How the Kentucky Children’s Hospital NICU is improving life for babies and their families

A decade ago, Dr. Peter Giannone joined UK HealthCare as our chief of neonatology at Kentucky Children’s Hospital. In the time since, our Neonatal Intensive Care Unit (NICU) has nearly doubled its beds, from 54 to 97, and launched multiple outreach NICU efforts across Kentucky. As of May 2024, UK HealthCare provides ongoing support to seven NICUs in Central and Eastern Kentucky, and manages the NICUs at Baptist Health Corbin and Frankfort Regional Medical Center.

We recently caught up with Dr. Giannone to talk about what makes our NICU stand apart, why it’s important to continue evolving, and how we help NICU families after their stay.

What distinguishes the NICU at Kentucky Children’s Hospital from others in the region?

Dr. Peter Giannone: We are the only Level IV NICU in the region, and one of only two Level IV NICU programs in the state. That means we provide the highest level of neonatal care there is. We have the most experience in the region caring for the smallest, most complex, critically ill newborns.

We not only support a high-risk delivery service for babies delivered here, but we also receive transports of sick newborns delivered at other hospitals in the region. About half of the patients in our NICU are admitted from other hospitals.

UK HealthCare is the only hospital in the region that is able to care for babies as small as 22 weeks gestational age, and our surgeons can operate on newborns who require cardiac and other surgical interventions. 

We have a new, dedicated neuro-NICU — for babies with brain injury or who have the potential for brain injury — that focuses on preventing further injury and achieving the best outcomes for those babies. 

We are also one of two ECMO centers in the Commonwealth for neonates (newborns 28 days or younger). Our team is able to put babies on heart-lung bypass whose heart and lungs are failing shortly after birth.

We are also one of the few NICUs in the country right now that has an active point-of-care ultrasound program, where we can do ultrasounds at the bedside on our little ones and help with real-time diagnostic changes. A big thing that does is decrease radiation exposure for these little babies. We don’t know the long-term effects of radiation, so that’s always a concern. 

In your time at UK HealthCare, what has changed most about how our NICU program helps Kentuckians?

Dr. Giannone: We have really fostered all the people on the team, and all the unique disciplines across the team, in a way that allows them to focus on their expertise and feel better valued. They all have a voice at the table, and that truly rounds out the care for a baby. 

There’s so many things going on with the family and stresses in the family – making sure that we get medications right with the pharmacy and making sure the baby is getting proper nutrition and growing properly, and all of that’s taken care of by our nutrition team. We make sure families have psychosocial support, because the more they feel supported, the better they are and the better they can care for their babies in the NICU. That’s been shown to decrease a baby’s length of stay and get them home sooner with their parents.

It’s all about embracing a multidisciplinary, team approach and putting the family at the center of our care while also making sure they feel involved in their baby’s care. We value their feedback and opinions as much as anyone’s.

Can you share more about how families are supported in our NICU?

Dr. Giannone: Having a baby in the NICU is often traumatic, and it’s definitely a stressful time for patients and their family members. We have to offer them several things to help them get through this. 

No. 1 is our social workers — they are great. They can help with the burden of travel, help families secure lodging at Ronald McDonald House when they are here. Parents are also allowed to stay at the bedside 24/7 in our NICU, and we have a sleep space for one of the parents if they need to stay. Our social workers can also help arrange transportation and provide gas money, if needed, to help them get here. For moms who are breastfeeding, we can offer them meal trays to make sure they’re keeping up their nutrition and are able to supply breast milk for their babies. 

There’s also all the mental stress that parents are going through. We currently have a dedicated NICU psychologist fellow who we hope to retain and continue on as our NICU psychologist. That’s really important, because we can identify families who are in crisis and under a lot of stress. Through the NICU psychologist, we can help them get further counseling, so they can stay grounded throughout their stay. We make regular, multidisciplinary psychosocial rounds on families who seem to be under the most stress. We also have hospital chaplains who are a great support to families. 

We try to do everything we can to support families in our NICU and are constantly trying to identify better ways to meet their needs.

How did we determine that a NICU psychologist was needed?

Dr. Giannone: We definitely saw that some NICUs were starting to bring in psychologists. We had a mother who was also a nurse at Frankfort Regional Medical Center. She was so open about sharing her story and the stress she endured, and the triggers she felt. Even something like driving on the same road, after the baby went home and was safe, was triggering. 

That really helped solidify that we need to do a better job helping families experiencing this trauma. It is an incredibly traumatic experience, because it’s not expected, usually. Everything’s coming in one big wave, so it’s important for them to know we’re here to help them get through it.

What do we offer to babies and their families after they leave our NICU?

Dr. Giannone: After our babies go home, we have a NICU Graduate Clinic. It provides specialized follow-up care for babies and young children until they’re about 3 years old. We see patients there who were cared for in our NICU, but also others who were born prematurely and are at risk.

We also have a special Complex Care Clinic where they can continue to have their multidisciplinary care coordinated by a neonatologist who’s familiar with their medical problems, even after they go home, to help with that transition and hopefully keep them out of the hospital.