Needed... Public Relations Ideas for failing LDRP

Jolie, BSN · Mar 23, 2005

Hello everyone,
I work in an LDRP unit. Since October we have been
losing revenue due to lack of new patients. The Docs
won't send them to us because we are the only hospital
in the area with no NICU. So, because of this, administration
said we were going to get our own NICU starting March 1st.
Well... March 1st has come and gone and we still have no
NICU. Our unit manager has taken it upon herself to do some
PR for our unit and needs ideas. The only problem is, I don't
think it will matter how much PR we do if the Docs don't
recommend us to thier patients. Any ideas?

I think you've answered your own question. PR is not what is needed, the abillity to respond to high-risk deliveries with neonatal intensive care capabilities is. The docs/midwives have the patients' attention for 9 months prior to delivery, during which time they undoubtedly share their opinions and preferences as to where the patient should deliver. Why should a prospective parent respond to some catchy PR campaign, rather than follow the advice of her trusted care provider?

I don't know when your manager began to promise that a NICU would exist on March 1st, but it is a lengthy process to develop one. Two years to plan, build, equip, and train staff, or hire experienced staff is not unreasonable. It sounds like your promise of a NICU was an empty one, and I would suspect that if one crops up any time soon, it will be poorly planned, and little more than a window dressing, not likely to be capable of providing quality care.

Sorry for your situation.

**canoehead, BSN, RN** · Mar 23, 2005

Why not promote your hospital as a low risk birthing centre with lots of 1-1 attention and all the pain control and comfort measures you can comeup with? Hire a massage therapist, hold birthing classes on site, and new parent classes. Can you "assign" two or four nurses to each pregnant mom and find a way to assure them a 90% chance they will get a nurse they know and trust in labor? that would be a HUGE selling point.

babyktchr, BSN, RN · Mar 23, 2005

Why not promote your hospital as a low risk birthing centre with lots of 1-1 attention and all the pain control and comfort measures you can comeup with? Hire a massage therapist, hold birthing classes on site, and new parent classes. Can you "assign" two or four nurses to each pregnant mom and find a way to assure them a 90% chance they will get a nurse they know and trust in labor? that would be a HUGE selling point.

I work in a 6 bed LDRP with no NICU in house. We do almost 1000 deliveries a year, of course low risk deliveries. In the instances that we have a high risk occasion, pts are shipped to high risk region center. If we have a bad baby...which happens even in a low risk situation, those babies are shipped also.

I think promoting your LDRP as a low risk facility wil be great for business. We often get praised for our care as being more personable than "bigger" facilities. I just can't imagine docs not delivering at a hospital that doesn't have a NICU...what a shame.

kc2004 · Mar 23, 2005

I work in a 6 bed LDRP with no NICU in house. We do almost 1000 deliveries a year, of course low risk deliveries. In the instances that we have a high risk occasion, pts are shipped to high risk region center. If we have a bad baby...which happens even in a low risk situation, those babies are shipped also.
I think promoting your LDRP as a low risk facility wil be great for business. We often get praised for our care as being more personable than "bigger" facilities. I just can't imagine docs not delivering at a hospital that doesn't have a NICU...what a shame.

Are there several hospitals near yours or is it in

a rural area? I ask this because our hospital is

one of about 5 or 6 medium sized hospitals within

a 50 mile radius. The Docs have privileges at usually

3 or more of these hospitals and so choose to send

thier patients to the ones who have NICU in house.

There are plenty of patients that would come

to our hospital if we had a NICU, but are being advised

not to.

babyktchr, BSN, RN · Mar 23, 2005

Are there several hospitals near yours or is it in
a rural area? I ask this because our hospital is
one of about 5 or 6 medium sized hospitals within
a 50 mile radius. The Docs have privileges at usually
3 or more of these hospitals and so choose to send
thier patients to the ones who have NICU in house.
There are plenty of patients that would come
to our hospital if we had a NICU, but are being advised
not to.

The nearest hospital is 20 miles away..the nearest NICU is 45 miles away...give or take. When we have to ship a bad baby...a team from the "big" hospital comes and then decides where the baby goes...depending on illness. Most times they try to take the baby to the nearer hospital, because the tertiary center is 2 hours away. We wait for the team for that time or longer to get to the baby. It can be hairy if the baby is really sick. I have been there for those...its not fun....but what is there to do. Our peds are good and they hang with us mostly when the babies are sick.

High risk OB moms are referred to the tertiary center. We do have some that plan on delivering there...but don't always make it...or they come to us first and then we ship them out.

High risk OB patients are referred to the "big" hospital, when it is, of course, in their best interests..both for mom and baby.

BETSRN · Mar 23, 2005

Hello everyone,
I work in an LDRP unit. Since October we have been
losing revenue due to lack of new patients. The Docs
won't send them to us because we are the only hospital
in the area with no NICU. So, because of this, administration
said we were going to get our own NICU starting March 1st.
Well... March 1st has come and gone and we still have no
NICU. Our unit manager has taken it upon herself to do some
PR for our unit and needs ideas. The only problem is, I don't
think it will matter how much PR we do if the Docs don't
recommend us to thier patients. Any ideas?

First, you cannot have a NICU without a neonatologist on staff so that's a tall order. There are probaby other areas in whcih to concentrate your efforts.

Physician backing is crucial. Do you have a special philosophy about birthing (normalcy, for instance) that could be enlarged on? Do you have any midwives?

I personally feel that your manager (and/or hospital administration) need to meet with ALL the doctors as a group before you can proceed with any real visions of change to increase your numbers.

We are a small community hospital and we do not have a NICU either. WE love it that was, as do our docs. We are close to a tiertiary care center and the patinets who we occasionally transfer there are always glad to come back to us. Bottom line is that they like our personalized care better.

Within the last year, we added pediatric hospitalists to our program. When we have 4 (we only have 2 now and one coming in June) we will have 24 hour coverage. It is wonderful having them and we don't have to call peds to come from offices for meconium, etc. OB's and Peds are VERY happy with these changes. They also benefit the entire hospital because they can do cases in the ER when appropriate and we wilol be able to keep more children in the community (instead of going to the children's hospital 20 miles away).

My point here is that this type of program might satisfy your OB's and would benefit the hospital in general. All I can say is that we are only 6 miles from a level 3 NICU and our docs always crab and fuss when they have to transfer a mother because they dislike going and working with staffs they do not know. They'd rather be with us and we give excellent care (as I am sure you do). We have the benefit of NICU close by.

I'd talk with the physicians first and try to work with them. Nothing will improve if you do not have their backing and support.

Congrats on having a manager ready to help you. You are very lucky! I wish more of us had that benefit!

kc2004 · Mar 25, 2005

The nearest hospital is 20 miles away..the nearest NICU is 45 miles away...give or take. When we have to ship a bad baby...a team from the "big" hospital comes and then decides where the baby goes...depending on illness. Most times they try to take the baby to the nearer hospital, because the tertiary center is 2 hours away. We wait for the team for that time or longer to get to the baby. It can be hairy if the baby is really sick. I have been there for those...its not fun....but what is there to do. Our peds are good and they hang with us mostly when the babies are sick.
High risk OB moms are referred to the tertiary center. We do have some that plan on delivering there...but don't always make it...or they come to us first and then we ship them out.
High risk OB patients are referred to the "big" hospital, when it is, of course, in their best interests..both for mom and baby.

It's the same at our hospital but we are losing patients due

to the fact that the Docs would rather deliver thier patients

at a hospital with an NICU than split up a mom and baby if

the baby needs to be transported.

Jolie, BSN · Mar 25, 2005

It's the same at our hospital but we are losing patients due
to the fact that the Docs would rather deliver thier patients
at a hospital with an NICU than split up a mom and baby if
the baby needs to be transported.

It's also a financial/liability issue for the OBs who already pay astronomical rates for malpractice insurance. I most recently practiced in PA, where malpractice rates are among the highest in the nation. Our hospital developed a NICU because the OBs demanded it, as their insurance either would not cover them at NICU-less hospitals, or charged them higher rates if they delivered at such facilities.

Spearfisher · Mar 25, 2005

I have worked in sales for the past ten years. You need to define your advantages (price, comfort, service) clearly over the competitors. If to the DR.s are not getting the results you want, then directly to your costomer (they need to ask the DR.s to go to you). If you really do have an advantage you will start to see more customers. Good luck.

SmilingBluEyes · Mar 25, 2005

Gosh, I am so sorry. Sure is a real problem when doctors are taking their patients (and business) elsewhere. Sounds to me as though you will definately have direct your selling efforts/advertising to your DOCTORS as much as you do the PUBLIC. I see that as a HUGE need right NOW for you.

If the doctors are not "on board"--- unless you can attract additional pracitioners that do OB (midwives/dr's/family practice docs)-- it will be very difficult for you to survive this. Anyway to bring "low risk" practioners on board?

Good luck there. I went thru an OB unit closure a few years back. NOT FUN.

kc2004 · Jun 2, 2005

Hello Everyone, Just an update for you. We had a mandatory

unit meeting with the "executive staff" today and they have

decided to close our unit effective July 1st. No attempt to

recruit Dr's, no NICU as promised, just closing. I think if they

had tried to save this unit it would have worked,but they didn't

even bother. :angryfire I've got 4 weeks to find another job.

I've worked here almost 11 years. I can't believe this is happening :crying2: