Facility Planning Of A Birthing Facility

Introduction

Building a birthing facility requires taking into consideration the proper legal and regulatory requirements that may affect the facility planning process. The analysis and evaluation of the legal and regulatory requirements will be performed for the City of Fresno, California. It is necessary to pay due attention to the local, state and federal regulations because these regulations provide certain requirements that should be followed by the birthing facility staff. Currently, about 82% of the states have developed legal regulations for birthing centres. These regulations may create certain barriers that should be eliminated in order to ensure successful performance of the birthing centre. There are the regulations that cover the issues like birthing centre staffing, the facility planning, fire and building codes, and the services provided by the birthing facility. The local, state and federal regulations provide important information about services provided,  as well as about the policies, procedures, organization, quality assurance, and evaluation. Moreover, these local, state and federal regulations can serve as a guide in planning birthing centre services.

Analysis of local, state and federal legal and regulatory requirements for a Birthing facility

The local legal and regulatory requirements for a birthing centre are the requirements of the city of Fresno, which include the requirement to provide pregnant women with high quality maternity care alternative and deliver the services which protect the health, safety and welfare of mothers and their babies. A birthing centre should be properly equipped and operated to reduce any risks to mothers and their babies’ health. High risk pregnancies are excluded. Childbirth is limited to the application of natural procedures.

The state legal and regulatory requirements for a birthing facility include California’s requirements provided by the Health and Human Services Agency, California Department of Health Care Services.  California Health and Safety Code Sections 1204.3, 1212, 1268, 1596.95 provide a number of state requirements for birthing centres. Some of them include:

  • A birthing centre should be  a provider of comprehensive, high quality perinatal services as defined in Section 14134.5 of the Welfare and Institutions Code (California Health and Safety Code).
  • A birthing centre should follow a quality assurance program (California Health and Safety Code).
  • A birthing centre should meet the established state standards for certification governed by the National Association of Childbearing Centres, or the key standards adopted by the state department (California Health and Safety Code).
  • A birthing centre should be “located in proximity, in time and distance, to a facility with the capacity for management of obstetrical and neonatal emergencies, including the ability to provide cesarean section delivery, within 30 minutes from time of diagnosis of the emergency” (California Health and Safety Code).
  • It is required that at least two attendants should be present at all times during birth – a physician and surgeon or a certified nurse-midwife (California Health and Safety Code).

The federal legal and regulatory requirements for a birthing facility include accreditation, license and other requirements. Accreditation is the major requirement for obtaining licensure. There is a need for providing accreditation of the facility which will demonstrate the quality of services  provided to consumers and how this quality is maintained. The standards that should be met include “Philosophy and Scope of Service, Planning, Governance and Administration, Human Resources, Facility, Equipment and Supplies, the Health Record, Research and Quality Evaluation and Improvement” (Standards for Birth Centres, 2016). The establishment of safe environment is one of the key standards which should be followed to ensure that mothers and their babies feel comfortable. Due attention should be paid to the system of control of equipment, supplies and medications (Standards for Birth Centres, 2016). Birthing centres should comply with the laws and regulations that govern their work in order to keep a current license. In addition, birthing centres should be accredited to demonstrate  their accountability and dedication to best practices.

Besides, among other requirements is compliance with the Patient Protection and Affordable Care Act (ACA) which requires providing payments for facility services to birth centres across the United States (Section 2301).

Evaluation of the impact of legal and regulatory requirements on the development of organizational health care policies related to facility design

It is necessary to evaluate the impact of legal and regulatory requirements on the development of organizational health care policies related to facility design for a birthing facility. The quality of the birthing facility depends on the compliance with the federal and state regulations, licensure requirements, and national accreditation requirements.

In fact, birthing centres in the United States should operate according to the standards defined by the American Association of Birth Centres. The key requirement is that birthing centres are allowed to work only with low-risk pregnancies. According to the established standards, pain medications and epidurals should not be used, while different pain management techniques are allowed to be used at birthing facilities.  The Affordable Care Act mandates Medicaid reimbursement for birthing centre facility services and health care providers (Shaw et al., 2014).  Hence, the development of organizational health care policies should be appropriate to ensure the compliance with the legal and regulation requirements for birthing centres. Due attention should be paid to the use of the properly constructed safe and sanitary equipment, its maintenance to protect health and safety of mothers and their babies.

In general, the established legal and regulatory requirements have a strong impact on the development of organizational health care policies related to facility design. The birthing centre should have well-developed administrative, personnel and clinical procedures targeted at facilitation of delivery of high quality of maternal care and childbirth care. The organizational environment should be   properly controlled to avoid any challenges, which may lead to negative health outcomes. The issues that require thorough consideration include patient safety, infection control, risk management, and others.

Evaluation of  accountability and liability implications for individuals and organizations within facility design

Evaluation of accountability and liability implications for individuals and organizations within facility design for a birthing facility provides an opportunity to assess the role of training and professional development of health care providers. Recent study shows that “despite an emphasis on facility-based birth with skilled providers, many women still choose to deliver at home, due in part to poor conditions in facilities or because of perceived or verified abuse/coercion/neglect at facilities” (Miller & Lalonde, 2015, p. 49). The increased level of accountability and liability for birthing centre staff  allows improving the quality of care. It stands to reason that professional accountability at a birthing facility helps to prevent different types of abuse, including “physical abuse, non-consented care, and discriminatory care, which have been termed disrespectful/abusive care during childbirth in facilities (DACF)” ( Miller & Lalonde, 2015, p. 49).  In general, accountability and liability implications for individuals and organizations within facility design should be addressed through training practices which help to improve attitudes and behaviors of birthing facility-based providers and enhance facility-based quality of care (complex technology, skilled providers, and experience to provide care for infants).

Analysis of legal versus ethical considerations related to facility design

There is a need for conducting an accurate analysis of  legal versus ethical considerations related to facility design for a birthing facility. According to researchers, “in the past few years the relationship between lack of quality of care and adverse maternal outcomes is being highlighted globally” ( Miller & Lalonde, 2015, p. 49). This fact means that legal requirements related to facility design should be strictly met, while ethical issues related to abortion, informed consent, neonatal care, surrogate motherhood and others should be addressed properly in order to meet the needs of consumers. There is a need for the facility design that prevents and eliminates disrespect and abuse during childbirth process. Researchers place emphasis on the United Nations’ resolution that requires preventing maternal mortality, which is “a human rights violation” (Miller & Lalonde, 2015, p. 49). It is required to provide professional management of all types of services delivered to mothers and their babies, placing emphasis on ethical standards appropriate for childbirth procedures. Birth centres may be different in structure and furnishing, but these facilities should pursue the common goal – to ensure professional assistance to pregnant women, mothers and their babies. Although birthing centres are appropriate for low -risk pregnancies, these facilities should meet the established ethical requirements for maternal care. Professional staff should have a good understanding of the scope of clinical practice for maternal care, the key standards of care delivery, organizational policies and local, state and federal laws and regulations. 

Conclusion

Thus, it is necessary to conclude that the compliance with the national standards set by the American Association of Birth Centres (AABC) provides an opportunity to deliver high quality health care services to childbearing families. The compliance with local and state regulations allows addressing the needs of mothers and their babies to the full extent to prevent the occurrence of disrespect and abuse and the lack of quality care in the birthing facility.

References

California Health and Safety Code. Retrieved from:<https://leginfo.legislature.ca.gov/faces/codesTOCSelected.xhtml?tocCode=HSC>           

Miller, S. & Lalonde, A. (2015). “The global epidemic of abuse and disrespect during childbirth: History, evidence, interventions, and FIGO’s mother−baby friendly birthing facilities initiative,” International Journal of Gynaecology and Obstetrics, 131: 49-52.

Shaw, F. E., Asomugha, C. N., Conway, P. H., Rein, A. S. (2014). “The Patient Protection and Affordable Care Act: opportunities for prevention and public health,” The Lancet, 384 (9937): 75-82.

Standards for Birth Centres. (2016). American Association of Birth Centres. Retrieved from:<http://c.ymcdn.com/sites/www.birthcenters.org/resource/resmgr/AABC_STANDARDS-RV2016.pdf>

The terms offer and acceptance. (2016, May 17). Retrieved from

[Accessed: March 28, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016.

[Accessed: March 28, 2024]

freeessays.club (2016) The terms offer and acceptance [Online].
Available at:

[Accessed: March 28, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 28, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 28, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 28, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 28, 2024]
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