NICU levels

[Anonymous]

Does anyone know where I can find a list of exactly what levels the area NICUs are - for example IIIB, IIIC, etc.

I am not having much luck finding this info through google. I found info on Children's and on VHU (looks like they recently partnered with Children's or something, per the article I came across).

I'm most interested in DC hospitals that deliver, however.

Thanks.

[Anonymous]

The highest level (4) in the immediate DC area are Children's and Georgetown.

[Anonymous]

For all I know, the highest level is now called IIIc instead of IV.

Also, the levels are not categorizing NICUs, but newborn nurseries in general. Level I is a well-newborn nursery, Level II is a special care nursery, and only Level III (a, b, c) is a NICU. So Sibley, for instance, does not have a NICU in the strict sense of the word.

Some hospitals list their level on their website, maybe not all.

[Anonymous]

No idea about a list, but I could type in the name of the hospital and "NICU level" and get the info. GW says III, and Holy Cross says IIIB. Not the most efficient way, but not too burdensome either.

[Anonymous]

I can vouch for Holy Cross as a frequent flier. Two babies there 2 years apart. They were excellent. What is the impetus for your query?

[Anonymous]

The INOVA system is good - with Fairfax having the highest level III (http://www.inova.org/healthcare-services/pediatrics/types-of-services/nicu.jsp)

You have to remember that Children's is NOT a delivery hospital so if your baby ends up there, you will not be there until you are discharged. Also, generally if your baby ends up there there are serious issues.

[Anonymous]

Anonymous wrote:No idea about a list, but I could type in the name of the hospital and "NICU level" and get the info. GW says III, and Holy Cross says IIIB. Not the most efficient way, but not too burdensome either.

Anyone know if GW is a III A, B, or C?

[Anonymous]

I read the same article you did yesterday - VHC is IIIB and Childrens is IIIC, the highest AAP designation.

From the article: Virginia Hospital Center's NICU is a Level 3B and can care for babies at and above 24 weeks gestational age. Approximately 10 percent of babies born at Virginia Hospital Center require NICU care. The medical capabilities of Level 3B include providing a higher level of respiratory support for babies requiring high-frequency ventilation with an oscillator, and providing nitric oxide for babies in need of help to circulate blood with higher levels of oxygen.  Babies requiring surgery would be transferred to a medical facility with pediatric surgical specialists and/or subspecialists that best fit the needs of the patient and family.

[Anonymous]

Georgetown and GW are levels IIIC and widely regarded as the best NICUs in the region. If you want a higher level NICU, you'd have to travel to New York.

[Anonymous]

I entered: "hospital nursey level i ii iii iv definition" in Google and found the following site:
http://mhcc.maryland.gov/consumerinfo/hospitalguide/hospital_leaders/hospital_leaders_help/glossary.html

This provides:

Level of care—The range of treatment or procedure a patient receives. This includes the medical level of expertise available.

Level I Nursery Services—Level I hospitals have all the capabilities for normal births and births with minor complications. This type of hospital is designed for newborns who have been carried to nearly full term and the delivery is expected to be uncomplicated.

Level II Nursery Services—Level II hospitals have additional equipment and staff to handle more complicated births. This level is for newborns with a slight potential for risk during the delivery. In general, Level II hospitals can provide care to newborns delivered at 32 weeks or at 3 pounds, 5 ounces or more. Level II hospitals also provide care for uncomplicated births.

Level III Nursery Services—Level III hospitals have equipment and staff to handle very complicated births. This type of hospital can care for babies who are premature (babies delivered before 32 weeks and at very low birth weights of less than 3 pounds 5 ounces) or who have serious illnesses or abnormalities requiring intensive care before, during, or after delivery. Level III hospitals also provide care for uncomplicated births.

Level III Plus Nursery Services—Level III Plus hospitals can provide care for very complicated births; they are located near a Level IV hospital to ensure rapid transfer of the newborn if additional care is needed. Level III Plus hospitals provide selected specialty services. Level III Plus hospitals also provide care for uncomplicated births.

Level IV Nursery Services—Level IV hospitals can care for the most complicated births. Level IV hospitals provide comprehensive critical care for the newborn and have a full range of specialty services. Level IV hospitals also provide care for uncomplicated births.

There is also very good information at: http://preemies.about.com/od/allaboutthenicu/tp/Nicu-Levels.htm

and if you click on the "Level 3 NICU" you'll see a breakdown of what IIIA, IIIB and IIIC include.

[Anonymous]

Anonymous wrote:Georgetown and GW are levels IIIC and widely regarded as the best NICUs in the region. If you want a higher level NICU, you'd have to travel to New York.

I think GW is only IIIB. Which is still really good, and sufficient in the large majority of cases. They can still deal with micropreemies etc.

Here is a publication by AAP spelling out their recommendations for NICU classification:

http://pediatrics.aappublications.org/content/114/5/1341.full#sec-9

There is no nationally standardized classificatory system, but in most areas, level IV is not recognized anymore, following AAP recommendations:

http://preemies.about.com/od/allaboutthenicu/qt/What-Is-A-Level-4-Nicu.htm

[Anonymous]

PP again - so in AAP's system, IIIc is the highest level, which GT has.

[Anonymous]

OP here, thank you all. Had my first in NYC so I'm not as familiar with DC area hospitals. Hoping we won't need the NICU again, but...would rather be prepared.

[Anonymous]

Isn't Inova Fairfax level IIIc too? I know of a 22w6d baby born there!

[Anonymous]

I was admitted to Virginia Hospital Center at 24 weeks with my dc, where my then ob delivered. I flat out asked her that if she thought there was any chance I could have my baby at that time, shouldn't I be at Georgetown? She said yes, made some calls and I was on my way w/in the hour. That to me says a lot, and thankfully my ob put me and my babies care before her ego.

I did not deliver until 34 weeks, but did need the GTown NICU. They are excellent and I will definitely deliver there next time just to be safe. The hospital approach dealing with my preterm labor was also a 180 from Arlington. Arlington gave me a million drugs, and told me that I would likely be in the hospital, laying in an inverted position, until I delivered. Gtown said my drug cocktail could have caused my lungs to fill with fluid, switched everything up, said to stay off my feet and sent me home in a week for bed rest and weekly appointments. I felt totally comfortable with this, but it is just still so amazing to me how different these hospitals were.

I'm sure you will be fine, but a definite thumbs up for the Georgetown NICU and prenatal care.