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Coordinated obstetric care reduces complications, infant mortality rates

Sharing crucial information across care settings throughout a care-community is increasingly mission-critical, especially in the unpredictable world of obstetrics and deliveries.

Hospital Labor and Delivery (L&D) departments endure dramatic volume fluctuations and many opportunities for complications, all generally unanticipated even though expected. Meanwhile, clinics and obstetricians routinely see and assess prenatal patients, capturing data from delivery dates to risks, then again the same women postpartum, now with their infants.

However, clinicians in these two interdependent settings generally share NO data, causing re-assessments or re-documentations on both ends, and compromising capabilities to perceive and meet risk-related needs.

After investing in Allscripts SunriseTM as its interoperable electronic health record system (EHR), one organization demonstrated the value of care coordination for mothers and infants. Clinicians and information technology (IT) professionals teamed up to fine-tune applications to their local needs and to create ideal implementations, with coding accuracy as a crucial business priority.   The goal was to share data from obstetrician prenatal clinics (OBs) with L&D, and then back again post-delivery, so that best care is always provided based on complete understanding of what has gone before.

Now, L&D continuously receives all prenatal information and updates electronically regarding the mother and fetus from OB clinics, including mother and/or  baby risks, foreseen complications, anticipated delivery dates, etc.  One OB observed:

“Standardization of the OB content has greatly increased the efficiency in how we view patient data. We don’t have to spend extra time asking the same questions for each visit. This is especially important when our patients arrive to Labor & Delivery and things are happening quickly.”

L&D now staffs for anticipated volumes and clinical requirements with 93.9% “ideal staffing” rates – ideal being not over- or under-staffed, and unsurprised preparedness for complications. Postpartum, the OB clinics now receive all L&D and hospital-based postpartum data for mother and infant(s), including risk-related information and assessments.

The organization achieved significant improvements within six months, including:

Labor & Delivery Department

  • 3.8% reduced infant mortalities
  • 5.9% reduced infant complications
  • 43.3% reduced maternal unanticipated complications or risks
  • 14.1% reduced L&D repeat risk assessments
  • 3.9% reduced staffing-related costs

Obstetric Clinic

  • 38.4% reduced patient wait times for office visits
  • 31.2% reduced patient wait time during office visits
  • 40.3% increased OB-with-patient time during visits – unanticipated and unperceived by OBs
  • 34.7% reduced unanticipated postpartum complications
  • 8.9% increased postpartum compliance to follow-up clinic visits

Clearly mothers and infants are better off with this technology-enabled coordinated care. And the organizations and caregivers benefit as well: it reduced costs per mother by 12.8% across the hospital and clinic, and reduced hassles for clinicians while improving their knowledge for patients.  It also reduced postpartum diagnostic tests and costs by 8.4%.

This success reflects the ability to transfer clinically pertinent information between hospitals, clinics, emergency departments, and others. Clients have had similar proven successes with other diseases, such as diabetes, sepsis, pulmonary diseases (e.g., COPD), pediatric asthma and more. So the ability to communicate throughout a community and care continuum ensures everyone gets best outcomes.

Editor’s Note: Steve recently shared this example by invitation to the United Nations, as part of the Infopoverty World Conference, a platform focused on to fighting the effects of poverty and national and regional misfortunes through innovative uses of Information and Communication Technologies (ICT). You can watch his presentation (from 35:22 – 49:29) here.

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