Contact: Dr. Michael Sherf, MD Director General Tel: 972-8-640-3408, Fax: 972-8-627-7364 E-mail: michaelsh@clalit.org.il Soroka Medical Center Irit Bibi External Affairs Tel: 972-8-640-3963, Fax: 972-8-640-3901 E-mail: iritbibi@clalit.org.il Dr. Gerry Showstack Resource Development Tel: 972-8-646-7435 Mobile: 972-54-220-2608 E-mail: shows1@netvision.net.il American Friends of Soroka Medical Center Rachel Heisler-Sheinfeld P.O Box 184-H Scarsdale, NY 10583 Tel: 914-725-9070, Fax: 914-725-9073 E-mail: americanfriends@soroka.org website: www.soroka.org
Neonatal Care at Soroka Medical Center Construction planned for new Neonatal Care Center The new Neonatal Care Center will serve all newborns in the Negev. More than 1,000 babies are born every month at Soroka Medical Center, more than at any other hospital in Israel. The new Neonatal Care Center will be fully protected against missiles in line with lessons learned during the war in Gaza. Background The Neonatal Department at Soroka Medical Center serves the one million residents of the Negev and is the busiest and one of the leading neonatal departments in Israel. With more than 14,000 births per year Soroka Medical Center has the busiest delivery room in the country. At any given moment, there are more than 150 newborn infants being treated by Soroka s neonatal services. The department operates according to ISO 9001 and was the first neonatal unit in Israel complying with these demanding international standards, ensuring the most advanced medical treatment including care for all premature births. Due in part to the recent increase in treatments for infertility, there is an increasing incidence of premature births. More than 15% of newborn infants have serious medical problems requiring intensive or special care. In the sole medical center serving the entire southern region of Israel, the Neonatal Department cares for more than 200 Very Low Birth Weight (VLBW) babies and more than 2,300 admissions a year. The neonatal medical team at Soroka has pioneered a unique model of care for its patients. Involving members of the infant s family in family-centered care, the medical team has developed methods that allow premature and other babies needing special care to start life in a normal caring atmosphere and increase both the probability and the quality of survival. 1
The existing Neonatal Department was built in the 1980's. The physical conditions of the facility have become outmoded and are no longer sufficient or appropriate. The unit was built at its time with the then most modern concept which included penetration of daylight through windows as well as glass bricks in the ceiling. Of late, during the War in Gaza and repeatedly since then, this has become a dangerous trap. During the War in Gaza which began in December 2008, the team was forced to swiftly evacuate all the new mothers and infants from the Neonatal Department to protected quarters within barely an hour after the first missile fell nearby. While there was some risk in moving the premature babies, the risk of injury or worse from missiles was intolerable, and the decision became clear as soon as Beer Sheva came under direct fire. Working under direct threat in a complex operation that enlisted the human and technological prowess of our doctors and nursing staff, and assisted by the Israel Defense Forces Home Front Command, the infants and mothers were transferred to a suitably protected building. All of the preemies survived the move to the improvised site without any injuries. The infants and their families were forced to remain in the facility to which they were transferred during the entire period of the war. Since then we have been forced to evacuate and move the unit repeatedly as Beer Sheva and Soroka have repeatedly come under missile attack. Neonatal Care Today The Neonatal Department staff includes eight senior neonatalogists, five rotating pediatricians in-traning and 80 nursing and support personnel. The guiding principles for treating the hospitalized newborns are to place emphasis on the infant's health and safety, engage parents' maximum involvement toward the infant's discharge to their home following an extended and often dramatic 2
hospital stay, and ensure proper preparation of the family to acquire confidence and assume responsibility for the care of their infant. The chairperson and physicians of Soroka s Neonatal Care Center are also deeply involved in bringing the best neonatal care to developing countries. Since 2002 the team has been involved in a large and unique program in Kumasi Ghana in collaboration with MASHAV, the Israel Ministry of External Affairs, and the Millennium Cities Initiative. This program is aimed at reducing infant mortality, and applies innovative concepts of low cost interventions and sustainability. This project is in concordance with the fourth millennium developmental goal (MDG4). The work includes physicians and nurses from the Neonatal Department and is performed primarily on a voluntary basis. The Neonatal Department is divided into four sections: 1. Delivery Room section or triage (DR) 2. Neonatal Intensive Care Unit (NICU) treating premature and very sick infants 3. Special Care Unit (SCU) for moderately sick babies and near preterm infants and 4. a step down or Recovery Unit (RU) for infants before discharge. Healthy newborns are cared for in the maternity wards with full rooming-in with their mothers. The Delivery Room section (DR - Neonatal Triage) is an innovative concept where a neonatal team including physicians and nurses are present 24 hours a day in the delivery area and provide resuscitation needs as well as the triage necessary before the infant is moved to rooming-in or any of the other neonatal units. The Neonatal Intensive Care Unit (NICU) provides level-three lifesaving care for preterm infants. The Special Care Unit (SCU) treats infants that need level-two treatment and those convalescing from the NICU. The Recovery Unit (RU) cares for preemies and other infants with special needs transferred to this unit after their condition has stabilized. They are cared for by their parents under the watchful eye and careful guidance of the medical staff. At the end of the stay in the Recovery Unit, the infants are discharged home with their parents who are now confident in their knowledge and ability to care for them. Collaboration with medical services in the community is also an integral part of the activities of the unit. At present the Neonatal Department occupies two separate areas, far from each other and the delivery room services. The Neonatal Intensive Care Unit is located on the ground floor of an old building that is unprotected against missile attack. The upper floor of another building houses the Special Care 3
and Recovery Units which are also not protected from missiles attacks. The delivery suites are located in a new modern building inaugurated in 2011. Due to the physical distance separating the buildings, the staff is forced to function as separate professional teams in separate spaces, a situation which creates hardship for the medical professionals, the families, and the staff. To make matters worse, each of the units is much smaller than is needed and the size dictated by today's criteria for treating infants and caring for their families. The Need Urgent need to construct a missile-proof facility in accordance with the security needs and dictates of the area Increase the number of beds from 58 (needed in 1996) to 87 (needed in 2012) responding to the natural increase of population Adapt the building and the care environment to the fast-paced advancing technology of neonatal care Adapt to the needs in keeping with new concepts of family centered neonatal care Develop the triage section in the delivery suites area Respond to the needs of the increasing number of medical students and other healthcare professionals trained in the department from 50 (in the 1980's) to more than 150 each year The Goal To expand and protect the neonatal care facilities to serve and care for all infants born to the familes of the southern half of Israel, providing them with medical care of the highest standards in a family-centered approach as pioneered at Soroka Medical Center, and in a safe and secure setting. The expanded facility will allow medical staff to provide the care needed to best nurture these newest Israelis and their families. Neonatal Care in the Future The new Neonatal Care Center will make it possible to implement the highest standard of care aimed at improving neonatal outcomes. 4
The highly improved conditions will allow us to implement the principles of Family-Centered Care to the fullest. Emphasis will be placed on integrating the parents into the unit's work plan, ensuring that they are involved in the infants' care and assume ever-increasing responsibility for that care. Neonatal Triage - The neonatal team including physican and nurses will function in the delivery rooms providing for the resuscitation and stabilization needs of all babies before they are moved to rooming-in or to any of the other neonatal units. Today, this team functions in a remote area. In the newly built maternity suites an area is designated for this team and needs to be equipped to meet this need. Neonatal Treatment Rooms will be the heart of the new unit, with additional beds and sufficiently spacious areas for each infant to allow at least one of the parents to comfortably care for their infant throughout the day. Care Areas will be created that allow an environment according to the highest available standards. Each area will be partially separated by dividers allowing privacy and will include equipment and furnishings necessary for parents to take care of their infant and relax comfortably between treatments. Lodging Facilities will be included for parents and their infants, needed as a step toward the family s independence before discharge. Leaving the highly monitored intensive care environment is often perceived as a significant challenge by parents; these rooms allow a smooth landing in the transition back to home and community. Training Rooms for Parents will be areas designed for group and individual instruction. Breast Milk Pumping Facilities will provide convenient arrangements for the mothers to express and store milk. Family Rooms will be welcoming areas for siblings and other family members accompanying the parents. The facility will also include a Resource Room that offers books, pamphlets, and instructional films on infant care and common problems encountered, links to information on the internet, as well as activities for siblings (videos, children's books, games, etc.). Dining Area for Parents will be conveniently located adjacent to the neonatal treatment rooms. Paramedic Support Area Room is needed for those professionals physical and occupational therapists, dieticians and pharmacists, and others involved in the complex multidisciplinary approach to the care of sick newborns. Training The neonatal department is involved each year in the training of more than 150 medical students from Ben-Gurion University s Medical School and The Medical School for International Health, a joint venture with Columbia University, as well as residents and fellows. 5
Program This preliminary sketch shows the main thrust of the needed construction of the new Neonatal Care Center, and its connections to the existing maternity units. Detailed plans will of course follow. Saban Birth and Maternity Center SHIELD NICU 1,000 m 2 Intermediate care 1,000 m 2 Utilities existing NICU 800 m 2 BRIDGE BRIDGE Delivery suites Maternity departments Utilities Admission triage existing future 6
Donation and Donor Recognition The new facility is currently in the planning stages. This urgent and important project will be of major proportions. Plans and renderings will soon be available. The new Neonatal Care Center can be named by the donor. Full and very prominent donor recognition will be provided at the Neonatal Care Center and at the Donors' Wall of Honor of Soroka Medical Center. The facility will be dedicated at a major dignified public dedication ceremony. The donor will be recognized in all publicity and publications of the Neonatal Care Center. Thank you for your consideration of this proposal and request 7
Soroka Medical Center Soroka Medical Center is among Israel s largest and most advanced hospitals, and the country s most active. Soroka is the only major medical center in the entire Negev, serving a population of more than one million inhabitants, including 400,000 children, in a region that accounts for 60% of the country s total land area. Soroka serves as the teaching hospital of the Ben-Gurion University Medical School, whose Faculty of Health Sciences is located on the hospital campus. On par with leading international institutions, Soroka is a recognized specialist in areas including early detection and treatment of breast cancer using minimally invasive procedures; revolutionary treatment of myocardial infarction involving genetic engineering; non-invasive removal of malignant tumors; leading research in the development of skin cell transplants; trauma rehabilitation of children and adolescents; pediatric infectious diseases; and much more. Each year, Soroka cares for more than 500,000 outpatient and clinic visits, 200,000 emergency cases, 80,000 hospitalizations fill its 1,000 beds, over 32,000 surgical procedures are performed, and more than 14,000 babies are born. Its neonatal and pediatric departments provide family-centered intensive care with world-class survival rates. Soroka s Trauma Unit is the largest and busiest in Israel, always on call, 24 hours a day, 365 days a year. Soroka serves as the regional trauma center for victims of terror and for all Israel Defense Force bases in and near the Negev. This need is unfortunately constant and increasing, most recently in light of the ongoing security situation in areas bordering Gaza. More than 3,000 trauma patients are admitted to Soroka annually. Soroka s physicians travel in mobile units to care for patients in remote clinics as part of Soroka s community outreach programs. Soroka educates the Negev s diverse population in preventive care and public health. Soroka is also the largest employer in the Negev, with more than 4,000 employees, including more than 800 new immigrants on staff at all levels of responsibility. Soroka Medical Center stands at the forefront of medical progress, and is currently upgrading and enhancing research capabilities and the healthcare it provides. Soroka s staff is dedicated to advancing research and to providing the best medical and emergency care, while treating the patient as a whole human being. 8