Regional Perinatal Center (RPC) Responsibilities

The Regional Perinatal Center (RPC) has the following responsibilities to its affiliated hospitals and patients:

Provision of Patient Care

• Provide all aspects of perinatal care including all subspecialty services, laboratory supports, and medical/diagnostic imaging services needed by pregnant women, newborns, and postpartum women
• Ensure the availability of pediatric cardiac surgery in less than four hours after birth 24-hours a day, seven days a week
• The RPC's Chiefs of Healthy Newborn Nursery and the Neonatal Intensive Care Unit (NICU) must be board certified in neonatal medicine and the Chief of Obstetrics must be board certified in maternal-fetal medicine in order to provide the highest level of guidance for perinatal health issues both internally and among affiliates
• Chiefs must jointly coordinate perinatal services in order to ensure the provision of a continuum of high quality perinatal services
• Ensure that in-house personnel are qualified to manage any type of emergency 24-hours a day, seven days a week
• If two or more hospitals jointly form an RPC, each hospital must have the ability to provide the same, high level of patient care to all pregnant women, newborns, and postpartum women

Provision of Consultation and Support to Affiliate Hospitals

• Ensure all affiliates have an understanding of the types of patients they are able to care for at their facility and are aware of when patients may need RPC consultation and transfer. This includes the affiliate providing guidance to its medical staff regarding the triage of high-risk pregnant patients to a more appropriate level of care when indicated.
• Provide 24-hour consultation and subspecialty services to all affiliates and ensure affiliates have an understanding of the procedure to access timely consultation
• Coordinate or perform transfers of high-risk pregnant women, newborns, and postpartum women to the RPC or facility with an appropriate level of care. Regardless of whether the patient will be transferred to the RPC, the RPC must be consulted and notified of the transfer by the affiliate.
• Have the capability of initiating a transfer from a referring hospital within 30 minutes of the incoming call from an affiliate hospital

Quality Improvement

• Develop and implement plans for continuous quality improvement for all perinatal services (obstetrical and neonatal) incorporating medical, as well as nursing and ancillary personnel (e.g., respiratory therapy, laboratory services, etc.). This plan must address quality improvement activities related to the RPC's provision of direct services as well as the RPC's role with the affiliate hospitals. This quality improvement plan must also contain a plan for obtaining input from affiliates regarding the services provided the affiliate by the RPC.
• Provide consultation to affiliates regarding the development and implementation of their plans for continuous quality improvement. Review all quality improvement plans and make recommendations for improvement as needed.
• Implement quality improvement activities internally as well as among affiliate hospitals including a review of:
  1. internal quality assurance program, policies, and procedures
  2. appropriateness and timeliness of maternal and newborn consultation, referrals, and transfers
  3. maternal and newborn serious adverse events or occurrences, including the following:
     • maternal and newborn fatalities
     • maternal and newborn morbidity in circumstances other than those related to the natural course of disease or illness
     • maternal and newborn nosocomial infections
     • maternal and newborn high-risk procedures
     • pathology related to all deaths and significant procedures
  4. periodic case conferences and review of selected medical records to discuss the findings and resulting improvements in the affiliate's quality of care
  5. analysis of statistical date from the Statewide Perinatal Data System (SPDS) for trends and emerging issues

• The RPC shall be deemed a member of the affiliates' quality assurance committee for purposes of this quality review
• Provide support for affiliates for the Statewide Perinatal Data System (SPDS) as follows:
  1. Provide training and ongoing technical assistance to all affiliates in the implementation and use of the SPDS, including the Core and Neonatal Intensive Care Unit (NICU) modules
  2. Provide education and awareness to affiliates as to the use of the SPDS data for quality improvement activities
  3. Compile and review data for new and emerging trends in perinatal care and share this information at regional perinatal forums