family and couplet-care rooms, the couplet rooms modeled on those of Sweden's Karolinska university hospital and extended at South Bend to accommodate multiple babies and group care. The system's reported early outcomes print as its own: average length of stay down 1.7 days since couplet care's introduction in the new unit, and patient-satisfaction scores averaging 4.7 on a 5-point scale. In December 2019 the Indiana State Department of Health certified Beacon Children's Hospital's NICU and Memorial's obstetric unit at Level of Care III for neonatal intensive care and obstetrics under the state's new perinatal levels-of-care requirements — the dated state verification that closes this row: a unit founded 1981, a national care-model first claimed by its own system and carried in its state filing, and a Level III standing verified by the state in 2019. Beacon Granger Hospital, at the CDP's edge in Mishawaka, carries eight inpatient beds and no neonatal service; a Granger baby who needs this care travels, as this ground's babies have since 1981, to Michigan Street in South Bend.

Sources:

1. Beacon Health System news release, "Beacon recognized by state as leader in mother-baby care" (2 December 2019) — IDOH Level of Care III certification for neonatal intensive care and obstetrics; NICU inception 1981; "first in the country to offer couplet care."
2. Beacon Health System, Physician Quarterly, Summer 2017 — the new Beacon Children's Hospital opened early May 2017; 95,000 sq ft; all-private NICU rooms; "the first where mothers who have just delivered can stay in the same room with their babies in the NICU rooms."
3. Tradeline, "Reimagining the NICU to Support Couplet and Family Care at Beacon Children's Hospital" (October 2018) — 39-bed NICU, single-family and couplet-care room designs, Karolinska model, cross-validated nursing, the −1.7-day length-of-stay and 4.7/5 satisfaction figures as the system's report.