Today I'm at Park City Hospital with Mackenzie Visentin, a labor and delivery nurse. Mackenzie, thanks for taking a break from delivering babies to come talk to me. Please tell us a little bit about yourself and what you do, and then I'd love to hear what's on your mind today.
Mackenzie Visentin: So, I currently work at the Park City Hospital in an, our unit is LDRP, so we take care of the patient from the minute they walk in until they go home from the hospital. I've been doing that about four years. I've also worked at other Intermountain facilities like Alta View and Primary children's and started out as a volunteer for Intermountain, so I really enjoyed working here for a long time.
Marc Harrison: Wow. So you've got a long Intermountain history.
Mackenzie Visentin: Yeah.
Marc Harrison: So, what's on your mind today?
Mackenzie Visentin: I wanted to ask about how we can expand OB services in a rural setting, specifically capturing the patients who live in the Wasatch Back but are still driving to Salt Lake or to Provo for OB care when it's not a medical necessity; it's by patient choice.
Marc Harrison: So, that's a good question. I'm going to give you my thoughts, but I'd like to hear yours in a second. I think in order to compete for patients, whether it's within the system or out, to keep people here, we're going to have to provide them with the experience they want. Right? And we're going to have to provide it at a cost they can afford.
I think at Park City Hospital we've got a beautiful environment. I've been through your floor, and it's an amazing floor and has a really great energy to it. I think really talking to those patients and understanding in a very specific way why they're leaving, I think, is really important.
So, whether they have concerns about what happens if the baby becomes sick during labor or concerns about different styles of delivery they want that we don't offer here or concerns about the economics, I think we really need to understand the data in a systematic way in order to decide what we need to do to have those folks stay close to home. Does that resonate with you? Does that make sense?
Mackenzie Visentin: Yeah, definitely. Identify the problems.
Marc Harrison: And then try and fix them.
Mackenzie Visentin: Mm-hmm (affirmative).
Marc Harrison: What does your experience tell you some of the reasons people leave are?
I think in the Park City community in particular, a lot of patients want an unmedicated delivery, which is usually managed by a midwife, and that's not something we offer right now. We offer the unmedicated experience that they want, but when they're pregnant, before they show up, they only think in their head that it's an OB, and they don't know that they'll be able to get that experience without a midwife.
Marc Harrison: Do we have a midwifery practice here at Park City Hospital?
Mackenzie Visentin: We don't, and I feel like that's a big missing piece that people particularly go to a midwife, and they will have to leave the valley to get that.
I don't know the history. I'd encourage us to try and understand what that looks like and why and consider rectifying it. One of the things I really worry about in this era is the affordability of healthcare, and to be able to offer a midwifery experience, which is often a bit less expensive to people, I think, may be very attractive to them, and to do that in the context of an excellent medical setting like Park City Hospital so that if things went awry, the baby and the mother could both be safe, I think could also be appealing. Has there been a serious look at midwifery here in the past?
Mackenzie Visentin: I believe so. At one point there was a midwife some time ago, but I've been on the unit for over four years, and we haven't had one during that time period. I know we've recently hired another OB, so we'll now have four OBs practicing here, and I'm not sure where we go from there with that.
I certainly am not averse to different styles of practice. One of the things that we're doing at our new hospital that we're building in Spanish Fork is we're attaching a home style delivery facility to the hospital. So, it will be actually separate, but it'll provide a low cost alternative for people. As you know, a lot of people are paying out of pocket for a lot of their obstetric care these days, but with the safety, we believe, of being proximate to the hospital.
So, I'm really open to all these different models, particularly if it achieves our goals around safety, quality, patient experience, and affordability.
Mackenzie Visentin: Sure, that sounds like something that would work well here as well.
Marc Harrison: Well, I'd encourage you to raise the question around midwifery here, and if you feel like you want to or need to, please feel free to send me an email with your thoughts, and I can try and connect you with the right people.
Mackenzie Visentin: That'd be great.
Marc Harrison: Would that be helpful?
Mackenzie Visentin: Yeah.
Marc Harrison: Great. Well, please do. As long as I have you here, can I ask you if you have any advice for me?
Mackenzie Visentin: Yeah, I don't know any advice I would give you.
Marc Harrison: Well, let me ask you another question. So, you've been here for four years.
Mackenzie Visentin: At the hospital since it opened, but just on labor and delivery for four.
Marc Harrison: Okay. Excuse me. So, you've been here at Park City Hospital for much longer than that. So, tell me what you think is going well or not well with the move to enterprise play and a One Intermountain experience?
I think what is going well is I think it's great that a patient can come to a rural facility, deliver a baby, and have the same experience they would have at a big facility; that they can feel that they're going to be safe, they're going to have the same standards, their baby's going to get the same treatment, whether it was born here or at a large facility. So, of course we've always done that to some extent, but continuing to standardize how the practices and make adjustments will help people feel comfortable in this community.
Marc Harrison: That's great. Is tele-neonatal resuscitation helpful to you?
It is. We use that quite a bit, especially if our pediatrician's not in the building. We have a physician immediately available while the pediatrician's driving into the hospital, which might be a 15, 20 minute period. So, that has helped the nurses feel safe, and it's really given great care to the babies.
Marc Harrison: Well, thanks for being on the team. It's really nice to talk to you.
Mackenzie Visentin: Yeah, thank you coming up.
Marc Harrison: I love coming up here. It's great. Thanks so much.
Mackenzie Visentin: Thank you.