Newborn Intensive Care staff and their allies pushed back against administrators’ plans to cut neonatal patient beds last Friday at Cook County Health and Hospital System’s board meeting.

On April 9th, Dr. Jay Shannon, chief of Clinical Integration for the Cook County Health and Hospital System, told senior Stroger Hospital pediatric staff that, because of a nursing shortage for the Neonatal Intensive Care Unit (NICU), the administration plans to limit the newborn unit to a maximum of 17 patients. Stroger Hospital’s renowned NICU unit has 54 beds and had an average census of 29 babies each day last year, born overwhelmingly to poor, minority women.

The move threatens the long-term fiscal viability of Cook County’s larger public healthcare system, say physicians and frontline staff, who have urged management for years to adequately resource the respected unit, which generates millions of dollars a year in net income for the County’s public health system. Frontline staff have also repeatedly refuted management claims that the NICU loses money, showing instead that the NICU provides between $10 and $14 million in yearly income from Medicaid, which pays for the care – a vital source of income for Cook County’s chronically cash-strapped public healthcare network.

NICU care providers reject Shannon’s claim that the move is related to “patient safety,” noting that under Shannon’s watch nurses on Stroger’s adult medicine and surgery wards routinely care for six to eight patients at a time – a gross violation of staffing norms – while NICU nurses currently care for one to three patients, in line with other hospitals’ staffing levels.

Shannon has told doctors to refuse to accept babies from other hospitals once the new bed limit is reached. About half of Stroger’s NICU patients are transported from other hospitals, and physicians argue that if they refuse transports, referring hospitals will stop calling, since other hospitals are eager to capture the revenues that these tiny patients provide.

“That would be a death sentence for our unit,” one NICU doctor said of management’s scheme.
Some NICU staff met briefly with Health System CEO Dr. Ram Raju after raising their concerns at the Finance Sub-Committee meeting on April 19. Despite assurances that staff would be hired to limit the effect or duration of an admission cap, many remain skeptical.