A note from Larry H. Chewning, President and CEO of Nash Health Care

Earlier this month the Nash UNC Health Care System Board of Commissioners, at the recommendation of the Corporate Leadership Team, approved several major changes to our Pediatric Care Programs. 


First and I believe most important, Nash will significantly expand the number of hours of Physician and Nurse Practitioner coverage specifically devoted to providing care to pediatric patients presenting at the Emergency Room.  When the Pediatric ER was first opened in the spring of 2014 we were seeing approximately 25 patients a day.  90% of these patients were arriving between the hours of noon and 10:00pm.  Thus, our dedicated staffing level was to have a Physician and Nurse Practitioner exclusively devoted to the Peds ER during this time.  In the last 3 years we have seen a significant increase in the number of pediatric patients presenting for care.  In 2016 we averaged 39 patients a day.  Thus far in 2017 we are averaging over 50 patients per day.  In February we hit our all-time one day high of 77 patients.  As a result, we have decided to have 12 hours of Physician coverage and 16 hours of Nurse Practitioner daily coverage exclusively dedicated to the Emergency Room beginning in April, 2017.  I believe that there are a number of factors that are contributing to the rapid growth in pediatric patients in the Emergency Room.  I believe that access to primary care in our area continues to be a problem.  In addition, we have seen growth in patients coming from outside of the traditional service area of the hospital.  We have many pediatric patients from Edgecombe, Halifax and Franklin Counties. This expanded provider coverage model also allows us to hold sicker patients in an observation status in the Emergency Room if required.  For instance, a child requiring the administration of an IV medication could remain in the Emergency Room for up to 24 hours.  We are all very proud of this heightened commitment to providing great care to our pediatric patients in this region.


Second, a decision was made to curtail inpatient pediatric services within the next 3 months.  This decision is based on a decline in the number of pediatric patients requiring inpatient admission.  In 2016 there were only 160 children admitted to the hospital.  Our average daily census for pediatric inpatients was less than 2 patients per day.  In making this difficult decision we felt that it was impractical to continue to staff and operate a nursing unit with only one patient per day.  In addition, our pediatricians on the medical staff believe that many patients previously admitted to the inpatient unit can be cared for in a 24 hour observation status.  Nash is one of the few remaining community hospitals in the state offering inpatient pediatric services that does not operate a pediatric intensive care unit.  For instance, one of our partner hospitals in the UNC System, Rex Health Care, that performs over 4,000 obstetrical deliveries, does not offer inpatient pediatric care.  For Nash it is important to note that infants that are 30 days or younger can be well cared for in our new Special Care Unit with our Neonatology Nursing and Physician staff. 


Last, it is important to note that no one in our nursing staff on the pediatric unit will lose their job as a result of this decision.  Each of our staff members in pediatrics will have several different job opportunities available and offered to them in our health system.


Clearly, the most important part of these decisions is devoting a significant amount of additional resources to care for pediatric patients presenting at our Pediatric Emergency Room.  It is clear that the people of our community have told us that the Pediatric Emergency Room is badly needed and the quality of care is great.  This is clearly evidenced by the increase in the number of pediatric patients we are honored to treat every day. 


Larry H. Chewning,

President and CEO

Nash UNC Health Care