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St. Mary’s Hospital and Regional Medical Center in Grand Junction, Colorado, has long been the regional provider of choice for maternity care. Delivering some 2,200 babies a year, St. Mary’s experienced robust Labor & Delivery utilization.
Earlier this year, however, a nearby hospital opened a new $50 million campus featuring a shimmering new birthing center that threatened to capture a sizable portion of St. Mary’s existing maternity market share. Fortunately, St. Mary’s turned to Ob Hospitalist Group to find a world-class solution to the new birth market threat. Find out what they did.
For more than a decade, the birth rate in New York state has been declining — down 7%. In the northeast region, the downward trend was actually 11%. With fewer births, area hospitals found themselves competing intensely for a shrinking maternity patient pool.
In 2010, Bellevue Woman’s Center, part of Ellis Healthcare, began a relationship with Ob Hospitalist Group to help cultivate the hospital’s status as a center of quality in OB care. A critical part of that strategy was to nurture collaborations with the center’s affiliated private Certified Nurse-Midwifes (CNMs) — a group of professionals well-positioned to attract more patients and stabilize the Labor and Delivery unit’s patient volume.
Dr. Julie DeCesare, OB/GYN Residency Program Director at Sacred Heart Hospital of Pensacola, had a double-sided quandary. Contracting with private physicians to be on call for the Labor and Delivery unit on nights and weekends was proving both expensive and insufficient. She carried the daunting challenge of staffing the unit 24 hours a day, plus she needed more faculty for her Residency Program at a time when the hospital was not motivated to hire more OB/GYNs. What to do?
As the number of working OB/GYNs continues to decline, the United States faces a widening gap in access to perinatal care services. The American College of Obstetrics and Gynecology (ACOG) estimates that the profession will experience an 18% shortage by 2030.
The practice of nurse-midwifery has been around for centuries and, despite years of struggle to achieve true legitimacy, recently has gained greater respect and acceptance by the medical community as well as healthcare insurers, who are now reimbursing for nurse-midwifery services in increasing numbers.
Ob Hospitalist Group (OBHG) recently released a case study connecting improvements in the quality of obstetric care at Overlake Medical Center in Bellevue, WA, with the establishment of a 24-hour, OBHG-managed Obstetric Emergency Department (OBED) at the hospital.
Overlake experienced a reduction in unattended deliveries, fewer C-section deliveries, and the complete elimination of early elective deliveries, all of which increase a patient’s risk for complications. At the same time, local physicians described “a total integration” of care with the coordinated services and support of OBHG hospitalists.
Between 2012 and 2014, cases of congenital syphilis tripled in California, with many clustered around the Central Valley and Kern County area. The staff at Bakersfield Memorial Hospital found that most women who gave birth to babies with congenital syphilis had no personal physician and received very little or no prenatal care before presenting to their hospital. Their understaffed Labor and Delivery triage unit often was the first and only caregiver these women had seen.
As up to 36 inches of snow blanketed central Virginia last month during a record-setting blizzard caused by Winter Storm Jonas, several Ob Hospital Group obstetricians scrambled to make sure there was coverage at area hospitals to serve any pregnant women who might experience labor during the storm. These physicians went beyond the call to ensure uninterrupted coverage during the storm, and their teamwork is noteworthy.
Ob Hospitalist Group (OBHG) is proud to announce the opening of eight new OB/GYN hospitalist programs in the 2015 fourth quarter, tying the 2015 first quarter as the most starts in a three-month period since inception. OBHG has implemented programs for the following hospital partners:
- Alexian Brothers Women & Children's Hospital, Hoffman Estates, IL
- Baylor Medical Center at Carrollton, Carrollton, TX
- Florida Hospital Tampa, Tampa, FL
- JFK Medical Center, Atlantis, FL
- Memorial Hospital Central, Colorado Springs, CO
- Mother Frances Hospital Tyler, Tyler, TX
- Northridge Hospital Medical Center, Northridge, CA
Salinas Valley Memorial Hospital, Salinas, CA
DENTON, Texas — Texas Health Presbyterian Hospital Denton has opened a special emergency room for pregnant women in the local community. The new obstetric emergency department, or OB ED, is located in The Center for Women at Texas Health Denton. It is staffed 24 hours a day by board-certified OB-GYN hospitalists, who are physicians that only see patients while they’re in the hospital.
Traditionally, women who are more than 20 weeks pregnant and present in the emergency room are sent to the labor and delivery unit for triage. From there, nurses evaluate the patient, but labor and delivery units are unlike emergency units; doctors are not always present, especially at night. This means that nurses have to coordinate emergency care with the on-call physicians, usually over the phone. When a patient is not in labor, it’s very common for them to be discharged without ever physically seeing a physician.
“The OB hospitalist model has really changed the way that we care for pregnant women,” said Dr. Vanessa Woolridge, an OB-GYN hospitalist on the medical staff at the hospital. “If they are having pregnancy complications, they want to be seen in a timely manner and by a physician knowledgeable about their condition."
Todd and Nancy Prevatt had planned on a natural childirth at home when her uterus ruptured, they rushed to Golisano Children's Hospital and baby Gunner was delivered by C-section with help from Hospitalist Kevin Burlison.
Taryn Nahm had ignored the sharp pain in her abdomen for more than 12 hours before she finally agreed to seek treatment at HealthPark Medical Center’s ER.
A shocking diagnosis came shortly thereafter: The 30-year-old was bleeding internally, the result of a complication from a pregnancy she had not known about. Nahm had lost the baby and, without immediate surgery to repair her ruptured Fallopian tubes, could lose her own life.
Doctors and nurses on a newly created obstetrics team at the hospital kicked into high gear.
“I was actually bleeding out internally. If I had just gone to bed that night I would not have woken up,” Nahm said about that Aug. 30 emergency room visit. “It’s still a range of emotions, processing all of it, even now.”
HealthPark, home to the Golisano Children’s Hospital of Southwest Florida in south Fort Myers, is used to dealing with such medical emergencies. But a program established last month will ensure that a board-certified obstetrician/gynecologist is at the hospital at all times, rather than the hospital relying on on-call physicians who may or may not be nearby.