Purpose: The
eight perinatal hospitals in the RWJBarnabas health care system, with ~25,000
deliveries annually, utilize bi-monthly interdisciplinary meetings to update
all sites on quality outcomes, evidence-based best practice, research
initiatives and education. This model trains Ob/Gyn residents, as well as the
entire health care team on an overall approach to maternity care.
Background: In 2015, the perinatal practices at each of the hospitals were
functioning independently, which
resulted in variation in clinical practice and outcomes, scant research and
different approaches to patient care models for resident education. The
RWJBarnabas Health leadership recognized the benefit of a systematic approach
to optimize this service and to best utilize the strengths and experience of
all its health care obstetrical providers. This would also translate into a
stronger model to enhance resident education. This approach was promoted by Dr.
Asch who stated in the September 23, 2009 JAMA that the best function Ob-Gyn
attendings in NY and FL came from residency programs that emphasized the
best-practice of evidence-based medicine in a culture of patient safety. Thus,
creating a win-win scenario for quality patient care and resident education.
Methods: Supported by corporate leadership the RWJBarnabas Health Ob Collaborative
was initiated. The obstetrical department chairs and the Ob nursing
administrators from each site met bi-monthly to review pooled data, develop
clinical bundles and institute standards of practice at each medical site based
on a common EMR. From the pooled data, clinical practice changes and research
ideas were also introduced that the health care team and the learners could initiate/participate
in.
Results: This model has been very effective in improving patient satisfaction,
quality and patient safety. This is especially notable in Pain Management, the
reduction of SSI and C/Section rates and increased TOLAC/VBAC rates. In addition,
medical education for residents includes utilization of standardized evidenced
based practices developed by the collaborative across all the sites. The
specifics of the data collection will be discussed.
Discussions: Not only
have there been benefits in the core missions of clinical care, teaching and
research, but this model has inspired a joint effort by others within the
health care system to further improve outcomes through collaborative
educational venues.
Topics: CREOG & APGO Annual Meeting, 2018, Student, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Systems-Based Practice & Improvement, GME, CME, Quality & Safety, General Ob-Gyn,
Gloria Bachmann, MD
