Fading maternity wards, winter on the way: Why this hospital CEO is planning ahead

Deborah Browning, MSN, RN, is the new CEO of USA Health's Children's and Women's Hospital in Mobile, Ala. As birthing services dissolve and the busy pediatric season looms, her sights are set on growth, she told Becker's

Editor's note: Some parts of this conversation were lightly edited for clarity and concision. 

Question: You're uniquely positioned as a women's and children's hospital right now. The healthcare industry has seen many maternity units shutter over the past year. Do the recent closures provoke any concerns?  

Deborah Browning: You know, it's interesting, because we've seen three hospitals announce in the last couple of weeks here in Alabama that they will cease delivering babies. So that creates for many women the need to drive for over an hour, hour and a half to reach care, and for some families that just doesn't or can't happen due to jobs, due to gas money, to travel. 

So it is going to be upon our team to think about how we begin to provide outreach to those communities, and whether we think about transport, whether we think about outreach clinics. We've got to find a way to partner with smaller communities and then refer them into our services as we can.

Q: Do you expect to see a surge in patient population as more local hospitals cease birthing services?

DB: I think it is very possible within our community that we'll see additional patients and need to be able to accommodate that volume. I also believe we need to partner for a strategy around maternal care during pregnancy so that when [additional patients] come to deliver, the outcomes are optimized.

Q: Speaking of partnerships — which are front-of-mind for many academic health systems right now — are there any specific organizations you're teaming up with? 

DB: We have been partnering very heavily with United Way here in Mobile, and then secondly with the Institute for Healthcare Improvement. The Children's and Women's Hospital at University of South Alabama was one of a cohort of academic medical centers that have spent the last several months partnering to study decreasing perinatal morbidity and mortality. 

[One project underway] is a home blood pressure monitoring program for women who have delivered their babies and have been discharged home. We also send our moms home with a bracelet that says "I've just delivered," so that if a mom presents back to the emergency room in her hometown and she's running a fever, she looks ill and she forgets to say, "Hey, I just delivered a month ago," it's a clue to the medical staff that this woman may be at risk for complications after delivery.

And then we are currently using adaptive software that helps us begin to look at how we provide care and how that care may be influenced by patient age, by patient race, so that we begin to understand our own disparities in care and begin to impact. That's really the first step for all of us as healthcare organizations, is recognizing within our doors where we can begin to do things better.

Q: What other priorities do you have for your first year as CEO? 

DB: The biggest priority is the development of our strategic plan for the growth of both children's and women's. Children's and Women's Hospital is unique in that it is a children's and women's hospital together — a pediatric tower and a women's tower — and so it's really beginning to think about what we may need for physical changes, renovations, additions, to give us more neonatal ICU beds, more pediatric ICU beds, because we will be really busy all during the winter. And we never want to have to divert a child from this community. 

Likewise, our OB business is busy and I think it will continue to grow, especially as other hospitals stop services, so how do we accommodate that growth given our current setting, and how do we plan to stay poised for future growth to meet needs? 

Q: Any specific challenges you foresee as you develop that strategic plan? 

DB: I think for all of us [in healthcare], it's recruitment of key subspecialty services. We know we're facing a shortage of OB[-GYN]s in the coming years, shortages within anesthesia. And these are problems that we all have, but they can certainly impact care and the services that we provide. 

I also think fundamentally, you know, we have a different workforce post-pandemic: many, many new graduates on nursing units, people who maybe have not worked in a hospital before. So how do we support people in healthcare organizations that are fundamentally changed forever since the pandemic? Although, we are now very uniquely able to respond in ways that we could not before the pandemic. So I think the pandemic gave us the opportunity to learn how to mobilize very quickly in times of emergency situations, and pull very strong teams together.

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