BY: GABRIEL KILEY
Mr. Kiley is managing editor, Health Progress, Catholic Health Association, St. Louis.
EVANSVILLE, Ind. — Eight years ago, Nora Mitz was four months along with triplets when she met neonatologist Maria Del Rio-Hoover, MD, of St. Mary's Hospital and Medical Center. The mother-to-be, in the midst of a difficult pregnancy, was worried about the quality of care that she and her babies would be receiving.
As is her usual style, Del Rio-Hoover took charge. She comforted Mitz, offered a personal tour of the hospital and its neonatal intensive care unit, and assured her the babies would receive the highest quality care. Mitz delivered her baby boys during an emergency Caesarean section in the 29th week of her pregnancy.
Today, Del Rio-Hoover, whose reputation for compassion approaches near-legendary heights in the region, continues to be a positive presence for Mitz, her 8-year-old sons (Henry, John David and Theo) as well as for many other children with special medical needs and their families. Del Rio-Hoover's compassion was the driving force behind her push to establish St. Mary's Center for Children, which opened in May 2006. The outpatient facility offers a multidisciplinary array of pediatric services for children, including those with chronic illnesses and developmental disorders.
The one-stop location means Mitz and other parents no longer have to travel from the tri-state area (southern Indiana, western Kentucky and southeastern Illinois) to larger cities in the Midwest so their children can visit specialists.
"Maria keeps getting more doctors into the center and keeps parents involved so she can add more services," Mitz said. "She continues to fight on behalf of children."
Del Rio-Hoover's advocacy is far reaching. Examples of a seemingly endless list of successful initiatives include:
- Spearheading the effort to get a Ronald McDonald House built on St. Mary's hospital campus.
- Developing a Children's Bill of Rights at St. Mary's to ensure consistent and compassionate care of children.
- Leading a Physician Directive Quality initiative geared toward "painless needles" for all children's lab services (staff learn how to numb the needle site, comfort the patient and skillfully draw blood or start IVs with minimal discomfort).
- Participating on state boards regarding access to care and funding for specialty pediatrics.
- Serving on various community organizations related to children causes.
Tom Lilly, senior vice president of the hospital's Foundation Operations, works closely with Del Rio-Hoover on fundraising efforts for the children's center, the Ronald McDonald House and other endeavors. Lilly said the doctor has helped raise roughly $3.5 million for the center and the house.
"Maria is really a pioneering physician who is equally engaged in her community service work as she is in her professional work. That's unique," Lilly said.
Offering A "Continuum of Care"
Children born prematurely with low birth weight are at higher risk for autism and other developmental issues. Del Rio-Hoover sought to establish a local facility to help parents gather information, referral and treatment resources. It's all in an effort to make sure children with special medical needs receive top-notch care throughout their childhood with the goal of long-term success in life.
"We can't wave goodbye (to the children and the parents) as they walk out the door," Del Rio-Hoover said. "In a smaller community, we not only have to help the children, but you also have to help the primary doctors find the necessary specialists."
Del Rio-Hoover needed quantifiable evidence in order to secure funding for the children's center. So, she worked closely with hospital officials to gather information from parents, physicians, health care providers, service agencies and educators. She also collected information through town hall meetings, focus groups and surveys. Through these interactions, the need for specialized programs relating to autism, behavioral feeding disorders and other pediatric sub-specialties (such as psychology, pulmonology and neurology) became evident.
Shelby Collins, director of the Center for Children, said Del Rio-Hoover and the staff believe in the "continuum of care from birth to 18 years old."
"For example, a child with autism might need to see a developmental pediatrician, a psychologist for social skills screening, a psychiatrist to manage their medication, and a feeding therapy specialist," Collins said.
Another component of the facility is the resource center, a comprehensive referral office providing free guidance and scheduling assistance to local and regional primary care physicians and their patients. Families meet with an insurance specialist to address questions regarding insurance and with a family advocate, who provides information and access to community agencies. Depending on the needs of the child and family, the center works closely with national medical centers and teaching hospitals.
Parents also like the colorful and friendly environment at the facility. "This is a welcoming place for a child," Mitz said. "Everything is at eye level. It's very touchable. It's not sterile. It's cheerful. There are televisions and things to do."
Keeping Families in Mind
When the Ronald McDonald House opens on the St. Mary's campus in fall 2009, Evansville, with about 348,000 residents, will become the smallest metro area in the country to have such a facility, hospital officials said. Ronald McDonald Houses provide temporary housing to families whose children need extended hospital care, and are typically located in larger metropolitan areas. Despite the obstacles, Del Rio-Hoover pushed hard and convinced business, hospital and organization leaders to support the project.
"Maria's been the catalyst for the project," said Kathy Scheller, executive director, Ronald McDonald House Charities of the Ohio Valley. She has known Del Rio-Hoover for 20 years, and her twin boys were patients of the doctor. "With Maria's assistance and personal advocacy for children and their families, the project is in the right location and will be another example of the quality of care children and their families receive from St. Mary's."
Del Rio-Hoover was born in Cuba, but her family fled to the United States in 1961 when conditions worsened under dictator Fidel Castro. Her father, an established pediatrician in his homeland, eventually became head of pediatrics at a hospital in Savannah, Ga., where the family settled. She knew at an early age that she wanted to work with children.
"My father used to say that medicine shouldn't be a profession, it should be a vocation, and if you don't love it enough to really like what you do, you can never be a really good doctor," Del Rio-Hoover said.
Del Rio-Hoover's affinity for children, particularly newborns, eventually influenced her decision to enter neonatology, a field that "has come so far in being able to care for these babies." She is one of four neonatalogists at the unit, which has more than 14,000 babies who have graduated from there since it opened in 1977.
"As we learn more about neonatology, survival and viability is now at 24 weeks or four months early," she said. "A baby born at 24 weeks who would normally be at one pound now has a 50 percent chance of surviving. Now we're not just into life or death, but the quality of life."
Vowed religious women have been another important influence in Del Rio-Hoover's life. As a child, she attended schools headed by Ursuline sisters in Cuba and the Sisters of Mercy in Savannah. Her connection to religious women continued in 1985 when she started working at St. Mary's, an institution founded by the Daughters of Charity. She credits the sisters for instilling faith and self-confidence throughout her life.
"The mission at St. Mary's is very important to me, and I realized it is very important to the Daughters," said Del Rio-Hoover, a 2008 recipient of Ascension Health's Living the Mission and Values Award. "It's important for us to treat each child with dignity and give them the best care possible."
Praise by Colleagues
Co-workers describe Del Rio-Hoover as passionate, energetic, dedicated and determined. They also call her a visionary and a mentor.
Del Rio-Hoover's deep connection to mothers and children is evident. Just ask Janet Raisor, the hospital's director of physical medicine and community outreach.
"In one meeting, Maria got up to take a phone call and she is talking in Spanish to the person on the phone," Raisor said. "She later told us she was speaking with a mom who was having trouble with her green card. Not only does she look out for the patient, but also the whole family."
Suzette Hershman, executive director of St. Mary's Physician Network, cites Del Rio-Hoover's tireless persistence.
"I'll come into work in the morning and have a voice mail from her from 3 a.m. with an idea," Hershman said. "Her mind is always going. What can I do to help? What can I do to bring the right people together? That's advocacy."
Del Rio-Hoover's passion for her job makes others want to help. "When you hear that passion, you want to invest in some of the solutions," Lilly said. "She's a solution person. Anybody can identify problems, but she is very good in providing solutions to those problems."
Del Rio-Hoover is reluctant to discuss her personal achievements, and prefers to praise her colleagues, which may help to explain why the center works so well.
"I've always been a dreamer and a visionary, but they don't become reality unless you have the right people to make it reality," Del Rio-Hoover said. "I'm just the catalyst; we have wonderful people here."
The Center for Children is the fulfillment of Del Rio-Hoover's dream to make the lives of children with special health needs and their parents a little easier. Mitz, like hundreds of other parents, are grateful for Del Rio-Hoover's non-stop advocacy.
"Maria is like the Energizer Bunny; she doesn't stop," Mitz said. "Once she gets something in her mind, Maria is one of those people who is able to rally the troops and get a group of people to stand up with her and get what she wants to get done."
For More Information
Learn more about the Center for Children by visiting www.stmarys.org, or calling Maria Del Rio-Hoover, MD, at (812) 485-4335.
Copyright © 2009 by the Catholic Health Association of the United States
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