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Feature Profile published in Point of View magazine

Women & Infants and Video

My grandmother was a nurse, my mother was a nurse, my older sister was a nurse and I’m not sure which generation would have ceased to be surprised and simply taken a “Media Center” in a hospital for granted. And, given my involvement with the media, I’m moderately embarrassed to admit that until a few years ago I had no idea that some hospitals around the nation actually produce their own programs and, furthermore, market this programing nationwide.

Women & Infants in Providence, Rhode Island, is one such hospital. Founded in 1884 as the Providence Lying In Hospital it was exclusively a maternity hospital where women could deliver their babies. The hospital moved into its present facility in June of 1986 and today boasts one of the finest reputations worldwide in not only obstetrics and women’s health care but also in newborn intensive care. Women & Infants delivers approximately 9,000 babies a year, and cares for some 1,200 newborns in its Special Care Nursery. Many of these babies have been sent from other hospitals around Southeastern New England to receive the specialized care for which the hospital is so well known.

“By producing their own programs Women & Infants is not only assured of getting exactly what it wants, but the hospital then owns the programs.”

And yes, I delivered my second child at Women & Infants. It was while I was recuperating and flipping through the in house programming guide, that I became curious about where the programs came from. In my search I went from an airy room on the fifth floor to the basement of the building to find the Media Center. What I discovered, to my surprise, was a very sophisticated facility already bursting at its seams, and that the programs immediately available to patients on the hospital’s in house network only count for a fraction of what the hospital produces. Their media output is really quite astonishing.

Women & Infants strong commitment to healthcare education and training is longstanding. This commitment is evident not only within the confines of the hospital itself, with internal training, but in the community at large. Affiliated with the prestigious Brown University Program in Medicine the hospital’s education outreach stretches into schools, community groups, and particularly to the immigrant and refugee communities which, in Rhode Island, number among the largest in the country. The hospital’s research revealed that within these communities video is an extremely acceptable educational tool. Says Renee Neri, Director of Patient Education and Community Liaison, “Often in unsettled and wartorn countries video is very prominent because this is the way a government communicates with its people. They send propaganda out on videotape so the people are used to watching it. Even the poorest homes would have a VCR.”

“Why does Women & Infants produce its own programs?"

The reasons for utilizing video are many and varied. Blue Cross, for instance, mandates that a well woman should deliver her baby and leave the hospital within two days. That’s not much time for a woman who’s been through the life changing experience of delivering a baby to pick up the vital information she needs to care for her baby and herself upon returning home. The in house TV channel supplies programming that addresses these and many other health issues not only for women of childbearing age, but older. Subjects such as “maintaining femininity after a hysterectomy” and “coping with menopause” are everyday programming.

There is also a crying need for video and multi media internally to assist physicians in peer training, resident training, nurse training, for keeping up with healthcare trends, and for imparting information about new areas of healthcare such as Gynecologic Oncology. The need for video is rapidly increasing. Even the public relations department now uses video during its annual meeting to show the Board of Trustees and staff the current status of the hospital and also the direction in which it is moving.

Using video also addresses the problem of limited literacy in the many communities the hospital interacts with, and has proven to be a cost effective and efficient tool with which to communicate healthcare issues.

But why does Women & Infants produce its own programs?

“Because,” says Jane Suvajian, the hospital’s Media Specialist and the guiding force behind the Media Center, “Women & Infants is so far ahead of other healthcare facilities in developing new areas of healthcare, and new techniques and technology there’s really nothing commercially available that keeps up with us, or meets our needs.” By producing their own programs Women & Infants is not only assured of getting exactly what it wants, but the hospital then owns the programs. This gives it the freedom to market them, loan them, or even give them away without having to answer to anybody. If sold the programs are sold at a fraction above cost because the hospital’s commitment is to education. The goal is to bring notoriety to the hospital and because of the unique non profit status of the hospital whatever profit that is made on programs is channeled straight back into production.

“Even the poorest homes have a VCR.”

The Media Center was created in 1981 to respond to all hospital audio/visual needs servicing a number of different departments within the hospital Nursing Education, Medical Education, and Patient Education. The Center concentrates it’s efforts on centralizing all audio/visual resources, gathering material from around the country for preview, shooting internal medical procedures for in house lectures or documentation, maintaining and servicing the audio/visual equipment, and maintaining the hospital’s TV network which, as of this January has been upgraded to cable. And it’s not unusual to find Suvajian “scrubbing up” to go into an operating room and shoot a surgical procedure which is then transmitted live to a conference room for teaching purposes.

It is the department of Patient Education, however, which produces the bulk of the hospital’s original programming. 16mm and 35mm film has been used internally at the hospital since it first became commercially available, but it wasn’t until 1976 that this department began to use videotape, and in 1987 began to seriously generate broadcast quality videotaped programs. Using an independent production team, headed by Dolphin Communications, Patient Education first produced a series of nine videotapes in seven languages for patients of limited literacy. The series was funded by the Rhode Island Foundation, and focused on such topics as a visit to a hospital, childcare, mother care, Hepatitis B, lead poisoning, tuberculosis, and sexually transmitted diseases.

Multi language production is a necessity for the hospital. In fact, “. . .the Civil Rights Laws,” explains Neri, “require that we provide equal access to care regardless of a person’s ability to communicate in English.” Very often the whole area of bi lingual and multi lingual education is driven by Federal Mandate. The hospital can document that at any one time approximately 20% of its patients don’t speak English. This places a tremendous strain on the nursing and teaching staff which is alleviated somewhat by the existence of videotapes in a choice of languages. The seven languages used in production are English, Spanish, Portugese, Hmong, Laotian, Vietnamese and Cambodian. This multi language production poses some interesting challenges for the producing staff because few people on the team speak anything other than English and maybe some Spanish. To ensure complete accuracy the producer uses two translators who are required to check each other’s work. The multi-language nature of this and other projects creates other production challenges, one of which is the almost exclusive use of voice-over narration rather than lip sync while still maintaining audience interest.

“Within these refugee communities video is an extremely acceptable educational tool.”

Because of the nature of patient education the programs must attract and reach a variety of races, cultural groups and ages, so a “people grid” is used to ensure equal visibility is given to all these different groups. But particularly challenging to the producers is the intimate nature of some of the programs. People feel a natural reluctance to appear on camera to discuss subjects such as sexually transmitted diseases in their own community in the event that they are seen by others who know them.

The subject matter of the programs produced by Patient Education is varied. A recent project, funded by a parent group, highlighted the hospital’s Special Care Nursery. “Your Baby In Special Care” was geared towards parents whose babies were in need of intensive care. The program sought to alleviate fears and anxieties about the nursery and why their child had need of it. The videotape also demonstrated to parents how they could actively participate in the care of their newborn even though confined to the Nursery.

Another project just completed focused on teen pregnancy and parenting. “I Got You Babe” helps young parents learn how to care for their babies, concentrating particularly on child safety. Before production began the producers formed a focus group of teenage parents to help find the correct pitch for the program. They found that using peers speaking naturally on camera had more of an impact than using actors in a scripted setting. Neri emphasizes that they are “very open to learning different ways of communicating with (their) audience” because clearly the most important result of any production is audience participation and education. This program is shown in teen parenting classes, in schools, and is also loaned to teen parents for home use if need be.

“Their media output is really quite astonishing.”

Patient Education is building a reputation for quality programming that extends beyond the hospital and non hospital clients are approaching them for production. The department recently completed a series of three tapes for the Rhode Island Department of Health (again in seven languages) for use with the MIV testing process. State law now requires that all pregnant women, all people going for family planning information, anyone diagnosed with a sexually transmitted disease, and others, be offered the opportunity to be tested for AIDS. The consent process is so complex that the RIDH felt a need to put a good part of it on video. The tapes are not supposed to replace human interaction and are designed to accompany the consent booklet pausing at certain points for the viewer to ask questions.

Yet another project in the pipeline is for the State agency for Mental Health Rehabilitation and Hospitals. The goal here Is to produce programs that help parents and foster parents care for drug affected babies whose needs are so unique.

“We don’t know where video production will go but we’re keeping all of our options open,” said Neri energetically. “We’re bitten by the bug.” And by the looks of things the Media Center is due for relocation, to larger premises.