Women's pavilion to provide state-of-the-art care

No matter how many years he has done it, the wonder never leaves.

As medical director of women’s services at the Medical University of South Carolina, David Soper, M.D., is used to crises. In obstetrics, it’s normal fare. Even in the pregnancies that are “normal,” about 15 percent will take a surprising turn. 

He’s calm, cool and collected during those crises. But get him talking about the wonder of doing ultrasounds and how lives will be impacted by the new Pearl Tourville Women’s Pavilion, and he tears up. Technology has advanced so much that abnormalities can be diagnosed during ultrasounds at 10 weeks, when the baby is the size of a lima bean.

“It’s incredible. It’s one of the wonderful things we do,” he said, particularly when an early diagnosis leads to a better outcome. It’s why it’s so fitting that the Pearl Tourville Women’s Pavilion was named in honor of Orangeburg resident Pearl Tourville. “It’s a reflection of what it is all about. Your mother – they always make you feel good about yourself. That’s a precious, special sort of thing. To be a part of that for mothers who maybe expect the worst and to be able to provide a better outcome is all part of the wonder.”

Robin Mutz, administrator for women’s health and executive nursing director for MUSC’s Children’s Hospital, agrees, saying that the generous $10 million donation will go a long way to reshape women’s care. 

“This is gong to be a place that gives hope and futures to people who wouldn’t have that otherwise. It is named in honor of a mother by her family. It obviously shows great love that they would use their resources in this way. Now for generations to come, there will be families that begin a new stage of their lives all because of the generosity of this family. It’s a wonderful legacy to a mother who’s obviously loved very much.”

The pavilion is part of the new $385 million, 10-story Shawn Jenkins Children’s Hospitalslated to be completed in 2019. Equipped to handle the toughest and most complicated of pregnancies and neonatal care, the pavilion will give patients access to highly specialized equipment, rare procedures and advanced sub-specialists in pediatrics and maternal fetal medicine, all in one centralized location. 

“Obviously we will provide routine care, but the majority of our care will be focused toward women who have complex, complicated pregnancies or who have the potential for a high-risk outcome or a sick child. So that gives it a very unique perspective. It’s not a community hospital. It’s very high-end, high-tech, but high-touch at the same time,” he said, explaining that compassionate care is a driving principle.

The facility itself has 12 labor and delivery rooms and five high-risk antepartum rooms that are actually inside labor and delivery for women who need a higher level of care. “It’s almost an obstetrical ICU level of care for women who need constant surveillance and high acuity nursing care. They will be cared for in a setting where we have all their resources at their fingertips.”

MUSC’s Advanced Fetal Care Center will be housed on the second floor. If a women gets a prenatal diagnosis that says that the baby has a problem, she will be surrounded by a team dedicated to getting her and the baby through the delivery with the best outcome possible. That means maternal fetal medicine specialists, obstetrical sonographers, pediatric sub-specialists – whoever is needed – is brought to the table, she said.

“They surround that baby and create a plan of care before that baby is even born. So the patients know where they’re going, they’ve seen the team that will take care of them, they’ve seen the facility and then they will come back there for their delivery. It’s great continuity of care.”

The pavilion will have two dedicated operating rooms for obstetrics. There are 29 postpartum beds in the tower designed as single room care so families can stay together. The Neonatal Intensive Care Unit, one floor above, has 82 beds. “It’s the largest NICU in the state. We will have seven NICU couplet care rooms, so that means mom as an inpatient and her sick baby can stay together.”

Research shows the physiological benefits for mom and baby are significant, Mutz said. “It’s important these families stay together and form that bond in taking care of their baby from the time that baby’s born,” she says, citing research that shows when moms spend more time holding their babies, the child gets better pain control and regulation of temperature and breathing. 

“And mom and dad have changed that diaper since the first one, so they are not terrified of a sick baby to take home.”

The pavilion will provide a spa-like atmosphere, complete with valet parking and an express stork elevator that opens directly into labor and delivery. The floors feature a theme of arts of the Lowcountry, with rooms 1-1/2 times the current room size. They’ll overlook the Ashley River with floor-to-ceiling windows. The rooms are appointed with separate zones so there’s a space for caregivers, the patient and the baby. “We want babies to stay with their families. It promotes breastfeeding and helping them feel comfortable in taking care of that baby when they go home.”

Families said they wanted extra outlets for electronic devices and a desk with a workspace, so those have been included in the design. This is important, especially for families that are there for a long time. The goal is seamless care and keeping families together.

Another core concept is putting patients first. For example, a stabilization unit used for babies in a medical crisis features a window so families can see what is happening to their child. “Research shows families do want to see when their child is in crisis. You want to know everything possible was done.”

They want families and children to be comfortable. There’s a proposed outdoor green space where they hope to set aside an area for new mothers. “We all know doing one thing normal and being able to go outside can be so critical to healing.”

By the time the hospital opens in 2019, there will be a technology plan in place to ease communication, including the provision of digital boards in patient rooms for virtual interactions with caregivers. Mutz said core to women’s services are the principles of quality and safety, good communication and making sure patients are at the center of care. 

For example, there are ways to incorporate patients' electronic medical records as a safeguard in increasing the use of scientifically-driven protocols that are state of the art for care.

“The differentiator for us is the ability to really put the patient and family at the center of the care and let the care revolve around them rather than them just being the dumping ground of care. It’s ensuring how the patient’s care and wishes are incorporated into that even in these high-risk situations.”

Mutz said it will require a culture change. This is more than just a new, fancy building. MUSC already is entering into a phase of operational design to incorporate a patient-family centered model of care. “We’re going to start doing something different now.”

For example, obstetric nurses will be partnering with NICU nurses to provide care to mom and baby in the same space, a change that is significant to staff. In the past, mothers with really sick children might have gone days before seeing their child because they were being cared for in different spaces.

“This is going to be pretty different and pretty exciting. Removing barriers of separation really will transform care here.”

It also will bring specialists together in a space that’s more convenient to families. 

Mutz said most people don’t realize children aren’t just little adults. Babies and children have very specialized needs. “In a children’s hospital, you have a pediatric anesthesiologist who understands how to intubate someone whose throat is the size of a straw. There is a pediatric respiratory therapist. There are all the pediatric specialties right at your fingertips.”

Mothers will have access to advanced maternal-fetal-medicine specialists who support the general obstetrics and midwifery staff.  Soper said it’s a combination of high-tech and high-touch care. The pavilion will have the latest in maternal and fetal monitoring to take care of the sickest babies and mothers, and still support those mothers who want that home-style birth experience in a hospital. The difference is, they’ll have top specialists on hand to handle whatever emergency might occur in that delivery situation, he said.

Services provided by the fetal center will include intrauterine surgeries, such as a procedure to address twin-to-twin transfusion syndrome when there is a sharing of blood vessels between twins. Doctors already are performing percutaneous umbilical blood sampling, with the ability to do intrauterine transfusions of babies who have significant anemia. “We can put catheters in babies’ bladders who may have obstructions because of urologic abnormalities. We can reduce amniotic fluid for women at risk of going into pre-term labor because of polyhydramnios.”

Soper said the pavilion will be beautiful, calm and soothing. What he likes most, though, is he thinks families will feel safe. Hopefully, nothing will go wrong, but if it does, they are there to take care of the “seriously and even catastrophically-ill woman.” 

And it’s not just at birth. There’s a continuity of care that can be established for the child’s life, particularly for those high-risk cases where an early diagnosis and prognosis can radically affect a child’s quality of life. 

“Obstetrics is the highest of the highs and the lowest of the lows,” Soper said, adding that he’s excited about how the pavilion will affect not only the care of Lowcountry children but people across the state. He’s thankful for the generous donation that’s making it possible, because the very best care comes at a price. 

“You need to be able to attract the best, the brightest, the most innovative and creative team.”

As a research-academic medical center, MUSC has faculty who are creating the medical protocols and standards of the future,” he said. “We’re writing the literature, providing guidance for practicing physicians. We need these faculty stars who can populate our university and our hospital, and we need to be able to support those people with the technology and an environment so that they can be successful.”

Soper wants to attract providers with special skills who think outside the box and can offer patients interventions that are not available elsewhere. “What we do is wonderful. I think we have to see that kind of wonder and that kind of good in everything we do. We have to get that kind of person here,” he said, adding that it’s not just on the physician level but for nursing and all the staff. 

“The real byword in medicine going forward in this millennium is team. If you can put your team together, you can win the Super Bowl. We want to win the Super Bowl.”