Interdisciplinary Team: The Level III OB Center must have an interdisciplinary

Interdisciplinary Team: The Level III OB Center must have an interdisciplinary team that includes individuals with expertise in and/or knowledge about the specialized care, treatment and services required for perinatal care. The interdisciplinary team includes individuals and specialized services to support the care, treatment, and services provided by the program. The following individuals and services are represented on the team: 1. Obstetrics and Gynecology physician: The Obstetrics and Gynecology physician with obstetrics training and experience must be available for consultation at all times. 2. Obstetrics: A board-eligible or board-certified obstetrician must be physically present on site at all times. 3. Qualified Physicians/Certified Nurse Midwife: Ensure that a qualified physician or certified nurse midwife with appropriate physician back-up is available to attend to all deliveries or other obstetrical emergencies. a. Must arrive at the patient’s bedside within thirty (30) minutes of an urgent request; and b. Must complete annual continuing education, specific to the care of pregnant and postpartum patients, including complicated conditions. 4. Maternal-Fetal Medicine (MFM): A MFM specialist with inpatient privileges must be readily available at all times, either on site, by phone, or by telemedicine. Timing of the need to be on site is directed by the urgency of the clinical situation; however the provider must be able to be on site to provide direct care within 24 hours. The MFM specialist shall also be available at all times for consult for all pregnant or postpartum patients in the ICU. 5. Anesthesia: Board-certified anesthesiologist must be on site 24 hours a day, 7 days a week. 6. Intensive Care Unit (ICU): There must be the availability of an adult medical and surgical ICU that accepts pregnant women and women in the postpartum period. The ICU must be staffed by adult critical care providers on site 24 hours a day, 7 days a week. 7. Internal medicine providers, family medicine providers, and general surgeons must be readily available at all times for obstetric patients. 8. Nursing: Nursing leaders and qualified labor, delivery, surgical, and recovery nursing personnel who have special training and experience in the management of women with complex and critical maternal illnesses and obstetric complications in adequate numbers to meet the needs of each patient are readily available at all times. 9. Laboratory and Blood Bank Services: Laboratory personnel must be immediately available to obtain and process appropriate samples and report urgent/emergent results. Blood bank services must be available at all times to determine blood type and Rh type, crossmatch blood and perform antibody testing. There must be in-house availability of all blood components. There must also be guidelines or protocols in place for: a. Massive blood component transfusion; b. Emergency release of blood components; and c. Management of multiple blood component therapy. 10. Radiology Support: Radiologic services with interpretation must be readily available at all times and include: a. Specialized obstetric ultrasound and fetal assessment (to include Doppler studies); b. Computed tomography scans; c. Magnetic resonance imaging; d. Standard non-obstetric ultrasound imaging e. Standard obstetric ultrasound imaging; f. Maternal echocardiography; and g. Basic interventional radiology (capable of performing uterine artery embolization). 11. Respiratory and Pharmacy: Respiratory care personnel and a registered pharmacist should be readily available at all times. a. Appropriate equipment and personnel physically present at all times onsite to ventilate and monitor women in labor and delivery until they can be safely transferred to the ICU. 12. Support Staff: a. Lactation Specialists: Lactation Specialists or support staff with knowledge and skills in breastfeeding and lactation to meet the needs of maternal patients must be available at all times. b. Social services, pastoral care, or bereavement services must be provided as appropriate to meet the needs of the patient population served. c. A dietician or nutritionist should be available with the appropriate training and experience for the population served. 13. Subspecialists shall be readily available, per the facility’s policy, for inpatient consultation, which include critical care, general surgery, infectious disease, hematology, cardiology, nephrology, neurology, gastroenterology, internal medicine, behavioral health, and neonatology.