The Wayne State University School of Medicine at the Detroit Medical Center is submitting an application for renewal in the Multicenter Network of Neonatal Intensive Care Units. The Division of Neonatal-Perinatal Medicine has both an inborn service at Hutzel Hospital and an outborn service at the Children's Hospital of Michigan. Hutzel Hospital contains a tertiary perinatal center with the largest inborn service in the State of Michigan, with a 100 bed regular newborn nursery, 36 bed intermediate nursery, 12 bed admission observation nursery and a 35 bed NICU. Children's Hospital of Michigan is only one of 2 neonatal centers in Michigan with a 40 bed NICU providing the entire spectrum of medical and surgical services needed for the care of high risk infants. The Division works in close collaboration with the Division of Maternal-Fetal Medicine, staffed by 10 specialists in Maternal-Fetal Medicine, and a specialist in Reproductive Genetics. The Division of Maternal-Fetal Medicine is applying for participation in the Maternal Multicenter Network. The strengths of the Neonatal-Perinatal Division include the vast number and diversity of the patient population. The Wayne State Center had 8900 deliveries in the inborn service at Hutzel and 624 admissions to the outborn service at Children's. The Wayne State site has the additional capability of including two more inborn sites: Grace Hospital (4211 deliveries) and St. Joseph Mercy (2400 deliveries). Nursing support is excellent, with 1:2 nurse to patient ratio for ventilated neonates, 2 respiratory therapists, and a social worker dedicated to each NICU. State of the art technology is available, including cardiorespiratory monitoring, 24 hour sonography, CT and MRI. The existing neonatal-perinatal data base is extensive. The educational and research programs are very strong, with daily and weekly conferences between Neonatology, Maternal-Fetal Medicine, Reproductive Genetics, and subspecialties when necessary. The newborn follow-up program has a well-established track record in obtaining grant monies and assessing LBW neonates with hemorrhage, BPD, drug exposure and ECMO. The Neonatal-- Perinatal Division has actively participated in the current Network by contributing the largest number of neonates for data collection in the geneTiC data base. The enrollment of neonates into the IVIG study continues to improve monthly. The IVH observational study, the third ongoing Network study, was planned and organized by the WSU Center Site, with Dr. Shankaran as PI for this study. To make the conduct of clinical trials within the Neonatal Network more efficient and cost-effective, the WSU Site plans to have realistic projections of patients to be enrolled; have 24 hour coverage for patient recruitment, with current research nurses covering the day shift and on-call fellows recruiting at night (for a small fee). If the WSU Site is accepted on the Neonatal and Maternal Networks, research nurses will be cross-trained both for recruitment and for carrying out specific parts of protocols. Patient attrition will be reduced by innovative means, including a small gift/monetary compensation for participation.
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