Smooth Way Home™

Supporting a successful transition for fragile infants and their families from the newborn intensive care unit back to their community

The Smooth Way Home Program works to improve the social, developmental and medical outcomes of very fragile infants by enhancing the coordination of care and the quality of services provided to them as they transition from the newborn intensive care unit back to their home and community.

Southwest Human Development has played a leadership role in bringing together a wide range of community partners, including state agencies, community service providers, parent advocacy groups, hospital personnel, physicians and health insurance providers to address the needs of this very vulnerable population.

Goals

  • Increase the number of NICU babies who are connected with early intervention services prior to discharge or very shortly after discharge
  • Provide training and technical assistance to the community of early intervention providers related to specialized developmental assessment tools and intervention approaches appropriate for very fragile newborns and infants
  • Provide mentoring and resource support for families whose babies are transitioning home from the NICU
  • Special emphasis on support for families whose babies have eating/feeding disorders
  • Provide increased screening and support for parents coping with Perinatal Mood Disorders (PPD, PP OCD, PP Anxiety, and PTSD)

Support for Hospitals, Special Care Facilities or Arizona Professionals

Smooth Way Home can provide discharge planning support utilizing the published guidelines from the National Perinatal Association. Discharge support includes education on local and state community resources, referrals to resources on behalf of the hospital (including AzEIP), and bedside education, support, and postnatal depression screening to caregivers.

Smooth Way Home strives to support Arizona professionals working with fragile infants and their caregivers. We offer professional development opportunities throughout the year aimed at enhancing knowledge of the prevalence, development, regulation, and overall work with these babies and families.

Smooth Way Home Visitation Services

Smooth Way Home provides home visitation services to high-risk families who are transitioning from the newborn intensive care unit (NICU) back home to their community. Our fragile infant specialist home visitors offer families developmental guidance in caring for their baby, emotional support, and help in accessing community resources.

Additional supports that can be accessed through Smooth Way Home include feeding and lactation support, infant massage instruction, systems navigation, and services in Spanish.

WHO IS ELIGIBLE?

Families who have spent time in the NICU or special care nursery would benefit from additional support. We provide in-person home visitation services within Maricopa County and virtual home visitation services throughout the state of Arizona for infants under eight months old, adjusted age.

Click here to complete the referral form to Smooth Way Home, Counseling Services or VINES.  

Smooth Way Home Brief Counseling Services

Smooth Way Home provides brief (up to 4 months) counseling to caregivers 18 years or older who are struggling with mental health concerns as a result of the birth/NICU experiences of their newborn baby. Counseling services are provided by independently licensed counselors. This service is currently available in a telehealth format to all of Arizona and there are no limits to serviceable boundaries. This service is provided at no cost to the family.

WHAT KIND OF CONCERNS CAN SWH BRIEF COUNSELING SERVICES ADDRESS?

Appropriate referrals include individuals who have developed significant symptoms of PPMD, anxiety, depression, relationship challenges, social isolation, sleeplessness, or other concerns around the birth of their child, including concerns proceeding the birth of the baby. Individuals who had significant mental health concerns prior to the birth of their baby or who are already actively engaged in counseling are usually not a good fit for brief counseling and should be referred on to an outside mental health provider. However, appropriateness of fit will be determined on a case-by-case basis by the SWH Counseling Program managers.

VINES: Virtual Neonatal Support Program

VINES offers virtual telehealth support for you and your fragile infant after your NICU stay. This program will help you bridge the gap between your baby’s discharge from the NICU and your transition home to community care.

SCHEDULED FOLLOW-UP APPOINTMENTS AND URGENT CARE

You may have a scheduled VINES appointment after your baby’s discharge to provide further guidance and medical follow-up during your transition home. Additionally, if you have an urgent medical concern, you can speak with a neonatologist or neonatal nurse practitioner during our hours of operation potentially saving you from going to the emergency room or urgent care facility and will offer you the specialized care you are looking for.

To be eligible to participate in the VINES program, your baby needs to have been discharged from the NICU within the past 30 days. You can register for this program with your Smooth Way Home coordinator prior to discharge or by calling (602) 633-8355.

For more information, please visit swhd.org/vines.

“Smooth Way Home: Getting Ready to Go”
A Video for Parents with a Baby in the NICU

Parents who are getting ready to bring their baby home from the newborn intensive care unit (NICU) often need special support. For many, their time in the NICU was frightening and even traumatic. It can be scary to leave the safety and protection of the NICU: parents often feel overwhelmed, alone and unprepared for the journey home.

The Power of Parents Talking to Parents

  • Parents trust what they hear from other parents who have shared similar experiences
  • The parents in this video share lessons learned and offer tips for managing the challenges and stressors they encountered when they took their own baby home from the NICU
  • NICU families need to know they are not alone, others have traveled this difficult path, and that they, too, will one day be able to return to their “regular” life

Intended Audiences

  • Parents who have recently returned home or are preparing to transition home from the NICU
  • NICU staff
  • Community providers

Materials

  • Video on USB drive with HD/SD video files
  • Facilitation Guide: Ideas for using the video as a supportive tool with families
  • Resource Guide: Websites, organizations and helpful materials

To request your complimentary copy of “Smooth Way Home: Getting Ready to Go,” please email [email protected].

NICU Parent Resources

Thank You to Our Community Partners

Thank you to Nourish, Raising Special Kids and Desert Neonatal Associates for your partnership in coming together to build the systems needed to provide coordinated care and state-of-the-art services to these babies.