Alexa Spivey was only four days old when she had open-heart surgery. After seven weeks in the hospital, five of those in the Neonatal Intensive Care Unit, she was finally able to go home on Sept. 25. But her parents, Christina and Micheal Spivey of Gould, Ark., were nervous about the extra care Alexa would require.

 

So the Spiveys were relieved when their primary care physician told them about a program called Following Baby Back Home.

 

Launched Oct. 1 by the Kids First program of the Department of Pediatrics at the University of Arkansas for Medical Sciences, Following Baby Back Home offers in-home care by a nurse and social worker to parents of high-risk infants.

 

"Our babies are birth to five (years), but we've realized for a long time that a child leaving the NICU doesn't necessarily get the follow-up care and support that they may need," said Carolyn Y. Marsh, the administrator of Kids First, a day healthcare program for children with special needs.

 

"They go home to a family that may not be prepared to care for that baby or have a support system that allows them to feel comfortable caring for a child that needs special care," she said.

 

The in-home program is funded for one year by a $600,000 grant from the Department of Human Services' Division of Medical Services, and will have to be re-approved each year. It is staffed by three teams of home visitors, made up of a nurse and a social worker, plus a program director who is a nurse, and a part-time social work supervisor.
Referrals to the program are usually made by the primary care physician while the baby is still in the hospital. To be eligible, an infant needs to meet one or more of eight criteria, such as a chronic, serious medical or congenital condition, ongoing feeding and growth concerns, prolonged ventilator support in the nursery or perinatal brain injury.
"The team goes to the NICU and meets the family there, and offers home services at no charge to the family, and they can say yes or no. It's totally voluntary for the family," Marsh said.

 

Some of the babies are discharged with special equipment or care instructions, Marsh said, and the nurse/social worker teams work to help the family feel comfortable with these arrangements.

 

The services are continued as long as needed, and are closely coordinated with the child's primary care provider and/or specialty clinics at Arkansas Children's Hospital to provide continuity of care.

 

Marsh said the goals of the program are to reduce preventable re-hospitalizations, improve the likelihood that medical appointments will be kept and immunizations given, and to build the family's skills and confidence in caring for their little one.
Already, 26 families have agreed to take part in the program. But although the teams have met with the parents, many of the infants are still in the hospital, so home visits haven't begun.

 

Alexa Spivey is one of the first babies to receive care under the new program, and her mom is grateful for the help. Christina Spivey has to weigh her daughter every day and take her pulse, and the nurse will come once a week to take Alexa's vital signs and answer any questions Spivey has.

 

"They said they would come any time I needed them to," Spivey said. "If anything goes wrong, I can call the nurse any time."

 

Spivey said the in-home care is easier and safer for Alexa, whose immune system is weak.

 

"It makes me feel better that she doesn't have to get out of the house and get exposed to the flu and other germs," Spivey said.

 

Alexa is recovering well from her surgery, her mom said.

 

"She's doing good. It's a slow process, but she's doing good. The doctor says her heart is getting stronger."

 

Marsh said the program only covers a portion of the state.