Click here to view video of Murphy’s remarks.
WASHINGTON – During a U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on the impact of the opioid crisis on children and families, U.S. Senator Chris Murphy, a member of the HELP Committee, touted a program at Yale-New Haven Children’s Hospital that improves health outcomes for infants born with opioid dependency. The Yale program has successfully reduced the average number of days infants with opioid dependency remain in the hospital from 28 days to just over 8 days. Murphy asked Dr. Stephen W. Patrick – Assistant Professor of Pediatrics and Health Policy, Division of Neonatology at Vanderbilt University Medical Center – about ways to expand the Yale-New Haven Children’s Hospital model.
“Yale Children's Hospital conducted a quality improvement study to look at how to best care for these kids. That meant low stimulation rooms, swaddling, soothing, feeding on-demand, trying to enhance the bond between mother and child. The results were really extraordinary,” said Murphy. “Average length of stay in the NICU went from 28 days to just over 8 days. Morphine treatment in the NICU decreased from 98 percent to 44 percent. How important is this treatment, and are we ready to do more of it?”
Highlights of Murphy’s exchange with Dr. Patrick are below:
MURPHY: “I wanted to come back to Dr. Patrick to expand on this conversation about Neonatal Abstinence Syndrome. A few years ago, Yale Children's Hospital conducted a quality improvement study to look at how to best care for these kids. And what they attempted to do was build a really comprehensive, non-pharmacological approach to caring for these infants.
“That meant low stimulation rooms, swaddling, soothing, feeding on-demand, trying to enhance the bond between mother and child. The results were really extraordinary. Average length of stay in the NICU went from 28 days to just over 8 days. Morphine treatment in the NICU decreased from 98 percent to 44 percent.
“And my question is, how important is it to prioritize non-pharmacological treatment for NAS, and are our hospitals ready for this? You have to have more nurses, you have to have dedicated physical space, in order to do this right. How important is this treatment, and are we ready to do more of it?”
PATRICK: “Well, my colleagues at Yale have built a wonderful program.
“It's vital. Non-pharmacological care is vital. We find as we do that in our hospitals, we're using less morphine. So which would you rather have? Would you rather have your mother on morphine, [or] putting moms, babies together? Creating that environment is so important.
“As far as whether hospitals are ready for it, I think we do have challenges in many communities, particularly rural communities. We know in states like ours, in Tennessee, and in my birth state, West Virginia, there's a really high number of opioid-exposed infants, and sometimes the Neonatal Intensive Care Unit is the only pediatric place in that hospital. So, I think when we think about how this is implemented – how do we begin to de-escalate the care that we provide for infants, and create a model where families can stay together – I think it may look slightly different in different hospitals. Hospitals that may not have the resources that Vanderbilt has to support lactation, we have a child life specialist who's building a cuddler program, so with moms who can't be there, we are able to support that.
“I think it's going to look a little bit different everywhere. But it is vital.”