Keeping Up with
Women and Children’s Health Services…

The Smith Hager Bajo Blog provides a forum to discuss the latest trends, best practices, and interesting facts related to Women and Children’s Health Services.  Thanks for visiting our blog!


Navigator Programs on the Rise

When investigating the best navigator programs in the US, I had the great honor of meeting and interviewing Lillie Shockney many years ago.  She is an RN, two-time cancer survivor, author, and has been the administrative director of the Johns Hopkins Breast Center since 1997. She is also certified as a breast imaging and breast cancer patient navigator.  She was a pioneer navigator who continues to make a difference in many lives.

Navigator programs have come a long way. The American College of Cardiologists launched a hospital navigator program that helps reduce readmissions and improves overall patient care (2104). While numbers are elusive, many hospitals offer navigator services for breast cancer, births, women’s health, and spine centers, to name a few.

How are these services funded? While past government funding is probably going by the wayside, private grants and hospital operations continue to fund navigators. As research published in JAMA, Harvard Busines Review, and other journals continues to show cost-benefit related to utilization, outcomes, market share, satisfaction, and other metrics, the number of navigator programs are expected to rise in US hospitals.

Posted on Tuesday, June 27, 2017 at 4:46PM by Registered CommenterSHB Webmaster | CommentsPost a Comment | References1 Reference

Baby Friendly Controversy?

The World Health Organization/UNICEF developed the Baby Friendly Hospital credential to promote breastfeeding in 1991. This noble effort has improved breastfeeding rates at many US hospitals, although it has had negative implications for women who cannot or do not want to breastfeed.

To become certified, a hospital motivates women to breastfeed: touts benefits, makes formula inconvenient and stigmatized in the hospital, and removes the option of free formula to take home if women do not breastfeed. Nurseries are often downsized to a few bassinets and babies stay in mom’s rooms to promote breastfeeding and bonding.  

Articles in the TIMES, on TV and in blogs report rigid approaches have resulted in some babies not getting enough nutrition from breastfeeding, and moms who feel like failures when they can’t breastfeed. Replacing zealotry on either side of this issue with compassion and understanding seems to be a better approach. 

Posted on Tuesday, June 27, 2017 at 6:21AM by Registered CommenterSHB Webmaster | CommentsPost a Comment | References1 Reference

Radically Change the Built Hospital and Medical Office of the Future

So if you’re building or renovating a big hospital with lots of bricks and mortar for emergency and non-intensive care, low tech imaging, and routine medical treatment, think hard about that decision, according to futurist Dr. Eric Topol.  He predicts that more than half of ERs for non-emergent care visits could be eliminated and many patients diverted from clinics and hospitals, as we adopt more virtual approaches to diagnoses and treatment. 

He said “A lot of the diagnosis and monitoring functions will be done through little devices- smartphones- by the patient with computer assistance. So it’s a real big change in the model of how we render healthcare.” (and where)

If you get a chance to hear a lecture or read articles/books from Dr. Eric Topol, do it!  He is a famed Scripps cardiologist, founder of Cleveland Clinic’s college of medicine, and futurist who provides a  provocative picture of how medicine should be practiced today and in the future. 

The future of medicine will be more in our “hands” than in traditional physical facilities.


Posted on Thursday, March 23, 2017 at 9:07AM by Registered CommenterSHB Webmaster | CommentsPost a Comment

Why hospitals and pediatricians should screen children for food insecurity

Did you know that approximately 16 million children are food insecure in the US - do not have consistent access to adequate food? That’s more than 1/5 of children. Even controlling for multiple risk factors, the children who are food insecure, are more likely to be sicker with more hospitalizations, have increased complications when recovering, and have higher levels of mental health issues.

The health of the US and the world can be improved by widespread participation in local and global efforts, and support of government policies to provide undernourished children access to food.  Health providers can make an even bigger difference by diligently screening children and families for food insecurity, educating, and enabling better access to food resources.

Posted on Thursday, March 9, 2017 at 10:00AM by Registered CommenterSHB Webmaster | CommentsPost a Comment

What is cell-free fetal DNA?

If you are interested in what’s going on with genetics, here’s the vocabulary term of the day. Cell-free fetal DNA (cffDNA) is fetal DNA circulating in the pregnant women’s blood stream. Clinicians get a blood sample and analyze its contents. One target of this type of testing is to reduce the need for women to be subjected to invasive procedures. In the past, testing might have been done only because of maternal age to help rule out specific fetal issues during pregnancy. For more information on the risks, benefits and alternatives to this test, see ACOG’s committee opinion. 

If you want to start a debate, ask your friends’ opinions about using this test for whole genome sequencing, or determining the complete DNA sequence of every gene of every baby for future medical and other uses.

Posted on Tuesday, March 7, 2017 at 8:41AM by Registered CommenterSHB Webmaster | CommentsPost a Comment