American Health Council welcomes OBHG Certified Nurse Midwife to nursing board

By OBHG Marketing on January 12th, 2018

We are proud to announce that OBHG Certified Nurse Midwife Christina Kopingon, MSN, ARNP, FNP-BC, has been appointed to the American Health Council's Board of Nurses. Kopingon serves as Midwife Team Lead at our OB hospitalist program at Bethesda Hospital East, in Boynton Beach, FL. Congratulations, Christina!

Read full article.

Folic acid should be priority for all women of childbearing age

By OBHG Marketing on January 9th, 2018

Over the past couple years, the Zika virus has stolen the spotlight from other concerns that newly pregnant women may have. As they worry that Zika infection can increase their risk for bearing a child with birth defects such as microcephaly, they may be interested to know that a certain dietary deficiency also can elevate the risk for birth defects of the brain and spine called neural tube defects (NTDs).

That critical preventive nutrient is vitamin B-9 or folic acid.

The body needs folic acid every day to support new cell development. However, it becomes even more critical for pregnant women, because they are experiencing accelerated cell growth. Folic acid is found naturally in foods such as dark, leafy green vegetables, beans, peas, citrus fruits, and even broccoli or asparagus. However many Americans do not consume enough of these foods, and more than half of natural folic acid is destroyed by cooking. Because folic acid is water soluble, the body uses it quickly and it needs to be replenished every day. That’s why folic acid is widely available as a dietary supplement. In fact, as a public health precaution, our government requires that cereal and other grain products be fortified with folic acid.

About 3,000 babies are born with NTDs every year in the United States. NTDs generally develop in the earliest weeks of pregnancy, before a woman may even realize she is pregnant. That’s why all healthy women aged 15-45 years old already should be taking folic acid daily to prevent NTDs in the event of an unplanned pregnancy. Physicians recommend that women take a daily multivitamin that contains at least 400 mcg of folic acid. Pregnant women should increase their daily folic acid to at least 800 mcg. Most prenatal vitamins should contain between 800 and 1,000 mcg of folic acid. Don’t exceed 1,000 mcg unless your OB/GYN orders it.

January 7-13 is Folic Acid Awareness Week. The best (and most simple) treatment of NTDs is prevention. Women should read the label on their multivitamins. If they don’t have 400 mcg of folic acid, they should ask their healthcare provider to recommend a supplement.

Collaboration with hospitalists, rather than competition, improves patient care

By OBHG Marketing on January 5th, 2018

On December 31, 2017, KevinMD.com featured an editorial from OBHG hospitalist and Senior Director of Medical Operations Dr. Charles Jaynes. In the article, Jaynes, a 34-year private OB/GYN veteran, writes why he supports hospitalist medicine while presenting perspectives from hospital leadership, patients, and private physicians alike. 

"Far from being competitors, we are first responders who optimize the safety net by providing emergent care until the primary provider is in place and knows the story," he writes. 

Read full article.

OBHG hospitalist quoted in NBC News article on delivery room disparities

By OBHG Marketing on January 3rd, 2018

Recently, Dr. Karen Scott, OB hospitalist at Alta Bates Summit Medical Center in Berkeley, CA, was quoted in an NBC News feature article titled "The elephant in the delivery room: How doctor bias hurts brown and black mothers." The story focuses on the poor treatment minority women report experiencing in the delivery room due to ethnicity, cultural background, or language.

In one of her quotes, Dr. Scott says: "African Americans in the highest socioeconomic group experience the same or higher rates of infant mortality, low birthweight, and high blood pressure and excess weight during pregnancy in comparison with white women in the lowest socioeconomic statuses."

Read full article.

OBHG Medical Director of Operations sharpens leadership skills for enhanced partnership

By OBHG Marketing on January 2nd, 2018

Ob Hospitalist Group (OBHG) physicians and leaders are always striving to become better at what they do, hungry for professional development opportunities. OBHG Medical Director of Operations (MDO) and OB/GYN Dr. Donald Toatley is no exception. Toatley lives outside of Phoenix, AZ and has served as MDO since October 2016. He also acts as team lead for our OB hospitalist programs at Mercy Gilbert Medical Center and Chandler Regional Medical Center

In October 2017, Toatley completed the first four-day session for his leadership certification with the Society of Hospital Medicine (SHM) Leadership Academy. Toatley estimated that about 300 hospital medicine professionals, including physicians, advanced care providers, hospital medicine leaders, and practice administrators, were in attendance at the 2017 session in Scottsdale, AZ. Leadership Academy students must complete three sessions over the course of three years to obtain the certification that focuses on “overcoming leadership challenges, effectively advocating for a hospitalist program, conflict management, improving patient outcomes, and more.” Toatley is just beginning his certification program whereas two OBHG MDOs, Dr. Susie Wilson and Dr. Sue Smith, recently completed their certifications. SHM brings in industry experts, such as chief quality officers, academics, population health specialists, and patient experience experts, to teach the sessions.

“The Leadership Academy gives you perspective and helps you to understand your hospital partner and their challenges,” said Toatley. “Often, we don’t think like that. We want to truly meet the end need and optimize the throughput so our hospital partners have an effective and efficient work process and we want to ensure that we are delivering our overarching objective – to provide quality, safe care.”

As medical director of operations, Toatley must be knowledgeable in both clinical and administrative sides of the organization.

“You must take off your provider hat and start speaking the language of a hospital administrator or those focused on operations and quality improvement, which is very different from our clinical language,” he said.

He also believes that the Leadership Academy has helped him to think more critically about how OBHG aligns our mission, vision, and values to deliver our promise to our business partners – to elevate the standard of women’s healthcare.

“I’ve learned to really appreciate our stakeholders and understand their drivers while considering how OBHG, as part of this team, can work together to put the patient at the center.”

Seminar attendees took the DiSC® profile assessment to gain insight into their own personalities as well as gain a better appreciation and understanding of how different personalities interact and negotiate. Toatley says he will be able to better communicate with hospital leaders during business development discussions to understand their drivers – reduce cost, improve quality, and mange patient experience.

Toatley plans to take what he has learned thus far at the Leadership Academy and disseminate it to his hospitalist teams. He hopes to reinforce a culture of safety where there is no “shame and blame” but rather a “mend and blend” mindset when it comes to learning from and minimizing errors.

OBHG leaders are not simply leaders in title. Like Toatley, OBHG leaders take it upon themselves to exemplify principled leadership among business partners and OBHG employees every day. It is this level of dedication and passion that sets OBHG apart.

OBHG clinicians named to SOGH board

By OBHG Marketing on December 29th, 2017

The Society of OB/GYN Hospitalists (SOGH) elected new officers and board members at its Annual Clinical Meeting in New Orleans this September. Among the new members are two OBHG clinicians, Dr. Jane van Dis and Dr. Stacy Norton. SOGH highlighted the board in its recent year-end message.

“The Society is energized by this tremendous group of volunteers and for their commitment to serve,” said SOGH officials.

"This is such an exciting time to serve on the SOGH Board of Directors," said van Dis. "We have the opportunity to define what our core competencies will look like, and what the growth of our profession will look like over the next few years. It is truly an honor and a privilege."

van Dis served as the 2017 SOGH Annual Clinical Meeting co-chair, and is also a member of the SOGH Development Committee and Finance and Administration Committee.

“I am honored and very excited to serve on the SOGH board. In addition, as co-chair of the 2017-18 Simulation Committee, I’m also excited to help implement simulations in more hospitals with hospitalist programs,” said Dr. Stacy Norton. As Simulation Committee co-chair she will help coordinate course offerings for the Annual Clinical Meeting and write about clinical simulations for the SOGH newsletter.

van Dis and Norton aren't the only OBHG hospitalists who will be guiding the organization next year - future team lead Dr. Robert Fagnant will provide historical knowledge and advice as a member of the Advisory Council.

SOGH Officers & Board

Tanner Colegrove, President
Northwestern Medical Group - Lake Forest, IL

Catherine S. Stika, President-Elect
Northwestern Medical Group - Chicago, IL

Arthur Townsend, Treasurer
Methodist Le Bonheur Healthcare - Memphis, TN

Shefali Ghandi-List, Secretary
West Valley Women’s Care - Phoenix, AZ

Meredith Morgan, Past President
Women's Hospital - Houston, TX

Jennifer R. Butler
UC Irvine Medical Center - Irvine, CA

Brendan Carroll
Providence Portland - Portland, OR

Stacy Norton
OBHG Hospitalist, Memorial Hermann The Woodlands Hospital – The Woodlands, TX

Kim Puterbaugh
Fairview Hospital - Cleveland, OH

Dayna Smith
Piedmont Fayette Hospital - Fayetteville, GA

Brook Allen Thomson
Children’s Hospital of San Antonio - San Antonio, TX

Vanessa Torbenson
Mayo Clinic - Rochester, MN

Jane Van Dis
OBHG Hospitalist, Bakersfield Memorial Hospital - Bakersfield, CA

Ngozi Wexler
Medstar Montgomery Medical Center - Olney, MD

OBHG partner, Covenant Children’s Hospital, featured in news

By OBHG Marketing on December 27th, 2017

Covenant Children's Hospital, an OBHG partner in Lubbock, TX, was recently featured in the news for the development of their new obstetric emergency department. 

"Sometimes you'll go to a regular emergency department, and the nurses and physicians are not always accustomed to caring for a pregnant mother, so we really feel like they get expert care if they come to an OBED," said Marybeth Murphey, director of business development at Covenant.

We are pleased to have such a strong partnership with Covenant Children's and hope that an OBHG presence will have a significant impact on the area's pregnant women and their babies!

Full story.

New OBHG program: Ocean Medical Center

By OBHG Marketing on December 26th, 2017

Ob Hospitalist Group is proud to announce the launch of our latest hospitalist program at Ocean Medical Center in Brick, N.J. earlier this month. Ocean Medical Center is part of the Hackensack Meridian Health system and is a 281-bed community hospital. Our partnership is beginning as a part-time triage and will transition to a Type A obstetric emergency department in early 2018.

Team members (pictured left to right) include Team Lead Dr. Fred Nichols, Dr. Susan Passarella, and Dr. Robert O'Donnell (not pictured: Dr. Andrew Farkas). We are looking forward to collaborating with Ocean Medical Center to serve the area’s pregnant women!

OBHG hospitalist accepted into AOA Health Policy Fellowship program

By OBHG Marketing on December 22nd, 2017

Dr. Deanah Jibril, Ob Hospitalist Group Team Lead at CHRISTUS Mother Frances Hospital-Tyler in Texas, is now lending her voice to help guide U.S. health policy. She was recently accepted into the prestigious American Osteopathic Association (AOA) Health Policy Fellowship program.

Jibril is one of 11 participants selected from about 100 applicants nationwide for the year-long leadership training program that is also directed by the American Association of Colleges of Osteopathic Medicine and the Ohio University Heritage College of Osteopathic Medicine.

The course is designed for practicing or teaching osteopathic physicians and other osteopathic medical educators who are preparing for professional leadership roles and positions of influence in health and higher education policy, according to AOA.

The Health Policy Fellows attend an intensive, five-day academic orientation before entering a regimen of nine, three-day seminars on crucial policy issues at the local, state, and federal level. The program has trained more than 240 fellows since its founding in 1994.

Beyond a practicing OB/GYN

Fellows are chosen based on their scope of practice and experience so they are able to effectively represent the profession, said Jibril. “Having worked with OBHG was part of why I was chosen, I think, along with teaching at the medical school and working in private practice for a long time,” she added.

Jibril is President of Texas Osteopathic Medical Association (TOMA) District 5, an alternate delegate for TOMA House of Delegates, and a member of the American Osteopathic Association. She is an Associate Professor of Family Medicine at the University of Texas at Tyler and Adjunct Faculty in OB/GYN at University of North Texas Health Science Center, University of Texas at Galveston and Touro University, and OMM at the University of Incarnate Word in San Antonio

Jibril recently returned from a week in Washington, D.C., where she met with various groups touching healthcare. She also began to learn about position presentation methods and objectivity, she said.

“We learn to create policy briefs that are timely and to be a resource for legislators on the local, state, and national level,” said Jibril. Fellows also learn how the executive and legislative branches of state government interact to effect health policy and how medical professionals can influence and share health policy at the local, state, and federal levels, according to AOA.

At the conclusion of the fellowship, participants become members of a resource team that can be called upon to present or help form an opinion to present to a legislative body.

An added focus in health policy

Jibril said her areas of expertise will likely influence future presentations, “Moving forward I will probably be selected to present on healthcare and economics. I have an MBA, so I will be able to present real numbers to go along with the position statements.”

“The need in healthcare will be great over the next five years, it is predicted to be a tumultuous time,” she added.

Before the fellowship group meets again, Jibril will read nearly 10 articles and continue writing a position statement, not to mention delving into a new textbook on the American healthcare system. “We must write position statements, which is not always a doctor thing. I write quite a bit anyway, so it was a logical next step,” said Jibril. “I always like to stay busy and I needed another challenge.”

Making a difference as an OBHG hospitalist and beyond

In both practice and policy, Jibril said she feels like she is continuing to make a difference. “I am pleased to have a seat at the table in representing healthcare,” said Jibril. “OBHG’s mission of elevating the standard of women’s healthcare is working to do good in every single community,” she added.

Her experience has allowed her to take advantage of the fellowship opportunity, said Jibril. “And I’m thankful to OBHG for providing a diverse experience--I really enjoy taking care of people,” she said. 


Check out the rest of the fellows for 2017-18.

OBHG partner OB emergency department featured in news

By OBHG Marketing on December 20th, 2017

Ob Hospitalist Group partner, Bon Secours St. Francis Health System in Greenville, SC, was recently featured in an article on UpstateParent.com about their OB emergency department. 

“A patient having a problem with her pregnancy, instead of going to an emergency room where she would have to wait a long time, they can be in and out much quicker and be seen,” Bon Secours St. Francis Health System Maternal-Fetal Specialist Phil Grieg said. “They don’t have to wait. Not having to go through a general emergency room, they go straight up the elevator and can be seen immediately.”

We appreciate our partnership with Bon Secours St. Francis as we collaboratively elevate the standard of women's healthcare! 

Read full article.

Syphilis on the Rise in California

By OBHG Marketing on December 18th, 2017

By: Jane Van Dis, MD, FACOG, OBHG Medical Director for Business Development
This article was originally published in the December 2017 issue of the ACOG District IX newsletter.

“Health care providers should have syphilis on their radar and ensure that all pregnant women are tested at the first prenatal visit. Pregnant women with risk factors for syphilis, sporadic prenatal care, drug use, and those living in areas with high syphilis morbidity (particularly in central California) should be tested again for syphilis early in the third trimester and at delivery.”  —Heidi Bauer, MD, CDPH, STD Control Branch Chief

The syphilis crisis in California continues to grow. Ob-gyns are often the first line for women seeking health care and therefore play a key role in education and treatment. The California Department of Public Health (CDPH) recently announced that syphilis, chlamydia, and gonorrhea rates are at a 25-year high in California. The state now has the third highest rate of primary and secondary syphilis and the second highest rate of congenital syphilis nationwide. The following eight counties in California have the highest risk of syphilis infection:

  • Fresno
  • Kern
  • Kings
  • Sacramento
  • San Bernardino
  • San Joaquin
  • Stanislaus
  • Tulare

In these high-prevalence areas, it is recommended that ob-gyns screen, not only in the first trimester or at the initiation of prenatal care, but additionally, early in the third trimester (28-32 weeks) and again at delivery. Also, any woman who presents with a fetal death after 20 weeks’ gestation should be tested for syphilis. Public health officials in California recommend that no mother or neonate should leave the hospital without documented maternal syphilis status.

Visit the CDPH website to find more information for providers and patients.

Taking a risk to better manage OB risk

By OBHG Marketing on December 15th, 2017

Medical malpractice liability is a persistent concern in healthcare. Nationally, costs related to malpractice liability top roughly $150 billion annually,  and one of the most significant risk areas is in obstetrics. 

Ob Hospitalist Group's Heather Moore, Director of Risk Management, Quality, and Compliance, recently wrote a piece for Becker's Hospital Review detailing how hospitals can reduce OB liability. 

Read full article.

New OBHG program: United Regional Health Care System

By OBHG Marketing on December 13th, 2017

In late November, we launched our latest OB hospitalist program at United Regional Health Care System in Wichita Falls, Texas.

We have hired a team of highly skilled, board-certified OB clinicians to run this new obstetric emergency department (from left to right): Dr. Audrey Puentes; Dr. Edward Clark; Dr. Julie Thomas; Dr. Miguel Cintron; Dr. Gaynelle Rolling; and Dr. Cheng Song. Dr. Song and Dr. Clark will provide backup coverage, and Dr. Cintron will serve as the program's team lead.

"OBHG and United Regional Health Care System have kicked off a solid partnership to continue to provide ongoing high-quality care for pregnant women in Wichita Falls and the surrounding area," said Dr. Rakhi Dimino, Ob Hospitalist Group Medical Director of Operations. "This program is highlighted by allowing the return of the University of North Texas Family Medicine Residency Program to the inpatient obstetrical unit at United Regional Medical Center. The OBHG team looks forward to not only elevating the standard of care for pregnant women in Wichita Falls, but also mentoring and teaching family medicine residents in OB care."

From burnout to balance: Q&A with an OB hospitalist

By OBHG Marketing on December 8th, 2017

After missing too many events in his children’s lives and suffering from career burnout like so many obstetricians do, Dr. Stephen “Todd” Bashuk was ready for a change.

Last year he decided to leave his private practice in Georgia and pursue a new career path. He accepted a position as an Ob Hospitalist Group team lead at one of our hospital programs near beautiful Fayetteville, Arkansas.

He moved into the OBHG medical director of operations role at his hospital earlier this year.

Bashuk says the transition has made a tremendous positive difference in his life.

We asked him to discuss his journey to hospitalist medicine, how his work has impacted patients, and how his own family life has changed.

What was your work life like before you joined OBHG? 

“I was in private practice and being pushed and pulled in a million different directions. I had read that OB/GYNs had a 51 percent burnout rate; I think it is higher.

What made you decide to transition to hospitalist medicine?

I was working and one of my kids needed something to be done and I realized I couldn’t do it. I knew at that moment that I was missing too many things in life and something had to change.

I think many physicians become hospitalists to regain that work-life balance – regain control over their lives – and move forward.

How has your experience been so far?

It’s been a year since I took the position and I absolutely love it. I love the lifestyle and spending a lot more time with my family. During the last year I also realized that I was making a huge difference.”

How are you improving care for patients?

"We see every patient who comes to the obstetrical emergency department. We’re there in the hospital 24/7 for emergencies which helps improve patient safety. The unassigned patients who don’t have a doctor benefit the most. These are often high acuity patients and caring for them can be very complicated.

We also help make the community doctors’ and nurses’ lives better so they can deliver better care.

How does the hospital benefit?

Liability is reduced because there is an experienced, board-certified OB on hand at all times. When I see the number of saves in my hospital each month, multiplied by the number of OBHG programs, I realize that there are 300-400 saves every month—and that’s huge.

How did your family feel about your career change?

"I was pretty burned out when I met my wife Diane. She encouraged me to pursue what would make me happy. I went from a private practice in Atlanta to a lead hospitalist in Arkansas – that’s a huge change and a huge adventure. She was right there with me.

Between us we have six children ranging in age from 14 to 20. So there are always family fires to fight! (Laughs)
 
What do you do with your newfound leisure time?

We like to travel and have visited the Grand Canyon, Panama, and Cuba just since I’ve joined OBHG. And we are scheduled to visit Guatemala and Peru to climb Machu Picchu!

What would you say to physicians considering hospitalist work?

We all went into this field to take care of people. Being a hospitalist taught me that you can take care of people and go to your daughter’s championship game too."

OB hospitalists give the gift of time this holiday season

By OBHG Marketing on December 6th, 2017

By: S. Todd Bashuk, MD, Ob Hospitalist Group Medical Director of Operations based out of Fayetteville, AR

Ah, the holidays. I remember being in med school and my family celebrating Thanksgiving in Atlanta while I was in St. Louis studying for finals. I thought it was no big deal – I’d have privacy to study, and frankly, going to my brother’s house and eating turducken wasn’t exactly Disney World. I could not have been more wrong. Domino’s does not make a turkey and dressing pizza nor does Hunan Wok make General Tso’s turkey. But as much as my brother annoys me, I missed his Bill O’Reilly rant and his turducken. When it was time to celebrate the new year, I sat alone in a call room, eating cafeteria-pressed turkey while the world celebrated. I missed my dad’s collard greens and black-eyed peas.

What’s a holiday? Thanksgiving, Christmas, and New Year’s come to mind first, then Fourth of July, Labor Day, Easter, and Memorial Day. But everyone is different. Some folks consider their birthday, Cinco de Mayo, or their son’s baseball game as times of celebration. During the holiday season, there is no greater gift to give a colleague than a day with their family instead of Christmas in a call room.

I became an OB hospitalist a year and a half ago. I had been in private practice for 15 years, and during that time, I missed everything important to me. After years of suffering from burnout and depression, I decided to make a change. With my wife’s support and blessing, we decided to blindly jump into the volcano, and I became a hospitalist for Ob Hospitalist Group (OBHG).

I have met so many great people during my time at OBHG, including some wonderful OB/GYNs still in private practice. My closest friend has been in practice for 60 years – let’s call him Dr. Mike. This man takes care of everyone else in the world and has the biggest heart of anyone I know. When I started working at Willow Creek Women’s Hospital (Johnson, AR), he was tired, burnt out, and honestly irritable. Dr. Mike was so far from the man he really is. Since OBHG has implemented a program at Willow Creek, he has slept in his own bed every night and he celebrates Christmas with his family. He was even able to attend his granddaughter’s kindergarten graduation. Because of the partnership between OBHG and Dr. Mike’s practice, he doesn’t have to miss important life events anymore. The few times I’ve had to call him back, he comes quickly and willingly without complaint. He is my super-secret back up and comes even if he is not on call.

Amidst this holiday season, I’d like to highlight the service OBHG can provide to the community. Providing coverage for our community physician partners gives them the freedom to do what they love. Whether it’s a major holiday like Christmas or a special event like a child’s dance recital, our hospitalists can make the biggest difference. At OBHG, we are giving some of the best gifts that can be given: time with family and safe deliveries.

Three OBHG partner hospitals named favorite place to have a baby

By OBHG Marketing on December 1st, 2017

We are proud to announce that three Ob Hospitalist Group partner hospitals in the Richmond, Va. area were named Richmond’s Favorite Place to Have a Baby in Style Weekly’s annual Family Favorites poll. Bon Secours St. Mary’s Hospital in Richmond, Va.; Bon Secours St. Francis Medical Center in Midlothian, Va.; and Bon Secours Memorial Regional Medical Center in Mechanicsville, Va. were named first, second, and third, respectively. We are fortunate to have such wonderful partnerships with the clinical teams at these hospitals so we are able to collaboratively raise the bar when it comes to women's healthcare! 

Read full article here.

On a medical mission

By OBHG Marketing on November 28th, 2017

Dr. Lisbeth Jordan has always been driven to improve health and health care. Not just at home in Bellevue, Washington, but around the globe.

She has been able to follow her passion and do meaningful work in several developing countries. But when she was working as a private practice physician, the intangible rewards she gained through service to others came at a cost to her clinic.

Now an Ob Hospitalist Group clinician, Jordan can not only set her own schedule and spend more time with her family - but she can volunteer without the stress and anxiety that comes with leaving a business unattended.

In recent years she has traveled to Serra Grande, Brazil to help build sustainable health and education initiatives in partnership with the local community. This year she served as team lead for a project aimed at educating and empowering the area's teenage girls.

Read full testimonial.

Q3 2017 “You Delivered!” award recipients announced

By OBHG Marketing on November 24th, 2017

Each quarter, Ob Hospitalist Group employees nominate teammates who have gone above and beyond to demonstrate the company's core values.

The OBHG leadership team selects one clinician and one support staff member to receive the You Delivered! award for their outstanding performance. For the third quarter of 2017, OBHG recognized OB hospitalist Dr. Peter Genaris, and Senior Hospital Operations Analyst Jorge Lopez.

An excerpt from Dr. Genaris’ nomination:

“Dr. Genaris is a hero...he has saved so many lives this summer it is incredible. He successfully emergently delivered a patient who presented to the OBED with a complete placental abruption which allowed both mom and baby to be resuscitated from this life-threatening condition. He emergently delivered a patient who had a uterine rupture while attempting to VBAC, thus saving both mom and baby.

He performed these life-saving feats with grace and humility, and with compassion and respect for his patients and their families.

The physicians and nursing staff recognize his accomplishments and outstanding bedside manner with the simple statement of: "We love him!" As his teammate and team lead, I could not wish for a better team member to work with. His work ethic and ability is unparalleled. He deserves recognition for his grace under fire and for his heroic life saves.”

An excerpt from Mr. Lopez’s nomination:

“Jorge and I have collaborated on many projects and I have found him to be extremely knowledgeable in Excel. Conservatively, his efforts [creating and testing a new time saving process for the team] have saved about 48 hours of productivity each quarter going forward. This service-minded approach to his role is evident from his work with our team, and he has now had a positive impact on my entire department as well.

I believe Jorge embodies the core value of "genuine service" by intentionally and joyfully utilizing his abilities to the best of his ability.”

Congratulations to both third quarter You Delivered! awardees! 

 This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Ten reasons why it’s time to implement an obstetrics hospitalist program

By OBHG Marketing on November 21st, 2017

By: Amy VanBlaricom, MD, Ob Hospitalist Group Medical Director of Operations based out of Seattle, WA

Did you know that as the U.S. population grows, the number of physicians going into the OB/GYN specialty remains the same? The OB/GYN shortage will increasingly become an issue, but OB hospitalist programs can help relieve community physicians who are stretched too thin and quickly burning out

As Medical Director of Operations at Ob Hospitalist Group (OBHG), I see firsthand the impact our hospitalist programs bring to our partners, the community, mothers, and babies. Here are 10 reasons why it’s time for your hospital to elevate the standard of women’s healthcare and seriously consider implementing a 24/7 OB hospitalist program. And I’m not talking just any program - OBHG’s program.

1. OBHG hospitalists support your nurses

With an OB/GYN in the hospital 24/7, nurses have around-the-clock support. They can ask questions, voice concerns, and get second opinions on interventions in real time versus having to hunt down a private physician and pulling them out of their office. OBHG hospitalists attend multidisciplinary board rounds and address concerns about patients. They are able to make recommendations on whether to engage a private physician.

2. OBHG provides increased safety through OB triage and emergency response

OBHG hospitalists are always onsite to care for any obstetrical emergency that may walk through the door. This can improve outcomes in high-volume programs with high acuity rates or lower-volume programs where physicians may have minimal experience with emergencies. Our program can also positively impact your hospital’s medical malpractice insurance premiums and save money.

3. Our hospitalists engage and build relationships with your private physicians

Our clinicians collaborate and build relationships with private physicians. As private physicians feel more comfortable with OBHG doing their deliveries, they are able to be more productive in their offices. They are also more likely to continue doing OB and retire later due to having hospital coverage and an increased quality of life. Private physicians are more likely to offer VBACs to their patients if there is a physician in-house. Additionally, our hospitalists can see, manage, and coordinate care for unassigned and uninsured patients to tuck them in with an outpatient provider where necessary. This can improve outcomes to these patients who would most likely otherwise fall through the healthcare system cracks.

4. OBHG programs entice new business from community physicians

The presence of an OBHG hospitalist program in your hospital may bring in new business from primary physicians, midwives, or family practice physicians in the community who may not have brought their patients in before. Once our program is implemented, our clinicians collaborate with you to conduct community outreach to those untapped patients who may not have otherwise come to your hospital. You can promote the 24/7 presence of an OB physician in case of emergency.

5. Our OB hospitalists improve safety through enhanced communication

OBHG hospitalists consistently communicate with private physicians about their patients to provide the most seamless care possible. They are also involved in multidisciplinary drills and simulations to help remove systematic inefficiencies and bottlenecks. This helps to find holes in the system and work to repair them. Our hospitalists also have access to a national network of over 600 OB clinicians in our 130 programs and can share best practices and challenges.

6. Our hospital partners optimize care using our national dataset

OBHG’s hospital teams contribute to safety protocols and build quality metrics for all of our partner hospitals We not only help you report those metrics, but we help you improve data such as reducing cesarean section rates, lowering early labor induction, improving the time it takes to administer medication in hypertensive emergencies, offering VBACs, and more. All of these things improve safety and cut down on healthcare dollars spent, which results in improved outcomes and metrics. These are things that payors look for when they consider contracting with a hospital.

7. OBHG clinicians champion new initiatives within their hospital and outside

Our clinicians are not just OBHG employees, they are part of their hospital’s staff and community. They are healthcare leaders who take part in community and even statewide initiatives. Many of our programs are in critical-access hospitals or referral centers where improved systematic care for patients can be driven by standardized protocols for infection prevention, minimizing complication rates, and managing the complicated medical care of those who have not driven that management themselves. For example, one of our programs is involved in a statewide initiative to decrease perinatal and postoperative infection rates.

8. Our 24/7 presence can improve patient satisfaction scores

Your patients will see an engaged, caring physician every time. OBHG hospitalists are equipped to answer questions and provide instructions in-person versus having to communicate with the primary OB if he/she cannot be present in the hospital. This improves patients’ experience and overall impression of the hospital.

9. OBHG’s program can bring revenue to your hospital

In addition to the possibility of increasing volume of patients overall - what patient wouldn’t want to be seen by a qualified physician every time, if that were an option? We can also enhance your billing and coding process and capture revenue that you may be leaving on the table now by billing triage visits as OB emergency department (OBED) visits.

10. Our OB emergency departments increase throughput

By having a physician in the labor and delivery unit 24/7, patients can move through to delivery faster and experience shorter lengths of stay as they we can actively manage them. Primary physicians can request that our physicians start rounding earlier if they aren’t able to, which can result in more timely discharges. This can affect length of stay in the hospital in general, which improves hospital efficiency, and as a bonus, payors like it too.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG team featured in RevCycle Intelligence article

By OBHG Marketing on November 16th, 2017

Every individual who works for Ob Hospitalist Group (OBHG) impacts our vision to elevate the standard of women's healthcare.  This month, RevCycle Intelligence featured OBHG's Revenue Cycle Management Team, which runs like a well-oiled machine to streamline business operations for our 130 hospitalist programs across 30 states. 

Read full article here.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Are you ready for a disaster?

By OBHG Marketing on November 9th, 2017

When the hurricane season hit this year, Ob Hospitalist Group (OBHG) teams were prepared.  But thanks to carefully designed disaster plans, strong communication, and volunteers willing to step up, OBHG's patients were well taken care of amidst the natural disasters. 

Read what OBHG's Dr. Jaynes and other hospitalists learned after this latest round of hurricanes that may help prepare your hospital for future emergencies.

Read full article on at TodaysHospitalist.com.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Overcoming exhaustion: How one OB reclaimed her energy

By OBHG Marketing on November 7th, 2017

By Nahille Natour, MD

It was my third trip to the hospital that day. 

I had a few patients in labor to check on and while I was there, I was called to the ER due to the premature delivery of non-viable twins. 

Luckily the deliveries were uncomplicated, but any time there’s a pregnancy loss, attention to the emotional must accompany the physical care of a patient.

And so you answer questions asked between tears. You express your mutual grief. You provide resources and you encourage use of available support. While you can’t take away her pain, you give all that you have.  

Once I get home, I crumple onto the couch to catch the 10 p.m. newscast and I remember that I have to catch up on the day's charts.

It was a tough day - preceded by tough days and followed by tough days.

And while not every day involves a loss, caring for patients requires a tremendous amount of energy. Helping patients make difficult decisions, advocating for their interests with insurance companies, finding ways for them to afford medication - and all the while lending an empathetic ear and clicking away on your keyboard in an electronic record. 

If doctors don’t have a way to replenish and invigorate their souls on a regular basis, they can quickly find that they don't have any more left to give.

It happened to me.

This recurrent depletion of energy quickly leads to emotional exhaustion, which is one of the components of burnout. The Medscape Lifestyle Report 2017 surveyed physicians of all specialties, and of the responders who were obstetrician/gynecologists, 56% reported that they were burned out. Further, a recent study showed that 36% of OB/GYNs suffer high levels of emotional exhaustion.

Why is this important? Multiple studies have shown that when physicians are burned out, productivity and quality of care declines, medical errors increase, patient satisfaction decreases and doctors leave the work force.

How do we make improvements? Many organizations have started physician wellness programs to address this issue. And while the picture of wellness differs from person to person, there are a few things all of us can do.

Set priorities and boundaries. Participate in activities that you enjoy and stay connected with your community, friends, and family.

I had a tough time doing this on my own; luckily I was able to transition to a position as an OB hospitalist with Ob Hospitalist Group. My schedule is flexible and when I’m off, I am free to take care of me.

It is a liberating feeling knowing that when my shift is over, I will be going home and I won’t be taking work with me. I still enjoy plenty of continuity with patients, but I don’t have to worry about declining reimbursements and office staff.

Joining Ob Hospitalist Group was a solution that kept me in clinical medicine and helped me rediscover my passions - both within and outside the hospital. 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

What’s it like to be an OBHG hospitalist?

By OBHG Marketing on November 3rd, 2017

Dr. Rakhi Dimino, OBHG medical director of operations and OB hospitalist at Houston Methodist Willowbrook Hospital, describes what it's like being an OBHG hospitalist. From workload to types of procedures performed to what she does during her downtime on shift, Dr. Dimino provides a complete overview of what an OBHG hospitalist may do during a typical day.

 

 

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Family sends heartfelt thanks to OBHG team

By OBHG Marketing on November 2nd, 2017

A patient and hospital employee of Ascension Health sent his heartfelt thanks to our hospitalist team at St. Vincent’s Medical Center Southside in Jacksonville, Fla.

James and Jackie Sommer are the parents of Heidi, who is expecting a little brother in mid-November. They plan to deliver at one of our partner hospitals, St. Vincent's Medical Center Southside, outside Jacksonville, FL.

James shared his recent experiences with our OB hospitalists:

“We are expecting our second child and my wife has been categorized as high risk," says Sommer. "We have been to the Family Birth Place at St. Vincent’s Southside on two separate occasions with scares. In those two visits, we were treated by Dr. Jocelyn Rogers and Dr. Nancy Miller, respectively. Both of them did a fantastic job with treatment, but it was their bedside manner that was exceptional (Dr. Miller is hilarious)."

"Not only was the treatment timely, but the emotional relief they provided to my wife made the visits very low stress," Sommer continued. "I just wanted to express my gratitude for their level of service and hope you continue the great work."

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

One in 10 U.S. babies is born prematurely

By OBHG Marketing on October 31st, 2017

The entire month of November is dedicated to premature birth awareness, and with good reason. Every year, about 15 million babies are born prematurely, or before 37 weeks, across the world.

The United States has one of the highest rates of preterm births among industrialized counties. In 2016, about one in every 10 babies born in the U.S. was premature. The March of Dimes is taking action by raising awareness among expectant mothers and educating the public about how to prevent premature birth. Currently, the preterm birth rate in the U.S. is 9.6 percent, and the March of Dimes aims to reduce this to 8.1 percent by 2020. 

Who is most at risk for a preterm labor?

There are many factors that could contribute to premature labor, but the CDC and the American Pregnancy Association list some of the more common causes.

Social, personal, and economic characteristics:

  • Low or high maternal age
  • Black race
  • Low maternal income
  • Socioeconomic status

Medical and pregnancy conditions: 

  • Infection
  • Prior preterm birth
  • Carrying more than one baby (twins, triplets, or more)
  • High blood pressure during pregnancy
  • Presence of uterine or cervical abnormalities
  • Recurring bladder and/or kidney infections
  • Underweight or overweight before pregnancy
  • High blood pressure, kidney disease, or diabetes

Behavioral:

  • Tobacco and alcohol use
  • Substance abuse
  • Late prenatal care
  • Stress
  • Working long hours with lots of standing
  • Domestic violence, including physical, sexual or emotional abuse
     

What are the signs and symptoms of preterm labor?

Premature birth may be avoided if a pregnant woman recognizes the signs of preterm labor and quickly contacts her physician. Some warning signs include:

  • Five or more contractions within an hour
  • Watery discharge
  • Low, dull backache
  • Abdominal cramps 


So what can pregnant women do to reduce the risk of early birth?

Although preterm birth is complicated and has many causes, there are several steps women can take to help reduce the chances of their baby being born prematurely. According to the CDC, pregnant women can:

  • Quit smoking
  • Avoid drugs and alcohol
  • Get early prenatal care and continue to see a physician throughout the pregnancy
  • See your physician if you experience any signs or symptoms of a preterm birth
  • If a woman has previously experienced a pre-term birth, she can talk to her physician about receiving a progesterone treatment
  • Wait at least 18 months between pregnancies 

 

Help spread awareness

In 2015, preterm birth and low birth weight accounted for about 17% of infant deaths, according to the CDC.  Babies who do survive could have the following health issues:

  • Breathing problems
  • Feeding difficulties
  • Cerebral palsy
  • Developmental delay
  • Vision problems
  • Hearing problems

Although premature birth can occur for many reasons, there are things pregnant women can and should do to lower the risk and help promote a healthy pregnancy and newborn. 

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Seeking experienced OB/GYNs for open positions

By OBHG Marketing on October 26th, 2017

Ob Hospitalist Group, the nation's largest dedicated employer of OB hospitalists and the most innovative company in the industry, is seeking board-certified OB/GYNs for several open positions in desirable locations across the U.S.

If you're a highly skilled, passionate, and service-minded obstetrician ready to practice the medicine you love while enjoying an average of 21 days off per month, we would like to talk with you!

A few of our current open positions:

ARKANSAS

Looking for a more 'natural state' of being? Pristine hiker's paradise Arkansas may be the perfect fit. The state offers scenic beauty, clear lakes and streams, and exciting wildlife-watching opportunities within its 52 state parks and three national forests.

OBHG manages obstetrical emergency department programs at two facilities in Arkansas, one near the buzzing activity of the state's largest university. Full and part-time roles are available.

If you're ready to explore the possibilities, please contact our Senior Clinical Recruiter Natalie Petrizzo for more information. 

Read more about the program, local area, and lifestyle or view all current opportunities in Arkansas


OKLAHOMA

OBHG is seeking candidates for one of our newest additions to the Oklahoma market - our program at a state-of-the-art hospital located in Norman.

The facility's leadership is very excited for the obstetrical emergency department to open and the hospitalists will play a significant role in building the program.

With one of the country's fastest growing economies, Oklahoma has a lot to offer. Norman is just a 30 minute drive from Oklahoma City, and it is a good sized city (the state's third largest) in its own right. 

If you're ready to explore the possibilities, please contact our Senior Clinical Recruiter Natalie Petrizzo for more information.

Read more about the program, local area, and lifestyle


NEW YORK

Binghamton, New York is home to one of our newest programs. The city's focus on healthcare and higher learning is partly due to SUNY Binghamton University, a public research university that has been compared to Ivy League schools for the quality of education it provides.

The OBHG team will have opportunities to perform gynecological surgeries and participate in resident education. The labor and delivery floor is also supported by midwives. 

An additional perk for this location is a $20,000 sign-on bonus!

If you're ready to explore the possibilities, please contact our Senior Clinical Recruiter Liz Selfridge for more information.

Read more about the program, local area, and lifestyle or view all current opportunities in New York.


TEXAS

Texans will want to take note of our openings in two different areas of the Lone Star State.

Lubbock, home of Texas Tech University, offers wineries, 265 days of sunshine a year, and loads of family-friendly activities. It also boasts the ever-popular Alamo Drafthouse! Working as part of our obstetrical emergency department team in Lubbock comes with a great standard of living, as the housing and other costs are very affordable.

Austin is one of the coolest and fastest growing cities in the country, and OBHG now has positions available at three hospitals in the area. These roles will likely fill quickly, so apply soon! 

And we just added a new program in historic, culturally rich San Antonio, home of The Alamo.

If you're ready to explore the possibilities, please contact our Senior Clinical Recruiter Jason Fyler for more information, or view all current opportunities in Texas.


In an era of widespread physician burnout, OBHG understands the importance of work/life balance for our valued clinicians. Our full-time roles come with responsibility, influence, excitement, and autonomy, but also allow enough time off for a fulfilling personal and family life. Read some of our physicians' personal stories.

Intrigued? For more information about the positions highlighted here along with all our current job opportunities, contact the clinical recruiter seeking candidates in your region. Our expert recruiters, all skilled in health care and physician placement, will answer your questions about the hospitalist lifestyle, discuss how our programs work, and explain what you can expect from the hiring process.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Pain, pills and postpartum drug use

By OBHG Marketing on October 23rd, 2017

OBHG Senior Director of Medical Operations and OBGYN Dr. Charles Jaynes wrote a piece about the current state of opioid use as it relates to obstetrics. His article was published in Becker's Hospital Review this month.

"A recent study in the journal Obstetrics and Gynecology which examined opioid use among women who had a C-section concluded that most women—especially those with normal in-hospital opioid use—are prescribed opioids in excess of the amount needed," wrote Dr. Jaynes. 

Read full article here.

What quality care means to OBHG

By OBHG Marketing on October 18th, 2017

From our frontline clinicians to our Risk Management & Patient Safety team, quality is a top priority across the board at Ob Hospitalist Group (OBHG). In observance of Healthcare Quality Week, we wanted to share what we are doing to ensure quality care for all patients across our national network of OB hospitalist programs. 

OBHG developed the SAFE program to elevate the quality of care for our hospital partners while simultaneously decreasing medical malpractice liability and risk. We offer our partner hospitals several services through SAFE, including a hotline and quality assurance reports to identify areas of potential risk and opportunities to improve patient safety best practices. We are also committed to capturing data to identify areas of potential risk mitigation, finding opportunities for quality improvement, and ensuring transparent and engaged interactions with our provider teams and hospital partners. All OBHG clinicians and hospital partners have access to a variety of best practice and educational offerings aimed at increasing the quality of care. 

When it comes to quality, our team is all in. OBHG obstetrician Dr. Lydia Sims of Houston Methodist Willowbrook Hospital said:

"By definition, quality represents a high level of excellence. At OBHG, our clinicians obtain a high level of excellence by providing patient safety, meeting standards of care, demonstrating patient advocacy, while simultaneously using evidenced-based medicine and experience in caring for our patients."

OBHG Chief Medical Officer Dr. Mark Simon said this about healthcare quality:

"Quality is ensuring that we deliver the best possible care to each and every patient in a timely, reproducible fashion. That is why we work so hard to disseminate best practices to our team of clinicians across the country and measure the impact of our care on the communities that we serve."

OBHG CEO Lenny Castiglione had this to say: 

"Quality begins with the people that we hire and the teams we build. As an organization that is focused on bringing life into the world where complex clinical situations exists, we have to exceed the standard and leave no room for error. Therefore, we are very intentional about measuring our outcomes and constantly raising the bar. Our commitment to quality and safety is the core of our mission and operating model."

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Speak up, physicians: How to use your voice on social media

By OBHG Marketing on October 12th, 2017

Time is a precious commodity for most physicians, but many are now opting to set aside a few hours a week to establish and maintain a social media presence.

Physicians use public social media platforms to engage and educate

So how can online networking sites benefit doctors?

Social platforms like Facebook offer physicians an accessible way to communicate directly with the people in their communities. Posting a few family photos and a favorite quote can effectively ‘humanize’ a doctor by providing a glimpse into his or her personal life and values.

A business Facebook page can also serve as an extension of a professional practice website – offering a convenient space (that often appears prominently in Google search results) to post office hours, services offered, and contact information at a glance.

Equally important is the need for clinical expertise and knowledge sharing to help improve patients' health literacy.

In an era when many people attempt to diagnose themselves online before consulting an expert, it’s crucial that trained physicians participate in the public conversation to help counteract the vast amount of specious health information and advice found on social posts, blogs, and message boards. 

Creating a personal brand can help medical professionals manage their online reputation

Online consumer reviews are not just for restaurants anymore. Patients can post reviews and ratings for their doctors on Facebook, Google, Yelp, and any number of other sites.

Healthcare systems have also started to develop and implement their own ratings systems, hosted on their external websites, to increase transparency and help build trust among patients. This approach also allows hospital administrators to choose the methodology used to generate ratings and determine which data is most relevant.

Because web ratings have become so ubiquitous, many physicians have proactively created an online brand to help alleviate any critical or inaccurate reviews.

Those who do not have the time or inclination to friend request, tweet, and post on a daily basis can outsource the effort – several enterprising companies now offer services designed to monitor and manage busy medical professionals’ online reputations. Firms like Empathiq and RepCheckup can generate positive content for their clients’ social pages, solicit patient reviews, and help follow up with those who post negative comments.

Influencer physicians gain followers by sharing helpful content

A number of doctors who have built large followings on social media are able to leverage their networks to promote their own safety initiatives, books, and research findings, but they also use the platforms to keep followers in the know about trending topics.

Influencers can fill a content curator role for their followers – highlighting the ‘news you can use’ from a content landscape that can be overwhelming. A personal Facebook page or Twitter feed is a handy place to keep track of particularly interesting articles.

Physicians can also share their insights and expertise by hosting or joining live Twitter chats, where they can answer questions (marked with a custom hashtag) about a specific topic during a set period of time.

Boston-based surgeon and bestselling author Dr. Atul Gawande currently has 221,000 followers on Twitter, where he posts about everything from government health policy to new and interesting medical inventions - like ‘smart tattoos’ that change color to indicate a rise in blood sugar.

About 157,000 Twitter users follow internal medicine physician Dr. Kevin Pho. His website KevinMD.com has become a hub for the clinician voice - publishing thousands of candid blog posts and articles penned by medical professionals and students and earning accolades from the New York Times, Forbes, and CNN.

Obstetrician and OBHG Medical Director of Operations Dr. Rakhi Dimino recently contributed a blog post to Pho's site focusing on the importance of bedside manner and end-of-life discussions. 

Read more about becoming a KevinMD.com contributor here.

Networking sites created for doctors offer private collaboration and custom tools

While traditional social media sites can help physicians engage patients and the public, and LinkedIn has emerged as the top professional networking site, platforms designed specifically for doctors are growing exponentially.

Doximity is barely six years old, but it is already the largest online physician network. It counts more than 70 percent of U.S. physicians as verified users - and now boasts more members than the American Medical Association. The site offers simple, iPhone-friendly tools that enable HIPAA-secure communication between doctors and patients, a mobile fax service, and continuing medical education credits.

Users can also peruse articles and studies relevant to their field in their newsfeed, re-connect with medical school or residency classmates, or search for new job opportunities.

Other physician-focused sites include the global 'virtual doctor's lounge' Sermo and clinical learning community QuantiaMD.

OBHG even offers a private discussion site just for our hospitalists. OB Exchange is a custom online forum where our 600+ highly-skilled OB/GYNs can collaborate, share resources, and network with colleagues.

Be sure to follow us on Facebook, Twitter, LinkedIn, and YouTube.
 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Don’t fear the flu shot: Here’s why pregnant women should get vaccinated

By OBHG Marketing on October 10th, 2017

Before flu season strikes again, it is particularly important for pregnant women to get the influenza vaccine. This protects not only the mother from potentially serious illness, but the baby as well – even for a number of months after birth.

Due to changes in the immune system and the heart and the lungs during pregnancy, expectant mothers have an increased risk of suffering serious complications if they get the flu. According to Ob Hospitalist Group (OBHG) obstetrician Dr. Lydia Sims, possible complications include pneumonia, sinusitis, ear infections, dehydration, and inflammation of the heart, muscles, and nerves. Sometimes these complications require hospitalization or can lead to preterm labor/premature birth, or even death.

When can pregnant women get the flu shot?
Pregnant women can receive the inactivated flu vaccine during any trimester. They should never receive the nasal spray, which contains live, weakened flu viruses. Pregnant women move to the front of the line when it comes to prioritizing vaccine recipients: 

“The flu vaccine is so important for pregnant women that even in times when the vaccine is scarce, pregnant women are considered high priority to get the shot,” said OBHG’s Dr. Michael Green.

What else can pregnant women do to prevent against the flu?
The best defense against influenza is the flu vaccine, but there are other preventative actions pregnant women can take to protect themselves. These actions include ensuring family members receive the vaccine; avoiding close contact; disinfecting surfaces at work, home, and school; and washing hands thoroughly and often.

What are the flu symptoms?
Flu symptoms differ from cold symptoms in that they develop suddenly and can include fever, chills, headache, severe cough, fatigue, and/or body aches.  

What can a pregnant woman do if she’s contracted the flu?
If a pregnant woman has contracted the flu, she can start taking Tamiflu®, Relenza®, or Repivab® within two days of incubation to help reduce the severity of the symptoms and lessen the chance of complications. Patients should talk to their doctors about which treatment is appropriate, and take steps to prevent spreading the virus to others.

Getting a flu shot should be a no-brainer
For pregnant women, getting the flu vaccine should be a no-brainer because it serves as the best protection against the virus for both moms and her babies.

“A pregnant woman getting the flu vaccine during the flu season is playing an active role in having a healthy pregnancy,” said Dr. Sims. “Unfortunately, once the baby is born, although he or she can get the flu, the baby cannot receive the flu vaccine until he or she is six months old. If the mother receives the flu vaccine during pregnancy, it provides immunity to the baby through the placenta reducing the newborn’s chance of getting the flu and its complications. Healthy baby...happy family.”


There are many online resources that offer information about pregnancy and influenza, including:
The CDC
The March of Dimes
The American College of Obstetrics and Gynecology

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Providence Alaska Medical Center: Making birth safer and friendlier

By OBHG Marketing on October 7th, 2017

Last week, the American Association of Birth Centers (AABC) honored the Ob Hospitalist Group team at Providence Alaska Medical Center with the Collaborating Physician Award for the empathetic and quality patient care they give to patients coming to the hospital from community birthing centers.

AABC presented the award during the opening ceremonies at its Birth Institute conference on October 5 in Anchorage, Alaska, according to Kate Slider, AABC Associate Director. The Collaborating Physician Award is presented annually and nominations are received from throughout the United States, said Slider.

OB Hospitalist Team Lead Dr. Lisa Johnson and her team, along with Dr. Kathryn Ostrom of Alaska Women's Health, were “instrumental in pushing for continuity of care by CNMs and convincing the medical staff of this,” according to the nomination. The Providence Alaska Medical Center team was honored for supporting the birth center CNMs with consultation, collaboration on high-risk clients, and assist with deliveries when needed.

The nominee added that the Providence Alaska Medical Center hospitalist team had helped maintain the birth center’s low C-section rate and “continue high-quality care even when transferred from the birth center.”

“This award is a result of an effort by each team member to engage the midwives who deliver in community birth centers, provide easy accessibility to them, build a collegial, team based approach which encourages appropriate transfers of care and improves communication. It represents exactly the kind of relationship and community service building we want to see by our teams,” said Medical Director of Operations for the Pacific Northwest region Dr. Amy VanBlaricom.

“Dr. Lisa Johnson and the hospitalist program has made birth in Anchorage safer, friendlier, and more supportive of families than it has ever been,” wrote the nominee.

Pictured above: Sean Johnson, who accepted the award on behalf of his wife, Dr. Johnson, with AABC President Lesley Rathbun (left) and Barbara Norton (middle) of Geneva Woods Birth Center, who nominated Dr. Johnson and OBHG.

Photo credit: Marketing TEA


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.



©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

A wonderful fit

By OBHG Marketing on October 3rd, 2017

Some people collect stamps. Others may collect salt-and-pepper shakers or even polka records. And then there are those who collect old pagers.

“My wife has a box full of old pagers and  iPhones that she has collected over the years,” said Dr. Peter Earl, an OB/GYN hospitalist at Memorial Regional Medical Center and at St. Francis Medical Center, in Mechanicsville and Midlothian, VA, respectively. “When I retire, there’s going to be a bonfire.”

Dr. Earl is happy to leave those annoying devices behind as he enjoys life now as an Ob Hospitalist Group physician.

“I like the time off very much. And I like the providers I work with,” he said. “They treat us well, as colleagues. I very much like that. Even in a ‘demanding’ month, I might work 10 days instead of seven. But that’s still only 10 days of work out of the month! It’s something I wish I had done quite a few years before I did it.”  

Read more

OBHG highlighted in ‘Modern Healthcare’ article on outsourcing specialists

By OBHG Marketing on October 2nd, 2017

Modern Healthcare recently published an article about why hospitals are increasingly looking to outsource to reduce costs and improve operations. Many hospitals are now using outside companies for patient interaction tools, such as registration kiosks; equipment budget management; and medical specialists. Modern Healthcare interviewed Jami Walker, Ob Hospitalist Group director of hospital operations, for the story. 

"Forming partnerships with each hospital allows us to understand the needs from a patient standpoint and a community standpoint," Jami said. "The traditional model is not sustainable, especially with an aging medical staff."

Read full story here.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Two outstanding OBHG employees win internal “You Delivered!” award for Q2 2017

By OBHG Marketing on September 29th, 2017

Each quarter, Ob Hospitalist Group (OBHG) employees nominate teammates who have gone above and beyond to represent OBHG's core values. OBHG's leadership team chooses one clinician and one support staff member to receive the You Delivered! award for their outstanding performance. For quarter two of 2017, OBHG recognized Dr. Denise Sutler, OB hospitalist in our Cypress Fairbanks Hospital program in Houston, Texas, and Angie Holcombe-Tyrrell from our Development & Support team in Greenville, SC.

In Dr. Sutler's nomination, Dr. Theresa Castillo wrote: 

"Dr. Sutler had an incredible save a few months ago. She responded to a patient who was having a uterine rupture. This patient had recently arrived to Labor and Delivery. She had been counseled by her primary OB about risks of a vaginal birth after cesarean (VBAC) and wanted to try because her sister had recently had a successful VBAC. She was moved to a labor room and shortly after that the nurse reported the patient was having an increase in vaginal bleeding and pain.

Dr. Sutler arrived quickly to evaluate the patient and noticed that there was a significant amount of bleeding. When she went to check the patient she could not feel a presenting part. She quickly called for an emergency cesarean section. The patient was placed under general anesthesia and the baby was delivered within a few minutes. When Dr. Sutler got into the abdomen the baby was floating outside of the uterus and the placenta was still attached. The primary OB arrived and the team was able to save the patient and her uterus. Immediately after delivery the baby had Apgar scores of eight and nine. If Dr. Sutler had not been there, this positive outcome might have not been possible.

Dr. Sutler is a great team player. She always goes the extra mile to help out the staff, and in the short time that she has been at Cypress Fairbanks she has earned the respect and appreciation of all the staff and administration. I truly believe she deserves to be recognized for her commitment to patient care and for truly delivering excellence."

OBHG's HR team nominated Angie Holcombe-Tyrrell, and Human Resources Business Partner Jessie Simpson wrote:

"During the second quarter, Human Resources went through transition with some of our systems and team members. Angie has been leading our ADP Optimization project and essentially stepped in to fill a leadership role for our department to help us solve critical outstanding issues and implement processes to assist with day-to-day tasks. This is completely above and beyond her duties as the Manager of Application Development in IT. When ADP issues arose that created roadblocks, Angie was in our office problem solving within minutes." 

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Dr. Wilson, OB/GYN, explains the immeasurable benefits of working with OBHG

By OBHG Marketing on September 26th, 2017

Dr. Susan Wilson, board-certified OB/GYN, joined Ob Hospitalist Group (OBHG) in 2011. She is a Medical Director of Operations and acts as Team Lead at Summerville Medical Center in Summerville, SC. Dr. Wilson explains how she values her work-life balance and has found her calling within OBHG. 

"I believe that I'm a much happier person and, consequently, a much better physician," she said.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Prestigious OB/GYN leadership role now open

By OBHG Marketing on September 22nd, 2017

Ob Hospitalist Group, the nation's largest dedicated employer of OB hospitalists and the most innovative company in the industry, is seeking an extraordinary physician for one of our company's key professional/clinical leadership roles.

If you are a highly skilled, passionate, and service-minded obstetrician open to a new opportunity, we would like to talk with you.

The Site Medical Director position is based at our hospital program in the San Francisco Bay Area - a highly desirable area and one of the most diverse, influential, and dynamic cities in the world.

Read more about the position responsibilities and requirements

Read more about the program, local area, and lifestyle

This is a challenging role, and the ideal candidate will be a natural and experienced leader able to effectively guide a large medical team.

The position offers very competitive compensation, full benefits, paid medical malpractice insurance with tail, unparalleled physician support and resources, and a robust network of more than 600 OB hospitalist colleagues who speak your language - in addition to a sign-on bonus and relocation assistance.

At OBHG, we understand the importance of work/life balance for all our clinicians. While this full-time role brings with it a high level of responsibility - it also allows enough time off for a fulfilling personal and family life. Read some of our physicians' personal stories.

Intrigued? For more information please contact Senior Clinical Recruiter Jason Tafoya via email, or call him directly at 864.908.3723.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

The opioid crisis: From one OB/GYN to another

By OBHG Marketing on September 19th, 2017

Written by Dr. Becky Graham, board-certified OB/GYN and OBHG hospitalist

Unless you live under a rock, have been doing medical volunteering in a foreign country, or are just too busy to notice, we have an opioid crisis in the United States.

Throughout my career as an OB/GYN physician, my colleagues and I have used several strategies to notify one another that a patient is drug-seeking - such as adding flags to charts in the electronic medical record (EMR), drawing an eye on the patient’s paper chart by their name, etc. The bottom line is that none of these have worked. But why? As an educator who became a physician, I believe it is education from top to bottom - from physicians to nurses, and from pharmacists right down to the patients. Let me demonstrate what I mean.

As the physician, you are aware we have a national crisis on our hands. You are diligent about following the ACOG guidelines for opioid use in pregnancy as listed in the ACOG Committee Opinion Number 711 from August 2017:

  1. Early screening, intervention and referral for treatment for pregnant women with opioid abuse
  2. Screening for all substance abuse in the first prenatal visiting any of the validated screening tools given
  3. For chronic pain, practice goals include strategies to avoid or minimize opioid use, highlighting alternative pain therapies
  4. Using pain management physicians to safely help an opioid user withdraw from opioids
  5. - 9. You get the idea - there are lots of great suggestions in this committee opinion

Here’s our reality: you are in a very busy office, at a family activity, or sound asleep at night and you get the call. “Dr. X, your patient, Y, says her pain is not well controlled with either Motrin or Tylenol. Can I give her Norco or Tylenol #3?” You remember the patient well: Routine vaginal delivery, no laceration, so why does she need a narcotic/opioid?

Before you can answer the nurse, she reminds you of the low pain management scores on the Press Ganey surveys. She also reminds you that the nursing manager has asked the nurses to be more proactive with the doctors to help with pain management. Do you cave in just to please the nurse and get back to what you were doing? Do you just say NO? Or do you take the time to reinforce to the nurse why your patient doesn’t need a narcotic or opioid? Or have you received too many of those calls and you are tired of being interrupted so you just check the box of the routine orders so you don’t get the call?

You see our dilemma. So, what is the answer? Again, I believe it is education. Take an active role at your hospital to reduce opioid use. Here are some ways to do this:

  1. Set expectations for your nursing and pharmacy staff.
  2. Do a presentation about the opioid crisis during the OB/GYN section meeting.
  3. Ask the nursing coordinator/director of your OB/GYN unit to allow you time to give the same presentation to the nursing staff.
  4. Invite the community pharmacists to a sit-down meeting to do a presentation and get their feedback.

Your office or the OBED is the starting place.  Make it clear at your first prenatal visit/OBED visit that opioids are harmful to the fetus. Leave copies of ACOG publications in your waiting room as conversation starters or references for your patients:

To summarize:

  1. Set patients' expectations at the first prenatal visit or in the OBED, and communicate with your partners at checkout if you had a drug-seeking patient.
  2. Make sure your office/hospital nursing staff is on the same page with you.
  3. Give your nursing staff a list of conditions for which opioid prescriptions are appropriate.
  4. Make sure all order sets give you the ability to prescribe only NSAIDs and Tylenol when appropriate.
  5. Only prescribe opioids following ACOG recommendations.
  6. Have a unified approach that includes all OB/GYN physicians, nursing, pharmacy, and patients.
  7. I believe education is the key to reducing the opioid crisis in the U.S.
     

View or download full blog post here. 




This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Ready for Irma

By OBHG Marketing on September 15th, 2017

Just as Houston was beginning to pick up the pieces in the wake of Hurricane Harvey, another storm was right on its heels, headed straight for Florida. Again, Ob Hospitalist Group (OBHG) team members executed OBHG’s emergency protocols before Hurricane Irma hit land to ensure the safety of mothers and their babies during this time. 

“It’s truly an example of how our operations team, with the support of the broader company, really rises to the occasion to fulfill our mission of being there in the worst times, not just in medical emergencies but also during natural disasters,” said OBHG CEO Lenny Castiglione. 

OBHG’s clinical and operations teams continued to provide seamless coverage in their OB emergency departments and worked extra hours and even days to provide a safety net for clinicians who may not have been able to make it to the hospital due to the storm.

“Dr. Mark Kufel and Dr. Brayan Stuart went above and beyond. They were committed and worked tirelessly and compassionately to ensure the patients got seen and cared for,” said Nancy Heurtas Savina of Baptist Hospital of Miami. “They worked seamlessly with each other, had a very positive attitude, and the teamwork between the OBs in house and OBHG team was like none I have ever seen. We are all very relieved and happy they were here.”

Our team of OBHG clinicians at St. Joseph’s Women’s Hospital also provided coverage for community OB/GYNs who could not travel to the hospital to care for their patients.

“We appreciate OBHG’s foresight in providing the extra resources to ensure our patients were cared for safely,” said Pamela Malone-Quarles, Director of Patient Care Services in Delivery and Surgical Services at St. Joseph’s Women’s Hospital in Tampa. “In addition, we appreciate your in-house availability for any providers who could not make it to the facility due to the inclement weather conditions. OB Hospitalist Group continues to be an excellent partner, ensuring safety as our top priority. We are so thankful to have a partner whose priorities aligned with our organization. It is a pleasure to work with you and your physicians.”

OBHG is proud to be the employer for so many compassionate and caring individuals who are willing to go above and beyond for our hospital partners and patients every day, no matter the circumstances.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Building a robust clinical network

By OBHG Marketing on September 15th, 2017

OBHG’s online community creates connection and collaboration for clinicians nationwide

Ob Hospitalist Group (OBHG) offers a host of benefits for clinicians who are seeking a fulfilling practice combined with rewarding work-life balance. OBHG also offers our clinicians the chance to connect with fellow hospitalists nationwide via a robust online community: Ob Exchange.

A custom solution and one-stop resource
Created exclusively for our OBHG teams with input from our clinicians, Ob Exchange is a user-friendly online community that connects more than 600 clinicians in more than 120 programs across the United States.

This powerful resource offers:

  • Centralized access for clinical online tools used daily
  • Educational resources, including OBHG University and GNOSIS continuing education
  • Clinical peer-to-peer discussions
  • A nationwide clinical collaboration network
  • Instant, anytime access to essential documents
  • Dedicated communication space for each hospitalist team
  • News
  • Clinical content and best practices
  • Feature stories about fellow hospitalists

The customized online community is a one-stop portal for tools used daily by OBHG clinicians, including coding, charge capture tools, scheduling, continuing education resources, and team communications. 

The power of clinical collaboration
Ob Exchange is a supportive environment where OBHG hospitalists can trade clinical knowledge with fellow physicians across the nation. This connection allows our teams to rely on the strength of their peers in a collective network of more than 600 skilled hospitalists working together to elevate the standard of women’s healthcare. When faced with a challenging clinical situation or question, OBHG hospitalists can crowd-source advice and input from a knowledgeable team of accomplished clinicians.

Online discussion spaces are safe and interactive peer-to-peer forums for hospitalists to exchange clinical information, share best practices, and gather feedback. Whether it is the latest Zika protocols, tips for collaborating effectively with community physicians, or emergency preparedness best practices, all Ob Exchange members are encouraged to start discussions and post comments.

A wealth of knowledge
Ob Exchange provides anytime access to OBHG’s custom-designed educational hub: OBHG University. OBHG University includes clinical webinars, best practice guidelines, clinical articles, and policies and procedures that help clinicians maximize patient safety and quality of care. This resource is continually updated with the latest innovations and best practices to aid hospitalists in providing excellent patient care.

Team communication
In addition to a community-wide connection, each OBHG program location has a dedicated space where the hospitalist team can share documents, participate in discussions, schedule events, and more. Team spaces offer an intimate forum for our dedicated hospitalist teams to collaborate, coordinate events, and trade knowledge that affects their specific hospital program. These spaces within the community allow team members to access their team-specific information anytime, anyplace.

A deeper connection 
Ob Exchange’s personal profiles offer an opportunity for OBHG clinicians to connect with fellow medical school and residency alumni, members of professional organizations, and share their off-shift activities and hobbies. The community’s direct messaging capability also allows hospitalists to connect with colleagues who share common interests.

Hospitalist profile articles published on Ob Exchange offer an in-depth look into the lives of OBHG team members in and out of the clinical setting. News articles keep providers informed about the evolving field of hospitalist medicine and the expanding network of OBHG programs nationwide. In addition, team members pen clinical articles focusing on topics that are critical to OB/GYN hospitalist medicine, from emerging trends to tried-and-true skills.

Support and knowledge
Ob Exchange is simply one of the many resources Ob Hospitalist Group provides to its hospitalists to help them deliver exceptional care to women, efficiently serve partner hospitals, and elevate the standard of women’s healthcare.

OBHG hospitalists are highly skilled, passionate clinicians who love practicing medicine without the hassles of running a private practice. As the nation’s largest dedicated employer of OB/GYN hospitalists, we are always interested in talking with talented physicians and certified nurse midwives about joining our team. If you would like to learn more about the advantages of becoming an OBHG hospitalist, we encourage you to view our current job opportunities, and contact our friendly recruiters via email at Recruiting@OBHG.com or by phone at 800.967.2289.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG hospitalist team reaches 600 clinicians

By OBHG Marketing on September 11th, 2017

A Monumental Milestone: OBHG’s Hospitalist Team Reaches 600 Clinicians Nationwide

Ob Hospitalist Group, the premier provider of OB Hospitalist programs in the nation, is commemorating a historic milestone: 600 clinicians serving moms and babies across the United States.

As of September 2017, OBHG’s team of hospitalists includes 600 skilled clinicians who improve patient care and elevate the standard of women’s healthcare for hospital partners nationwide.

OBHG has reached this remarkable level of growth through a focus on delivering excellent value for its partner hospitals, ensuring a positive experience for its valued clinicians, and supporting its stellar team.

Since launching in 2006 at one hospital with a handful of physicians, OBHG has expanded its network to include more than 120 hospitalist programs in 28 states. 

Congratulations to all OBHG hospitalist teams and the staff who support them!

Learn more about becoming a hospitalist

Learn more about OBHG's hospital programs


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


 ©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Labor and delivery in the eye of the storm

By OBHG Marketing on September 8th, 2017

Ob Hospitalist Group's Dr. Charles Jaynes is based out of Austin, TX and was luckily far enough from Hurricane Harvey's path that he did not experience the wreckage firsthand. But as Senior Medical Director of Operations, Dr. Jaynes had an important job to do: help coordinate OBHG's hospitalist teams across five hospitals in Houston to ensure that they were prepared for the disaster and could continue to help patients. 

"As doctors, we’re used to putting our patients first. Last week’s storm reminded me how so many others at the hospitals do the same, from the cleaning crew to the nurses to the physicians. I’m grateful that so many of us served as “First Responders” during Hurricane Harvey, and by following aligned preparation and contingency plans, I’m confident we’ll perform similarly during the next storm -- and the ones that follow."

Dr. Jaynes wrote an op-ed piece published in Becker's Hospital Review in which he shares key learnings for labor and delivery departments admist disasters and emergencies.

Read full op-ed on Becker's Hospital Review here.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG welcomes new Chief Human Resources Officer

By OBHG Marketing on September 8th, 2017

(GREENVILLE, SC) — Ob Hospitalist Group, the largest OB/GYN hospitalist employer in the nation, is pleased to welcome Traci Bowen as new Chief Human Resources Officer. Bowen will be an integral member of the leadership team, guiding the company’s continued growth and building on its reputation as a healthcare industry leader.  

“I was drawn to Ob Hospitalist Group’s innovative model and dedication to improving women’s healthcare,“ says Bowen. “The positive culture, strong mission and commitment to both hospitalist and support employees makes the company a very desirable place to work. I’m thrilled to be a part of this team.”

Bowen comes to OBHG with more than 20 years of human resources experience and a successful track record of developing strategy, leading change initiatives, building cohesive teams and managing complex programs. She was most recently employed as Senior Vice President of Human Resources for Adeptus Health, the nation's largest operator of free standing ambulatory emergency room services.

She holds a Bachelor of Science in business administration with an emphasis in finance and economics from Texas A&M University, and a Senior Certified Professional credential from the Society for Human Resource Management. 

“People are the primary focus in our business,” says OBHG Chief Executive Officer Lenny Castiglione. “Ms. Bowen brings exceptional skills and expertise to this important role, along with years of experience working with national physician and clinical teams. We are excited to bring her on board.”


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG included on Inc. 5000 five-year Honor Roll for fastest-growing private companies

By OBHG Marketing on September 6th, 2017

(GREENVILLE, SC) – Ob Hospitalist Group (OBHG) is proud to be on Inc. 5000’s Honor Roll for being named one of the fastest-growing private companies in America for five consecutive years. OBHG is ranked 2,761 in 2017 in part due to a 124% growth in revenue over the last three years. Of the tens of thousands of companies that have applied to the Inc. 5000 over the years, only a fraction has made the list more than once. A mere seven percent have made the list five times.

Founded in 2006, OBHG’s national network has grown to include more than 560 dedicated OB hospitalists in 124 active and onboarding partner hospitals across 28 states. This growth means more expectant mothers have access to immediate care when presenting to the hospital with obstetrical complaints regardless of time, location, complication, or circumstance.

“OBHG’s growth is a clear indication that we are filling a need in obstetrics and that our services are valued by patients, hospitals, and community physicians alike,” said OBHG CEO Lenny Castiglione. “We continue to increase the safety and quality of obstetrical units all over the country with our comprehensive approach that involves much more than simply providing a team of physicians. Our clinicians are not only experienced, they are passionate in how they engage with the L&D nursing teams and community physicians to reduce the number of serious safety events.”

In addition to being named to this year's Inc. 5000, OBHG has received other national and statewide honors. These awards include being named to South Carolina’s 25 Fastest-Growing Companies for five consecutive years and included in the Best Places to Work in South Carolina.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.



©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG’s Dr. Mulder delivers babies during Harvey and reunites with granddaughter

By OBHG Marketing on September 5th, 2017

OBHG hospitalist Dr. Michelle Mulder delivered healthy babies at Christus Spohn Hospital South right as Hurricane Harvey hit Corpus Christi on Friday, August 25. She said the delivery via C-section took merely 20 minutes, right before the power went out. After she knew the mother and babies were safe, she turned her attention to her own granddaughter who was right down the hall in the NICU, born about four weeks earlier, at two and a half months premature. 

Watch video and read full story from KIII-TV here.

 

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Texas and Louisiana hospitalist programs weathered Hurricane Harvey

By OBHG Marketing on August 31st, 2017

A shift on labor and delivery units for Ob Hospitalist Group clinicians can be punctuated by quiet moments—and then sometimes there’s a hurricane.

The entire country watched as Hurricane Harvey barreled toward the Texas coast, bringing with it high winds of 130 miles an hour and horrendous flooding. On Aug. 25, the Category 4 hurricane crashed into the coast just northeast of Corpus Christi and dumped an estimated more than 50 inches of rain in some areas, according to the National Weather Service. "This is a landmark event for Texas," Federal Emergency Management Agency Administrator Brock Long said. "Texas has never seen an event like this."

Teams at the ready
In preparation, our OBHG programs in Texas activated their emergency plans, which ask two physicians to volunteer to staff each program. This plan ensures that one physician is not stranded at the hospital providing coverage during an emergency. Contingency plans were in place for hospitalist coverage over the coming days, said Senior Medical Director of Operations Dr. Charlie Jaynes.

Several days after Harvey’s landfall, Jaynes reported that all Houston-area programs were functioning with emergency coverage. In addition, programs in Corpus Christi, San Antonio, and Austin were all functioning normally, said Jaynes, who is based near Austin. 

Five hospitals with OBHG programs in Houston were affected by staffing challenges caused by the storm and flooding: Christus Spohn Hospital Corpus Christi – South, Cypress Fairbanks Hospital, Houston Methodist Willowbrook Hospital, Kingwood Medical Center, Memorial Hermann Katy Hospital, and Memorial Hermann The Woodlands Hospital. 

Baton Rouge General Medical Center in Louisiana, North Mississippi Medical Center in Tupelo, and Mississippi Baptist Medical Center in Jackson all had plans in place and readied themselves to face flooding as the then-tropical storm moved east.

Collaboration under duress
All programs in Hurricane Harvey’s path were staffed 24/7 by OB hospitalists providing coverage for labor and delivery. Jaynes praised each team’s collaboration with hospital staff and community physicians. Each hospital team worked together—from cleaning teams to nurses—and put themselves in harm’s way, away from otheir families, to do whatever it took to care for their patients, said Jaynes.

"I had doctors who were in the hospital for six days straight, and their families were at home without them," he said.

Twins were born at Christus Spohn Hospital South in Corpus Christi just as Hurricane Harvey made landfall on Aug. 25. A third baby was born at home with emergency personnel assisting, and the mother and baby were later transported to Christus Spohn Hospital South.

At Houston Methodist Willowbrook Hospital in northern Houston, two OBHG hospitalists took turns seeing patients during a very busy few days and said they received much help from community physicians. The hospital also accepted multiple patient transfers from other facilities in flooded areas. News outlets reported that Houston-area Ben Taub General Hospital and Bayshore Medical Center were moving patients and Bayshore had suspended all services.  

Memorial Hermann The Woodlands’ team north of Houston was operating with two hospitalists, one of whom could not return home due to flood waters. Local physicians were also helping this team on a busy Labor and Delivery unit. Two of The Woodlands team members rotated shifts for 4 days because roads were impassable due to flooding.

At Memorial Hermann Katy, one hospitalist team member had been working a bustling 24 hour shift with little sleep, however, also had assistance of community physicians. Memorial Hermann Katy, west of Houston, received transfers from nearby hospitals that evacuated patients. Meanwhile, northwest of Houston at Cypress Fairbanks Hospital, two hospitalists rotated shifts for 4 days and experienced a heavy patient volume. 

Deserved thanks
Despite separation from their families and lack of creature comforts like clean clothes and hot showers, all of our OBHG hospitalists worked with community providers to persevere and care for their patients. OBHG extends its heartfelt thanks to those teams that provided genuine service to patients and their babies through this trying and unpredictable situation.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG hospitalist delivers twins amidst Hurricane Harvey

By OBHG Marketing on August 30th, 2017

OBHG hospitalist Dr. Michelle Mulder delivered twins by C-section at Christus Spohn Hospital South as Hurricane Harvey hit Corpus Christi. Our hospitals and obstetrical emergency departments in the Corpus Christi and Houston area are open and treating patients during this disaster. Our teams of clinicians are ensuring that they can provide seamless coverage to all patients in need and have even doubled up on shifts. OBHG employees across the country continue to keep the victims of Harvey in their thoughts. 

"As the storm was headed toward Corpus Christie, OBHG clinicians Dr. Mulder and Dr. Davis made the call to put two clinicians on site until it passed," said OBHG Senior Medical Director of Operations Dr. Charles Jaynes. "We put two clinicians on shift at a time at three hospitals in the Houston area as well, some of whom spent up to six straight days at the hospital. These OBHG clinicians sacrificed riding out the hurricane with their families for ensuring that they could provide care to pregnant women and their babies who came into the hospital."

Read USA Today article here.

 

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG’s Dr. Rakhi Dimino stresses the importance of good physician bedside manner

By OBHG Marketing on August 29th, 2017

As an OB/GYN and family member, Dr. Rakhi Dimino has seen physician bedside manner from both sides. This OBHG Medical Director of Operations has experienced some of the best and worst behavior from physicians who were treating her mother in the hospital, and she shares why she believes good bedside manner is a must. 

"As physicians, we are called to do more than fix bodies," said Dr. Dimino. "We are charged with taking care of people, not just bodies. Our patients and their families need us most when there is nothing left to fix but a breaking heart and all-consuming sadness."

Read full blog plost published on KevinMD.com.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG physician interviewed by U.S. News & World Report

By OBHG Marketing on August 26th, 2017

Ob Hopitalist Group Medical Director of Operations Dr. Rakhi Dimino was interviewed for a recent U.S. News and World Report article featuring how hospitals are now handling emergencies involving pregnancy and birth.

Dr. Dimino told the news outlet that an obstetrical emergency department (OBED) provides a greater level of safety, especially for women who are at risk for pregnancy complications.

"All the patients have an opportunity to be screened by a physician-nurse team," she said. "It's the difference between predicting an emergency and simply reacting to an emergency."

Most OBEDs in the country are staffed with one OB-GYN and two labor-and-delivery nurses around the clock, Dr. Dimino said. Busier locations have two or more doctors working at a time, or a nurse-midwife or an advanced practice nurse for added support. She emphasized that the patient's regular obstetrican is always an important team collaborator.

Read more

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

New OBHG program featured in the news

By OBHG Marketing on August 25th, 2017

Brookwood Baptist Medical Center's new obstetrical emergency department (OBED) was recently featured in the local Birmingham, Alabama business journal. The OBED, developed and managed by Ob Hospitalist Group, will provide a safety net for patients and community OB/GYNs.

Amy Beard, the hospital's vice president of women's services, noted that circumstances around pregnancy and birth can be unpredictable.

"We are pleased to offer our patients peace of mind knowing they’ll receive immediate, specialized care no matter when they arrive at Brookwood Baptist Medical Center," she said.

Patient Courtney Farley told Brookwood staff she was impressed with the efficiency and professionalism displayed by the clinicians in the OBED.

“I was thankful that there was a special place for expecting women that was separate from the main ER," she said. "I felt cared for and safe. I believe that this is a service that takes Brookwood’s commitment to expecting mothers to the next level. I am grateful above all that my little one is safe, and I received my peace of mind because of this experience.

Read more

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.
 
 ©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Maternal mortality: causes and concerns from an OB hospitalist

By Dr. Rakhi Dimino on August 23rd, 2017

As a mom and an OBGYN, it hit me hard to learn that maternal mortality was higher in the United States than other developed nations. In the labor and delivery unit, I can vividly remember women who flirted with death and survived. One bled so profusely after birth that we heard the blood hit the ground. One mother sat straight up and said she was dying before she collapsed with an embolism. But we have read about other pregnant women who have died at home from a brain hemorrhage or from postpartum suicide. The birth of a baby should be one of the most normal events that a woman’s body endures, and even with access to modern medicine, we have not been able to decrease the maternal mortality rate in the U.S. for the last 25 years. Instead, it has actually increased. My home state of Texas leads the nation in the number of women who die during or shortly after delivery. Unfortunately, this is not a simple problem to solve, and there are many contributing factors.

The rise of chronic diseases
Although our knowledge of the birthing process has grown in the last quarter century, the profiles of women having babies has changed. Obesity, chronic hypertension, heart disease, and diabetes are all more common now than 20 years ago. The number of women delaying childbirth until their mid to late 30s or even their 40s has increased as well. As we increase in age, the prevalence of these same chronic medical problems increases even further. With improvements in fertility treatments, women who have previous medical conditions, such as cancer, are now able to pursue pregnancy. These baseline medical problems all increase the risk of maternal mortality.

Lack of access
But it’s not just that our bodies might be different from women having babies a few decades ago. Prenatal, delivery, and postpartum access to healthcare is lacking in large swaths across the country. As more and more rural hospitals close their labor and delivery units due to cost constraints, and the shortage of OBGYNs continues to grow, many women either go without care or must travel hours to get to a hospital with appropriate access to care. In most obstetrical emergencies, such as hemorrhage, stroke, embolism, and heart disease, minutes matter. There is no time for hours. Adding to distance challenges are astounding racial disparities. Black women are nearly three and a half times more likely to die from pregnancy related conditions than white women. Foreign-born women also have a higher maternal mortality rate. This begs us to look at access to pregnancy care as a key factor.

Issues in medical reimbursement
The way physicians often receive reimbursement might contribute to the problem as well. When physicians are reimbursed by the number of patients seen, time is money. In some clinics, one physician will see more than 40 pregnant patients in one office day. There is simply no time to listen to all of a patient’s concerns or adequately counsel them about which symptoms they should seek medical attention for. There is no reimbursement for any extra visits including screening of postpartum pre-eclampsia and depression about one week after delivery. This poor combination of potentially inadequate counseling and poor follow-up screens can contribute to missed early warning signs.

High C-section rate
As many have pointed out before, our high C-section rate likely contributes to maternal mortality as well. No one will argue that some C-sections are necessary. But many physicians do not offer a trial of labor after a previous C-section because most hospitals require a physician to be immediately available during the entire labor for safety reasons. It does not make economic sense for a physician to cancel an entire office day to be immediately present for one laboring patient. And yet each subsequent C-section leads to an increase of a life-threatening complications. At times, physicians are choosing what makes economic sense over what is best for the individual patient.

So what’s going to solve this issue? It won’t be physicians alone. It will take a collaboration of OB physicians, family physicians, OB anesthesiologists, nurse midwives, doulas, mother-baby nurses, hospital administrators, public health officials, lawmakers, and patients with their families. We must work as a village to build a safety net of support around our pregnant mothers, not just during pregnancy but after birth as well. Our team must realize that more intervention during childbirth is not always better, but a good support system is critical to decrease maternal mortality. As a team, we must be prepared to not only react to an emergent condition quickly, but also to predict and prevent one before it happens.

To build our maternal safety net, we must start thinking outside the box. Can we leverage technology and apps to monitor women at home who live remotely from a maternity hospital? Can we have doulas provide emotional support during labor and in the weeks to come, calling for help when concerning physical and mental symptoms arise? Can we decrease physician visits in low-risk women, and allow high risk patients to spend more time with physicians? Can midwives manage most low-risk prenatal and delivery care that could decrease our C-section rate while saving high-risk management for physicians? Could an inpatient OB hospitalist team be the glue that sticks this team together? None of these are new or impossible ideas, but they take good collaboration to maximize their usefulness.

The ability to study the causes of maternal mortality in detail is very important to solving this crisis. We cannot stop there. We must start building our collaborative support system. We must all be willing to work together and be a part of the solution to prevent the loss our mothers.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG partner to expand care for region’s women and children

By OBHG Marketing on August 18th, 2017

Mercy Gilbert Medical Center in Gilbert, Arizona, part of the Dignity Health system, is planning a new five story tower that will house an obstretrical emergency department (OBED) managed by Ob Hospitalist Group, along with high risk labor and delivery and postpartum rooms, and a pediatrics wing.

The building, which will expand and advance care for the region's women and children, was made possible by an alliance between Dignity Health and Phoenix Children's Hospital.

Construction is set to begin in 2018 and the new tower is expected to open by 2020.

Read more

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Local physicians appreciate presence of OBHG hospitalists

By OBHG Marketing on August 15th, 2017

When St. David's South Austin Medical Center first partnered with Ob Hospitalist Group (OBHG), local OB/GYNs were skeptical. Soon, they disovered the benefits of the partnership and the impact it has not only on their lives but the lives of their patients and their families.

“The hospitalists are easy to work with. They have made our call and coverage easier. They are very competent in their evaluation and treatment of our patients,” said Dr. Ana Eduardo of Hill Country OB/GYN in Austin, TX. 

 

View full case study.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2016. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

The OB/GYN shortage: from an OBHG hospitalist’s perspective

By OBHG Marketing on August 11th, 2017

As a former private-practice OB/GYN, Dr. Michael Green witnessed many of his colleagues trying to maintain their rigorous schedules as they neared retirement age. Seventeen years into his career, he was approached after a 2 a.m. delivery by a nurse who suggested that he look into hospitalist medicine. Although he first thought the idea of an OB hospitalist lifestyle seemed too good to be true, Dr. Green started researching his options. He soon decided to leave private practice behind for a career with Ob Hospitalist Group (OBHG) and he hasn’t looked back yet.

Dr. Green jumped ship and began working for OBHG in September 2016. He was recently promoted to Team Lead at Northridge Hospital Medical Center in Northridge, CA, and works with a team of eight clinicians.

He isn’t all that surprised that there is a national shortage of OB/GYNs. Much like the report Doximity released in late July, Dr. Green attributes the lack of physicians to several issues: the absence of younger OB/GYNs in practice; high maternity workloads; and earlier retirement age. In the sections below, we provide insight from Dr. Green on each of these issues affecting the OB/GYN industry today.

Difficulty recruiting OB/GYNs
According to Dr. Green, medical students and OB/GYNs just coming out of residency these days prioritize work-life balance. They don’t want an 80-to-100-hour work week, but instead wish to spend more time enjoying life outside of work hours. 

In the past, OB/GYNs had a well-deserved reputation for living a very difficult lifestyle and working crazy hours.

“This time last year, 80 hours was a light work week for me, 100 was the norm, and occasionally I would work 120 hours in a week,” said Dr. Green. “People don’t want to do that. There needs to be time for things outside of medicine.”

Supply and demand gap and heavier workloads
The healthcare industry has seen a tremendous amount of change since the advent of Obamacare. Now that millions of once uninsured patients have coverage, the system is stretched, said Dr. Green. The patient volume increased but the number of clinicians did not. Reimbursement payments from insurance companies have also decreased over the years.

“When I started in private practice in 1999, OB/GYNs could do 10 to 15 deliveries per month and make a really nice living,” said Dr. Green. “When I left practice last year, we were doing 30 to 40 deliveries, and we still weren’t making as much money. Every year, I was working harder and harder but making less money.”

Another factor affecting the supply of OB/GYNs is the cost of malpractice coverage. In the past, many family doctors performed deliveries. Now, this is not the case due to increased malpractice coverage fees. 

Dr. Green also attributes the dawn of electronic medical records (EMR) to the increased physician workload, especially for older clinicians.

“If I could go back and do one thing over again, I would take a typing class,” he said.

According to Dr. Green, many older physicians are not technically savvy, and it often takes them longer to work on the EMR than with the previous pen and paper method of keeping records.

“Physicians are struggling to get the EMR done each day, and they either can’t take as many patients or they stay after hours or come in on a Saturday to get their charts done.”

Early retirement
Along with the increasing number of medical students choosing shift work such as emergency medicine over obstetrics, a generation of experienced OB/GYNs have recently retired or are planning to soon.

“Anybody who could retire, has retired in the last five years or so,” Dr. Green noted. “The work has gotten too hard and the changes too extreme.”

There are some financial barriers that can keep obstetricians from simply reducing their work hours as they get older.

“If you’re in private practice and you’re paying your own malpractice, they don’t charge you any less if you work part time,” said Dr. Green. “For instance, if you are close to retirement age and want to slow down to working just a couple of shifts per week, you can’t, because the overhead is too high.”

Although many OB/GYNs would like to slow down, they are bound by their overhead.

“There are a lot of people who are 65 or older who would like to get out of the rat race of private practice, but they’re basically handcuffed by their malpractice company.”

How OBHG can help
Dr. Green says the opportunities hospitalist medicine provides open up a whole new world for obstetricians. In addition to fully paid medical malpractice coverage, OBHG offers flexibility, a predictable schedule and ample time off. This allows physicians to continue practicing later in life and extend their careers, while avoiding burnout.

“I’ve got another 7 to 10 years of working hard, and then I’m going to want to slow down, and OBHG allows you to do that. You can work just a few shifts per month if you want.”

The hospitalist lifestyle frees physicians from the frustrations of excessive paperwork and the many administrative demands that come with running a business. They can focus their energies on the passion that led them to pursue medicine in the first place – caring for patients.

“I’m really happy with OBHG,” says Dr. Green. “This has been an amazing transition for me. It’s probably one of the best decisions I’ve made in my life.”

 

Download full article here.



This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

August brings breastfeeding education, support

By OBHG Marketing on August 8th, 2017

While breastfeeding fell out of favor in the U.S. for a time during the 1960s and 70s due to women working outside the home and an overall lack of information and support, the practice has seen a reawakening as moms and clinicians learn more about the health reasons to nourish babies with mothers' milk whenever possible.

Because human breast milk contains protective hormones and antibodies, the risk of asthma, leukemia, obesity, ear infections, type 2 diabetes, and sudden infant death syndrome (SIDS) is lower for breastfed babies.

Colostrum - a nursing mother’s protein-rich first milk often referred to as “liquid gold” – plays an important role in developing a healthy digestive system. And her mature milk (produced three to five days after giving birth) contains the perfect blend and amounts of nutrients her baby needs to grow and thrive.

Breastfeeding also offers health benefits for moms – women who nurse their babies are less likely to be diagnosed with diabetes, ovarian cancer, and breast cancer. Some studies indicate it can help kick-start postpartum weight loss as well.

There are even environmental reasons to support breastfeeding. As more women opt for the most natural method, fewer formula cans and plastic bottles find their way to the ocean or end up in landfills.

In the past few decades, hospitals and birthing centers have strived to provide more comprehensive education and support for breastfeeding and facilitate optimal mother/baby/family bonding.

To help guide these efforts, in 1991 the World Health Organization and UNICEF founded the Baby-Friendly Hospital Initiative, a global program that encourages breastfeeding as the best way to improve infant health. The initiative awards certified “Baby-Friendly” status to facilities that achieve several specific evidence-based milestones, such as in-depth training for all health care staff and a policy that allows new mothers and their babies to remain together 24 hours a day.

This month is the perfect time of year for hospital leaders, clinicians and families to learn more about the myriad benefits of breastfeeding. Declared National Breastfeeding Month by the United States Breastfeeding Committee in 2011, the first week of August is also recognized as World Breastfeeding Week by the World Alliance for Breastfeeding Action.

The Centers for Disease Control has developed helpful resources outlining best practices, national policies, recommendations, and answers to frequently asked questions, along with a portal for the latest scientific research related to breastfeeding.

In addition, many health and women’s organizations, experts and supporters are using social media sites to share additional tips, stories, and articles this month. Use the hashtag #NBM17 to peruse the content or join the conversation.

Screenshot from @CDCObesity Twitter, August 2

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG clinicians complement, not compete with local OB/GYN practices

By OBHG Marketing on August 3rd, 2017

Ob Hospitalist Group clinicians do not compete with local providers, they collaborate with them, acting as an extension to provide a higher standard of care for women and their babies. Watch the video to hear more from OBHG Medical Director of Operations Nicholas Kulbida, MD.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Understanding the risk and liability that OB/GYNs face today

By OBHG Marketing on August 1st, 2017

Did you know that obstetricians and gynecologists (OB/GYNs) experience a higher probability of a lawsuit when compared to other specialties? From allegations of delay in care, failure to diagnose, and surgical injuries, there are many circumstances in which a physician might be named as an individual party to a lawsuit. In fact, by age 65, 75 percent of physicians in low-risk specialties and 99 percent in high-risk specialties will have experienced a lawsuit. According to several recent studies, OB/GYNS are among the most likely to be sued among all physicians. To better understand the liability that private-practice OB/GYNs face and how they can ensure their practice is safe, we asked Ob Hospitalist Group’s Heather Moore, Director of Risk Management, Quality and Compliance, to answer a few questions. 

Q: What are the circumstances in which a private-practice OB/GYN might be sued?

A: OB/GYNs practice in a fast paced, rapidly evolving, often complex labor and delivery setting. Like every other high-risk, high-reward profession, there’s always a possibility of failing to respond appropriately and effectively to that which is unanticipated and unexpected. That possibility exists for all physicians regardless of level of training and experience, but OB emergencies provide an emotionally charged environment in which delays can result in devastating outcomes for moms and babies.

In addition, there’s no such thing as a one-size-fits-all response to an emergency situation. Given all those factors, it’s critical that what we call “OB emergency departments” or OBEDs, are staffed with clinicians who can respond immediately to emergent situations in a team-based and patient-centric environment. While OBHG often assists community providers on routine procedures and deliveries, the availability for us to respond quickly and effectively to high-risk emergent cases of both private patients and unassigned patients is where we see the most outcome improvement for patients who present to the OBED.

Q: Doesn’t an OB hospitalist program protect a hospital from liability, more than a community OB and his/her practice?

A: It protects both, actually. In about 68 percent of lawsuits against OB/GYNs, more than one party is named in the lawsuit. While the event may happen in the labor and delivery unit or an emergency room, the private physician is almost always a party to the suit.

Statistics show that being on-site for immediate provision of care is critical. National obstetrical frequency of claims is estimated at about ten percent, and a 2015 Doctors Company study found 31 percent of these claims are associated with delays in care -- 22 percent related to delays in fetal distress and another nine percent with delays in delivery. While delays in care are often due to lack of staff availability and broken processes and can be complex in terms of their root cause, the perceived liability is almost always still focused on the primary provider. Nationally, our OB hospitalist programs are associated with significant (60 percent and more) decreases in adverse events resulting in medical malpractice claims.

More recently, a 2016 study identified a 15% reduction in perinatal serious safety events at hospitals where an OBHG program was implemented, and concluded that our OB hospitalist program was a key risk-mitigation initiative. So there’s clear benefit to hospitals as well.

Q: How can a clinician avoid a lawsuit before it is filed?

A: The practice of medicine is, by its very nature, subject to human fallibility and healthcare process errors, but the best way to avoid litigation is mounting a solid offense. Clinicians should make every effort to stay abreast of current education and best practices and have privileges at facilities that prioritize the same. There are also tangible things they can do, like document thoroughly and consult with a broad healthcare team for second opinions, which can buoy the chance that no litigation will occur.

It’s also very important that they do not embrace defensive medicine practice for fear of litigation. More than half of U.S. states now have “I’m sorry” laws that protect physicians who apologize after an adverse event from having those medical apologies being used as evidence in medical malpractice litigation. Medical apologies, along with early resolution programs, have been very successful in reducing claim activity. And if litigation does occur, physicians still tend to perform very well in lawsuits with over 70 percent of cases going to trial ending in defendant verdicts. Successful tort reform, along with “apology” protections, support providers in providing the best care possible without operating in a fear-based environment over the potential of litigation. We are firm believers that if you provide the best care possible to maximize the best outcome for our patients and work hard to ensure you maintain empathy and compassion for your patients, you will naturally mitigate a lot of potential risk.

Q: How can physician practices protect their teams?

A: Physicians should welcome quality assurance activities that identify quality improvement opportunities and be part of collaborative committees that look at clinical or process errors in a non-punitive manner. We need to continue to destigmatize discussing medical error so we can continually identify areas where physicians and healthcare organizations need to improve to provide better patient care. Taking a proactive and forward-thinking approach is the best way to mitigate future potential risk.

Physicians must work to institute a culture within their practices and hospitals that center on quality care and outcomes and fosters a team-based environment that focuses on patients first. When that culture is evident from the top down, other teams will adapt their practices to align with this cultural shift. OBHG’s risk management slogan is “healthy moms, healthy babies.” When the healthcare team works collaboratively to focus on the patient first above all else, the best risk and liability protection is already taking place.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Ob Hospitalist Group CEO and MDO share industry observations and tips to avoid physician burnout

By OBHG Marketing on July 27th, 2017

In a recent article published by Becker's Hospital Review, Ob Hospitalist Group Chief Executive Officer Leonard Castiglione and Medical Director of Operations Nicholas Kulbida, MD provide their observations on where the OB hospitalist industry stands today and how they believe it will evolve. In addition, they share tips for hospital leaders on how to help their physicians avoid burnout.

Click here to go to full article.

Think Like a Millennial - Reboot Your Career

By OBHG Marketing on July 26th, 2017

It was different when you were in medical school. You became a doctor to serve patients, and an obstetrician to give babies the healthiest possible start in life. Your chosen profession required numerous personal sacrifices, but you did whatever it took, and you made it. Now you’re a skilled, successful and well-respected healer - a pillar of the community. And you’re exhausted.

Plus, your bucket list is getting dusty.

Are today’s medical students looking for an easier path? They do tend to embrace a different set of values - unapologetically eschewing 24/7 availability and intense pressure in favor of work/life balance and, well, sleep. Maybe they’re onto something.

We know the healthcare landscape is rapidly evolving. While the changes can feel overwhelming or unsettling, a new culture brings with it new ways to work – and not just for the next generation.
You’ve read that hospitalist medicine is on the rise – according to a recent Medscape article more than 50,000 hospitalists are now employed at 75% of hospitals and most academic health centers. While pediatric and internal medicine hospitalists have been around for more than 20 years, OB hospitalist medicine is a younger specialty.

Visionary obstetrician Dr. Chris Swain developed the first Ob Hospitalist Group (OBHG) program and first Obstetric Emergency Department (OBED) in 2006.Today, we operate more than 110 programs in 28 states, and we’re growing fast.

But how does it work for physicians?

OBHG is not a locum tenens company or staffing agency that fills temporary gaps in coverage. We are an employer that offers experienced, board-certified OB/GYNs a solid career path that includes enough built-in time off for a fulfilling personal life.

All obstetricians who work for OBHG earn competitive compensation and paid medical malpractice insurance. Those who work seven or more 24-hour shifts per month in our hospital programs are considered full-time employees and also enjoy generous benefits.

What else is there? A lot. Once on board, our clinicians are connected to a robust, national network of more than 560 OB/GYN hospitalist colleagues who provide support, clinical collaboration and camaraderie. OBHG also provides continuing medical education resources along with the most current information about quality and safety initiatives and best practices.

Giving up private practice means giving up piles of paperwork, but it doesn’t mean giving up autonomy or influence. Our clinicians serve on hospital committees, help educate medical students and residents, and serve as staff team leaders within the hospital. Others may opt to pursue volunteer leadership opportunities their crazy schedules never allowed before, like joining their alumni board, supporting a community clinic or organizing a medical mission trip to Haiti.

They form collegial relationships with local community physicians that allow for idea sharing, seamless care coordination, safe transitions and increased satisfaction for patients, hospital leaders and clinicians.
OBHG is the largest employer of OB hospitalists today because it’s all we do. We speak your language, and we share your values.

When you’re ready to explore your career options with OBHG, our recruiters can guide you into practicing the medicine you desire and living the life you deserve.

 

Download full blog post here.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.


©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Three ways Ob Hospitalist Group programs are designed to save the lives of mothers and their babies

By OBHG Marketing on July 24th, 2017

Here’s a shocking fact: more women in the U.S. die during childbirth than in any other developed country, and experts think the problem will likely get worse. Since 1990, countries like South Korea and Germany have seen a sharp decline in the number of women who die in childbirth, while U.S. rates have been steadily increasing. But why? Experts attribute this trend to the rise in chronic health conditions such as high blood pressure, diabetes, obesity, women giving birth at older ages, rural access issues, and untreated maternal mental health problems. These health issues put women at greater risk for pregnancy and childbirth complications.

Even for healthy women, childbirth can be unpredictably dangerous. With proper education, training, preparation, and protocols, even the deadliest of complications can result in a happy ending. Kristen Terlizzi’s story is an excellent example of this. Had Terlizzi not given birth in California, she may not have lived. Lucky for her, the Stanford clinicians who managed her complicated pregnancy were prepared with precise protocols.

In 2016, Stanford health professionals decided to improve maternal mortality data collection, as well as protocols for life-threatening emergencies, and created the California Maternal Quality Care Collaborative (CMQCC), an initiative to make childbirth safer for moms. Despite the rise in deaths during childbirth across the country, California’s maternal mortality rate has declined by 55 percent between 2006 to 2013. If California can do it, so can the rest of the country.

OB Hospitalist Group (OBHG) provides the nation’s best OB hospitalist programs, and we believe that one of the best ways to lower mortality and improve maternal outcomes nationwide is to implement 24/7 OB coverage and an obstetric emergency department. But effective coverage is more than just a warm body in a white coat. OBHG provides all the pieces that make for a successful OB hospitalist program, and our mission revolves around saving the lives of mothers and babies. Here are three ways that OBHG goes above and beyond:


We recruit top-quality clinicians
OBHG clinicians have years of experience and are trained in best practices for labor management and obstetric emergencies. They undergo rigorous vetting by our recruiting team and are chosen based on their emphasis of service and collaboration. We understand that patient safety and excellent outcomes happen when every team member understands his or her role and is valued in it. Our clinicians share and discuss best practices via an OBHG intranet, and we keep our clinicians up to date on the latest evidence-based research in OB hospitalist medicine. Our clinicians not only participate in simulation drills, they lead them, recognizing that communication and practice are the keys to managing life-threatening emergencies. 


We maintain the highest level of education and training
Our clinicians can assist our hospital partners in an analysis of labor & delivery best practices and protocols. We require biannual education and testing of our entire clinician workforce in post-partum hemorrhage, shoulder dystocia, electronic fetal monitoring interpretation and pre-eclampsia/hypertension. We encourage active participation by our clinicians in all OB department committee meetings where policies and procedures are discussed and analyzed.  If a hospital is implementing a new protocol, such as use of tranexamic acid for post-partum hemorrhage, our clinicians have access to protocols on our internal clinician-only website.


We bring standardization of practice and implementation of protocols
Data sharing and metric analysis – OBHG provides real-time metrics and quality analytics. We take the guesswork out of quality improvement. Our clinicians receive monthly dashboards with detailed analytics describing the quality and acuity of their care. Among our clinicians, there’s a healthy competition to strive to be the best. We know that economic forces put ever more pressure on quality metrics tied to reimbursement and our clinicians will be your partner in quality.

From the moment of conception to the placement of new life on a mother’s chest, from the sound of the first heartbeat to the day a family takes their baby or babies, home, we know that the unforeseen and unexpected can suddenly happen on your labor & delivery unit. As OB hospitalists, we can be the difference between life and death in those moments no one ever saw coming. We are the safety net. We are the doctors trained to care for the cheers of new life and the complications that can occur in an instant. We are the responders taking the stairs, two at a time, to the post-partum hemorrhage, the second clinician in a shoulder dystocia, the one running toward a maternal code in the emergency room. Because mothers and their babies deserve to have a doctor there to save them, 24 hours a day, 365 days a year.

 

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG hospital partner has one of the lowest C-section rates in the U.S.

By OBHG Marketing on July 17th, 2017

Medically unnecessary C-sections are a thing of the past. Hospitals across the U.S. are clamping down on the number of C-sections they perform to reach the national target of 23.9 percent by year 2020. At a current national average of 25.8 percent, there's still work to be done. Many studies explore the C-section rate and trends, but a recent article published by Huffington Post uncovers an unexpected factor that can determine if an expectant mother will have a C-section.

Many hospitals around the country are ahead of the curve though. With a rate of 13 percent, OBHG partner Bakersfield's Dignity Health Memorial Hospital is among the top five hospitals in the U.S. with the lowest number of C-sections for first-time mothers. Bakersfield Memorial Hospital said it credits its partnership with Ob Hospitalist Group (OBHG) for their low C-section rate. Dr. Jane van Dis, MD, FACOG, is an Ob Hospitalist and Chair of the Department of Obstetrics & Gynecology at Bakersfield Memorial Hospital. She is a Board Certified OB/GYN and OBHG's Medical Director for Business Development. In a recent op-ed, Dr. van Dis discusses some challenges that Bakersfield Memorial Hospital had to overcome to reach its 13 percent C-section rate. She also provides three concrete ways for hospital leadership to consider in their effort to reduce C-sections and limit their organization's risk. 

OBHG OB/GYN Dr. Natour helps physicians struggling with burnout

By OBHG Marketing on July 14th, 2017

Ob Hospitalist Group's Dr. Nahille Natour recently shared her story of battling physician burnout as a private practice OB/GYN. Since joining OBHG, she has reclaimed her life with more time to spend with family and friends and to enjoy hobbies. 

"One of the most important relationships to nurture is the one with yourself," wrote Dr. Natour. "Physicians self-sacrifice all too often, and it is almost impossible to serve others effectively when your own vessel is empty."

Read the full story here.

What do you look for in a partner?

By OBHG Marketing on July 10th, 2017

Sorry, if you’re here for relationship advice, you’re in the wrong place. We’re talking business relationships here. But there are several things that all relationships – business or personal – must have to be successful.

Recently, Becker’s Healthcare and Bank of America Merrill Lynch spoke with three hospital and health system chief financial officers (CFOs) and a healthcare strategy expert about clinical and nonclinical partnerships. From this, they developed the Partnership Playbook for Hospital CFOs: A Guide to Collaborative Relationships that Enhance Operational and Clinical Effectiveness. Inevitably, organizations will face the fact that they are not equipped to provide all ancillary services in-house and will look to form partnerships with external experts. According to the participants in this study, healthcare organizations form partnerships, versus mergers, for many reasons including: to achieve economies of scale; to expand service lines; to diversify revenues; and to expand market presence.

Healthcare organizations are not only looking for reliable partnerships that can meet their needs and create efficiencies, they want partners that complement their vision, mission, and culture. This puts the onus on companies like Ob Hospitalist Group (OBHG) to deliver results while simultaneously managing healthy partnerships and working toward mutual goals.

In the Partnership Playbook, study participants cite many must-have qualities in a potential partner before they will sign on the dotted line, but some commonalities surfaced. The CFOs identified four main assets that set organizations apart:

  • likeminded vision
  • experience and credibility
  • cultural compatibility
  • financial commitment

At OBHG, we put our partnerships on a pedestal. Without strong collaboration across hospital leadership, staff and physicians, our program wouldn’t be successful. We value and strive toward excellence when it comes to each of the four qualities the CFOs in this study identified.   

Likeminded vision
Hospitals typically seek to establish partnership with an OB hospitalist program to elevate their women’s healthcare services. Where OBHG differs from other programs is that the cornerstone of our mission is focused on elevating the standard of women’s healthcare. OBHG solely focuses on OB medicine. Our physicians and support office team work around the clock to make a difference in the lives of our patients, their newborns, and families. We work with hospitals to determine their needs and how we can fill them. No cookie-cutter approach here. We recognize your specific objectives and goals, cultural expectations, and unique circumstances to create a highly effective, comprehensive, financially viable OB/GYN hospitalist program that is as unique as each of our patients. 

Experience and credibility
OBHG is the largest, sole provider of OB hospitalist programs in the country. We have more than 120 current and onboarding hospital partners across 28 states and are growing by the month. With more than 10 years in the industry, we have collected the largest data set that we use as benchmarks to determine success across our programs. OBHG’s analytics team provides quarterly reports, highlighting observations and recommendations for adding value. Saving lives is not just our mission, it’s our reality.

Cultural compatibility
One of OBHG’s key differentiators is our dedication to complementing our partners’ hospital staff and culture. We deliver more than just great physicians to each of our programs. We deliver complete solutions uniquely suited to our hospitals. OBHG’s approach to provider recruitment in today's competitive market is more than just filling a shift. OBHG believes strongly in hiring a cohesive team that will integrate into the hospital culture and forge strong working relationships with the staff and community physicians.

Financial commitment
We all know that it takes money to make money. Although there are upfront costs associated with starting our program and hiring board certified physicians, many times, our hospital partners can offset the cost of our program after a few years. Because we triage every patient and provide 24/7 coverage, most of our partners bill as an obstetrics emergency department. Our billing and analytics teams also provide monitoring and feedback on both professional and facility fee coding. We use benchmarks and our experience at similar hospitals to offer insights into appropriate coding definitions and levels.











OBHG is dedicated to not just forming a winning relationship initially, we are committed to continuously evaluating our partnerships to ensure that our teams achieve the best outcomes. We know that successful programs are impossible without strong relationships, so we put our partners first.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.



©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG hospitalist featured on Halifax Health’s Medical Minute

By OBHG Marketing on July 7th, 2017

This week, OBHG's very own Dr. Brenda Watson was featured on Halifax Health's Medical Minute. She talks about how having an OB physician in the hospital 24/7 can save the lives of mothers and babies during medical emergencies.

"Having a physician present on labor and delivery where an emergency can be dealt with in a matter of minutes makes a difference for both the health of the baby and the mother."

Click here to watch video.

Mindful of Her Blessings

By Kristine Hartvigsen on July 7th, 2017

Being an Ob Hospitalist Group (OBHG) clinician at Houston Methodist Willowbrook Hospital allowed Dr. Nahille Natour to follow dual passions — practicing OB medicine and coaching physicians struggling with burnout. 

“One of the great things about being a physician with OBHG is taking care of patients. Period,” she said. “Every day in private practice there was some financial issue that needed to be dealt with. I don’t have to do any of that. So I get to do what I do without those types of distractions.”

With the extra personal time afforded by her position with OBHG, Dr. Natour studied to become a Certified Physician Development Coach and develop a part-time business — Inspiring Balance — through which she speaks about burnout at conferences and counsels others who may have found themselves in a burnout-induced career rut.

Even with her side business, Dr. Natour still finds ample time to make bead jewelry (a hobby) and explore outdoor greenspaces.

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Newborn Group B Strep Infection is Highly Preventable

By Kristine Hartvigsen on July 6th, 2017

Group B Streptococcus infection does not discriminate. It can devastate the lives of celebrities, high-level government officials, and ordinary citizens of any educational or socioeconomic status.

About 22 years ago, it brought tragedy to ex-FBI Director James Comey and his wife, Patrice Failor. Their precious newborn, Collin, died just 9 days after being born with Group B Streptococcus (GBS) infection.

Patrice Failor later publicly campaigned for more widespread testing of pregnant women for GBS so those infected might be treated so they do not pass along the infection to their newborns during delivery.

About 1 in 4 healthy women carries GBS in their bodies, but they have no symptoms to cause them alarm. Although somewhat rare, it is possible for infected mothers to pass GBS to their newborns during childbirth. GBS infection can cause serious complications for infants, including pneumonia (inflammation of the lungs), meningitis (inflammation around the brain and spinal cord), or sepsis (bloodstream infection). About 3% of infected babies die.

Fortunately, GBS infection of newborns is highly preventable. OB/GYNs routinely test their patients for GBS as part of their prenatal care regimen. Because GBS bacteria normally live in a woman’s gastrointestinal tract, they are prone to continual regeneration and can return even after a round of antibiotics. Therefore, testing is most accurate within five weeks of a woman’s due date. If she tests positive for GBS, the mother usually is given prophylactic antibiotics throughout her labor and delivery.

According to the U.S. Centers for Disease Control, the likelihood of having a baby with GBS is only 1 in 4,000 if antibiotics are administered during labor and childbirth. Without antibiotics, the chance jumps to 1 in 200. Nonetheless, GBS remains the most common cause of severe yet preventable infection in newborns.

July is Group B Streptococcus Awareness Month. This is a great time to read up on the subject and direct any questions or concerns to your physician.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Why Discouraging Maternal Obesity is Not Fat-Shaming

By Kristine Hartvigsen on June 30th, 2017

Patient education has come pretty far in recent years. Most U.S. women today understand that being pregnant does not mean “eating for two.” In fact, invoking one’s maternal license to belly up to the smorgasbord can be detrimental to the health of both mother and baby.

According to the American College of Obstetricians and Gynecologists (ACOG), obesity is the most common healthcare problem among women in their reproductive years. An estimated 60% are overweight, and 35% are obese (generally defined at having a Body Mass Index [BMI] of 30 or greater).

ACOG recommends that women try to address obesity before they get pregnant, because even a modest weight loss of 10-20 pounds can have a profound impact on their later risk for pregnancy complications such as preeclampsia, gestational diabetes, fetal macrosomia, venous thromboembolism (VTE), miscarriage, premature birth, birth defects, cognitive deficits, and stillbirth. Their babies similarly carry a higher risk for such things as autism spectrum disorder (ASD), adult obesity, diabetes, adult heart disease, and neurodevelopmental delays.

A pervasive concern, especially for women who desire to deliver vaginally, is the risk for macrosomia (a baby that is considerably larger than average for a newborn). Large babies can make vaginal delivery difficult and increase the likelihood of cesarean delivery. A large baby is more likely to experience shoulder dystocia, in which the baby’s shoulder gets wedged at the top of the birth canal. Shoulder dystocia can cause a number of injuries, including nerve damage from a brachial plexus injury, which can cause upper extremity paralysis or loss of function.

Birthing a newborn with macrosomia also elevates a woman’s risk of incurring damage to the birth canal and perineum as well as experiencing dangerous bleeding or uterine rupture.

The most recent research on maternal obesity published earlier this year came from an examination of 1.2 million birth outcomes in Sweden. Researchers found that the risk for infant heart defects, nervous system malformations, and limb deformities increased commensurate with the mother’s degree of obesity at the beginning of her pregnancy. They found that the most severely obese women were 37% more likely to have babies with birth defects than normal-weight mothers.

Older research already has demonstrated a link between maternal obesity in the first trimester and later obesity in children. In fact, scientists hypothesized that increasing rates of maternal obesity can trigger an unwanted self-perpetuating phenomenon based on “in-utero fetal programming by nutritional stimuli.” In other words, the quality and quantity of nutrition passed to the baby through the placenta may permanently alter the baby’s metabolism. All the more reason for expectant women to exercise, eat healthy, high-quality foods, and be wary of portion size.

ACOG estimates that women in their second and third trimesters need an average of just 300 extra calories a day, which is about the same as a glass of skim milk and half a sandwich. How much weight a woman should gain during her pregnancy is best determined with her physician. However, some guidelines recommend that obese women carrying one baby should gain 11-20 pounds. Obese women carrying multiple babies should gain about 25-42 pounds.

Excessive body fat can make it more difficult for clinicians to properly view the baby’s anatomy via ultrasound and to hear the baby’s heart rate during labor. Another practical reason to monitor and manage weight during pregnancy is to avoid infections, the likelihood of a longer labor, and problems with breastfeeding. Obese women also are more likely to need more prenatal visits than usual to closely monitor for obesity-related issues.

OB/GYNs highly recommend that obese women schedule a preconception checkup before they are pregnant. This can help them get out ahead of weight issues and possibly even lose weight before becoming pregnant. At this time, clinicians can provide guidance for healthy eating and lifestyle during pregnancy.

“Pregnancy should not be looked at as a state of confinement,” said ACOG’s Dr. Raul Artal. “In fact, it is an ideal time for lifestyle modification. That is because, more than any other time in her life, a pregnant woman has the most available access to medical care and supervision.”


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

‘Ilioinguinal’ Doesn’t Mean You Speak Multiple Languages

By Kristine Hartvigsen on June 27th, 2017

It is difficult to pronounce, but its proper function can mean the difference between an easy or a troublesome recovery from cesarean section. The ilioinguinal nerve is one of three inside the belly wall that can be irritated, compressed, or damaged during a C-section. The others are the iliohypogastric nerve and the genitofemoral nerve.

What does this alphabet soup mean for women recovering from C-sections? Nothing. Or everything. It just depends.

Nerve injuries after C-sections are very rare. An estimated 1-3% of women experience persistent nerve pain after having a C-section.

The very act of surgery necessitates cutting some small nerves in the skin and surrounding tissues. So it is not uncommon for patients of all types to have some uncomfortable, usually superficial, post-surgical nerve symptoms such as burning, tenderness, or numbness around the scar.

The ilioinguinal, iliohypogastric, and genitofemoral nerves are located very close to the edge of a typical C-section incision. Because of this close proximity, these nerves may become irritated, bruised, compressed, cut, or trapped by scar tissue. In general, nerves don’t heal as readily as other tissues. However, in most cases, the nerves heal without any long-term effects. If a nerve injury does not heal in a reasonable amount of time, then nerve damage may result.

Once nerve damage is confirmed, common treatments may include:

• non-steroidal anti-inflammatories
• topical numbing medication (patch or cream)
• nerve blocks using steroid medication
• antidepressant therapy
• weight loss regimen (can relieve pressure on nerve)
spinal cord stimulation
• surgery

Women who experience prolonged post-cesarean nerve pain should consult their physician to discuss strategies to manage their pain.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

What is Shoulder Dystocia?

By Kristine Hartvigsen on June 23rd, 2017

Anything out of the ordinary that occurs during childbirth can be frightening. One uncommon occurrence is shoulder dystocia, which occurs when a baby’s head emerges from the birth canal but the baby’s trunk ceases to progress because the baby’s shoulder is lodged behind the pubic symphysis, or the joint between the left and right pubic bones through which the baby must pass to enter the birth canal.

Shoulder dystocia is a time-sensitive medical emergency, because if the situation is not resolved within 4-6 minutes, the baby can sustain neurologic injury, partial paralysis, or even death from lack of oxygen (hypoxia). The incidence of shoulder dystocia is relatively rare — between 0.2% and 3% of births.

Complications from shoulder dystocia also are infrequent and are successfully resolved most of the time. Infants may suffer fractured humerus or clavicle, brachial plexus injury, asphyxia, and/or umbilical cord compression. Less than 10% of babies affected by shoulder dystocia sustain permanent injury. For mothers, possible complications include severe hemorrhage and tissue lacerations to the cervix, rectum, uterus, or vagina.

Brachial plexus injuries (BPI), which occur in 4-16% of shoulder dystocia deliveries, are the most serious. A BPI occurs when the network of nerves that transmits signals from the spine to the shoulder, arm, and hand are stretched, compressed, torn, or completely severed from the spinal cord. Fortunately most cases of shoulder dystocia-related BPI resolve without any permanent disability.

Risk factors for shoulder dystocia delivery include:

• a very large baby (macrosomia);
• maternal obesity;
• maternal diabetes;
• multiple births such as twins or triplets (multiparity);
• late gestation; and
• past delivery with shoulder dystocia.

Shoulder dystocia, for the most part, is unpredictable and rarely preventable. It can happen with any delivery. In fact, up to half of shoulder dystocia cases had no association with known risk factors. And though macrosomia may be diagnosed beforehand, an estimated 84% of women who experience shoulder dystocia don’t have prenatal diagnoses of macrosomia. About 12% of women with a history of shoulder dystocia experience a recurrence in subsequent pregnancies.

Cases of shoulder dystocia necessitate an immediate, coordinated, multidisciplinary response that applies evidence-based algorithms to achieve the most favorable outcomes. Once shoulder dystocia is detected, the obstetrician should summon assistance from other clinicians. The time is noted and kept with announcements to the team at various progression intervals.

The woman in labor is told not to push while several recognized approaches are attempted to safely dislodge the baby. One of the most common is the McRoberts maneuver, in which the mother’s legs are pushed up against her abdomen to flatten and rotate the pelvis, allowing the baby to pass through more easily. If that doesn’t work, an experienced clinician will manually apply suprapubic pressure just above the fetal anterior shoulder, midline between the left and right pubic bones. Sometimes these two interventions are executed in combination. The McRoberts maneuver is successful 42% of the time. Combined with suprapubic pressure, it resolves 54% of shoulder dystocias.

After these steps have been taken without success, the obstetrician will attempt an internal rotation of the baby or try to extract the posterior arm from the birth canal. Sometimes women are instructed to get on their hands and knees to ease the baby’s exit through the pubic bones. A last resort would be the Zavenelli maneuver, in which the baby’s head is pushed back into the birth canal so an emergency cesarean can be performed.

It is important to keep in mind that shoulder dystocia is rare, and complications from it even rarer. Expectant women who aren’t sure about their risk should address questions about shoulder dystocia to their obstetrician.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

A Simple Sugar May Help Shorten Duration of Induced Labor

By Kristine Hartvigsen on June 21st, 2017

Delivering a baby is perhaps the most amazing physical feat a woman ever will achieve in her lifetime. Not unlike many sports, labor is intense and will test a woman’s pain threshold and endurance.

For decades, elite athletes have hydrated themselves with various performance drinks, such as Gatorade™, which contain salt, sugar, and water. The efficacy of sports drinks may have inspired Canadian researchers to apply the concept to childbirth.

Extremely prolonged labor can be dangerous both for mother and baby. So researchers with the University of Sherbrooke in Quebec, Canada, conducted a modest trial to test the impact of an intravenous solution of 5% glucose and saline on the duration of induced labor among first-time mothers.

Ultimately, they concluded that glucose supplementation significantly reduces the total length of active labor without increasing the rate of complication. They asserted that glucose “should be used as the default solute during labor.”

“We found that the median duration of labor was 76 minutes shorter in the group of women receiving glucose. There was no difference in the mode of delivery (cesarean section, forceps, etc.), or the neonatal well-being measures,” said Josianne Pare, MD, one of the study’s authors. “Glucose supplementation therefore significantly reduces the total length of labor without increasing the rate of complication. This is great news for women experiencing induced labor.” Dr. Pare presenting her findings at the Society of Maternal and Fetal Medicine annual meeting earlier this year.

SMFM colleagues acknowledged the potential advantages of shortening labor for first-time inductions, but some cautioned that women with preexisting conditions such as preeclampsia or heart issues should not receive high volumes of intravenous fluids. Reservations also were expressed regarding glucose supplementation of diabetic women.

"In patients with diabetes, supplementation with glucose would need to be titrated with insulin to prevent hyperglycemia in the mother, which can lead to hypoglycemia in the newborn after birth," Jeffrey Chapa, MD, director of maternal-fetal medicine at the Cleveland Clinic, told Medpage Today.

As with many early studies of various interventions, more research is needed before absolute conclusions can be drawn.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Involved Fathers May Help Reduce Infant Mortality

By Kristine Hartvigsen on June 18th, 2017

There’s a hilarious “I Love Lucy” episode when Lucy is going into labor, and it’s time to go to the hospital. Despite intricate planning and rehearsal, when the moment arrives, what ensues is lots of panic and fumbling with Ricky, Ethel, and Fred all forgetting their roles and actually leaving Lucy behind in their rush to get out of the apartment.

Every pregnant woman needs support, and the importance of a father’s role during pregnancy and labor too often can be overlooked. Having the father around to provide support during pregnancy and labor is not just “something nice” to have. There is sound evidence that a father’s early and ongoing involvement positively impacts the health of both mother and baby and even reduces infant mortality.

Researchers at the University of South Florida in 2010 studied more than 1.39 million cases of live birth between 1998 and 2005. Among their findings:

• Infants with absent fathers were more likely to be born with lower birth weights, to be pre-term, and to be small for gestational age.
• Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.
• The risk of poor birth outcomes was highest for infants born to black women whose babies’ fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
• Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia, and placental abruption, were more prevalent among women whose babies’ fathers were absent during pregnancy.

"Our study suggests that lack of paternal involvement during pregnancy is an important and potentially modifiable risk factor for infant mortality," lead author Amina Alio, PhD, told the journal Science Daily.

Dads can help expectant moms in a variety of ways. They can:

• share the emotional journey, reduce stress, and provide empathetic support;
• join in and reinforce healthy habits such as preparing nutritious meals, exercising, avoiding tobacco, drugs, and alcohol;
• ease pregnancy discomforts by giving back rubs and foot massages;
• accompany moms to prenatal visits and ultrasound appointments;
• attend childbirth classes with moms
• participate in shopping for baby clothes and decorating the nursery;
• pitch in with household chores;
• provide financial and/or insurance support;
• serve as labor and breathing coaches during labor; and
• be strong advocates for moms in the clinical setting.

One interesting manifestation of paternal support during pregnancy is a condition called Couvade Syndrome in which the father begins to experience their partner’s pregnancy symptoms. Also called “sympathetic pregnancy,” men with Couvade Syndrome may complain of weight gain, bloating, fatigue, heartburn, backaches, morning sickness, and even breast enlargement.

There is not much research archived on Couvade Syndrome, but it is not particularly uncommon. Several studies estimate that between 25-50% of U.S. men experience Couvade Syndrome at varying intensities. Theories include the possibility that the increased stress of impending parenthood may alter a man’s hormonal balance, lowering testosterone and increasing cortisol levels. Symptoms usually begin during the first trimester, abate during the second trimester, and return in the final trimester. Symptoms generally disappear after the baby is born, but some men have been known to exhibit symptoms similar to moms’ — such as postpartum depression — months after the birth.

In the past, fathers in our modern culture often got a bad rap for being absent or uninvolved. But they’re more involved in the lives of their children now than ever. There are resources to help. But it’s also vitally important that every one of us give our love to fathers everywhere so they feel empowered to be engaged with their families.

Happy Father’s Day!


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

News from One of Our Newest Partner Hospitals

By Kristine Hartvigsen on June 16th, 2017

Passing along some news from our new partner program at Dominican Hospital in Santa Cruz, California, which launched on May 10. Welcome!

 

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In Pregnancy, Sniffling May Not Be Just Emotional

By Kristine Hartvigsen on June 16th, 2017

Pregnant women have been known to tear up and reach for the tissue box when watching a moving Hallmark commercial or even reading a gloomy novel. This often is attributed to mood swings brought on by fluctuating hormones.

There are similar symptoms —also likely influenced by pregnancy hormones — that have nothing to do with internet videos of rescued puppies and everything to do with, well, basic nasal inflammation.

Rhinitis of pregnancy is fairly common, affecting more than 30% of pregnant women. It usually begins during the first trimester of pregnancy but can occur at any point in pregnancy. Symptoms include sneezing, coughing, congestion, runny nose, and postnasal drip, which also can cause sore throat. Rhinitis of pregnancy typically dissipates within two weeks of giving birth.

“Rhinitis” literally means inflammation. As a pregnant woman’s blood volume increases to support the fetus, small blood vessels in the nose can swell with extra blood, causing congestion and stuffiness. Pregnancy hormones such as estrogen also can increase mucous production, and progesterone can thicken that mucous, further aggravating the sinuses.

It may be difficult to differentiate pregnancy rhinitis from run-of-the-mill seasonal allergies or even the common cold. Usually, pregnancy rhinitis does not cause itchy, red eyes like allergies can. Also, women who experience low-grade fever, headache, and persistent cough may be suffering from the common cold or an upper respiratory infection. To know for sure, they should consult their personal physician.

For the most part, rhinitis of pregnancy is a harmless inconvenience. But for pregnant women who have severe asthma, it can be a concern because rhinitis can trigger or aggravate asthma symptoms. Women with uncontrolled asthma carry a higher risk for pregnancy complications than those with well-controlled asthma. Acute asthma episodes can reduce the oxygen supply to the fetus and compromise its safety.

Experts suggest that Inhaled Corticosteroids (ICS) are safe to use and most effective for long-term control of acute asthma in pregnant women. However, some patients won’t fill or follow their prescription regimen out of fear it can hurt the baby.

According to the U.S. National Asthma Education and Prevention Program (NAEPP), other ways to treat symptoms include use of antihistamines such as loratadine or cetirizine. The program also recommends that pregnant women who already are taking allergy shots continue receiving them. However NAEPP does not recommend starting allergy shots while pregnant.

Simpler, more natural remedies include drinking plenty of water, using saline solution, sleeping with the head elevated, and using a humidifier. Before taking any remedy for rhinitis of pregnancy, women should consult their healthcare provider first.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

The Right Tool Makes All the Difference

By OBHG Marketing on June 14th, 2017

Hospitals, just like other businesses, must operate efficiently and generate revenue to remain solvent and competitive. While their primary concern is providing quality care to their patients, it’s also unavoidable that administrators must monitor the bottom line. One would not be possible without the other.

As many hospitals create 24/7 Obstetric Emergency Departments (OBEDs) licensed under their existing Emergency Departments (EDs), a changing dynamic has emerged that directly impacts their revenue. The severity of a patient’s condition in the ED is calculated using what is called an “acuity scoring tool.” Accordingly, new OBEDS are using the ED’s tool to calculate acuity among obstetric patients, but the two are completely different.

An ED’s scoring tool is calibrated on the high end of the trauma scale. Obstetric patients rarely rise to the acuity level of, say, a gunshot wound. So using the same measurement tool for both the ED and the OBED is neither accurate nor recommended. Recent findings by Ob Hospitalist Group actually quantify the difference in terms of facility fee revenue.

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Never Feel Helpless Again

By Kristine Hartvigsen on June 14th, 2017

It’s the most frustrating, gut-wrenching feeling. People are in urgent medical need, and you don’t have the clinical skills or certifications to help. But there is always something you can do. And it’s even better if you do it regularly and not just during times of crisis.

What can you do? Give blood. Give now. Give often.

That’s the theme for this year’s World Blood Donor Day, June 14.

Every two seconds, someone in the United States needs blood or blood products. An estimated 36,000 units of red blood cells daily are needed to meet the need. Certainly not everyone is eligible to donate, but 38% of the population is. Yet less than 10% of these people actually donate, even when the mobile donation vehicles come to their workplace, church, shopping mall, or community center.

The need is constant, because blood is perishable. It has a refrigerated shelf life of about 35-42 days. There are no substitutes for human blood. It cannot be manufactured.

There are many medical events requiring life-saving blood transfusions. Someone with severe trauma injuries from such things as car accidents or gunshot wounds may need as many as 100 pints of blood. But did you know that people who suffer from such conditions as severe anemia, hemophilia, sickle cell disease, and various forms of cancer also need blood and blood products such as platelets or plasma on a regular basis.

Women who develop pregnancy complications such as ectopic pregnancy or obstetric hemorrhage also may need blood transfusions before, during, or after giving birth. The variety of needs for blood and blood products is exhaustive.

To be eligible to donate blood, a person must be in good health, at least 17 years of age (in most states), and weigh at least 110 pounds. It doesn’t take long — usually about 30 minutes from start to finish — and the process is simple:

  • Present valid identification, driver’s license, or blood donor card.
  • Answer some confidential screening questions about your health and travel history.
  • Have your vital signs and hemoglobin level checked (usually with a quick finger prick).
  • Sit in a comfortable, semi-reclining chair and have your arms inspected for the best vein (or you can voice your arm preference). That part of your skin will be disinfected.
  • A sterile needle will be inserted with IV tubing to draw blood. You will feel a quick pinch but it is over quickly. You may be given a small object to squeeze to stimulate blood flow.
  • Recline for 8-10 minutes while blood is collected into a hanging bag.
  • When finished, a bandage will be placed over the IV area. Remain onsite for 10-15 minutes while enjoying a provided snack and drink.
  • Be sure to drink plenty of water and avoid strenuous exercise for the rest of the day.

All blood types are needed, and some are more rare and difficult to obtain. There are eight blood types: A, B, AB, and O, with each being either rh positive or negative. The type most often requested by hospitals is Type O-, the universal donor type. It can be safely transplanted into anyone. If an emergency medical team does not know your blood type, they automatically will use 0-.

If you do not know your blood type, your personal physician can discuss testing you for blood type. You also can find out your type simply by donating. If you donate with The Red Cross, you will receive a donor card in the mail that lists your blood type.

When you donate blood, your body replaces its blood plasma within about 24 hours. Your body needs 4-6 weeks, however, to replenish red cells. For this reason, you must wait at least eight weeks between whole blood donations.

Your dedicated first-responders will tell you it is a great feeling to save a life. If you really think about it, when you donate blood, you essentially are a “first first-responder.” Call them whatever you like; blood donors are heroes in our book.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Babies Don’t Recognize Seasons. Neither Do We.

By Kristine Hartvigsen on June 13th, 2017

It’s summertime. Lots of folks — OB/GYN physicians included — are sinking their toes into the sand and reading dog-eared paperbacks. Without question, they work hard and are enjoying well-deserved time off. But we all know that the proverbial stork doesn’t take vacations. So who’s delivering the babies?

Because there’s no “off-season” on the Labor and Delivery (L&D) unit, many hospitals experience challenges finding qualified healthcare professionals to provide coverage for their busy L&D departments during the summer, on holiday weekends, or during school breaks.

Ob Hospitalist Group (OBHG) programs are designed specifically to provide around-the-clock, 24/7 safety net coverage every day of the year so that every pregnant woman coming to the hospital at any time of the night or day can receive immediate care from a highly qualified OB/GYN clinician.

OBHG hospitalists are onsite 365 days a year so local OB/GYNs don’t have to sacrifice prime time with their families or doing the things they love outside of the hospital. They can freely choose when they want to take leave without conflict or guilt. All the while, they know their patients are in good hands the entire time they are away.

Another perk? Hospital managers don’t have to sweat details of the L&D coverage schedule.

Best of all, patients under the care of an OBHG hospitalist receive the highest-quality of OB care available — winter, spring, summer, and fall. Quality is a constant standard that can’t be forfeited to the exodus of clinicians during highly coveted sabbatical dates on the calendar.

Quality is always top of mind at OBHG. We put our clinician candidates through a rigorous vetting process. Those who make the grade and join our ranks then receive comprehensive supplemental training in standardized best practices, safety/risk reduction, and emergent obstetric medicine.

In addition, OBHG regularly collects and reports National Quality Forum (NQF) OB/GYN metrics to its partner hospitals so they can see clearly, in straightforward terms, exactly how we are performing for them. OBHG consistently outperforms the national average on all NQF metrics we track. Our commitment to quality is so steadfast that we will assume some financial risk in the very unlikely event we fail to perform as expected.

Research consistently finds that delays in care of fetal distress is the No. 1 assertion (approximately 38%) in neonatal malpractice claims. With OBHG hospitalists on hand around the clock, delays in care are virtually nonexistent, and expectant mothers receive the highest-quality of OB care in the country.

With an OBHG-led solution, hospital managers win. Community physicians win. And, ultimately, maternity patients win.


Learn more about solutions available through OBHG.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

CDC Monitoring Rare Polio-Like Virus

By Kristine Hartvigsen on June 9th, 2017

In 2014, the medical world witnessed a curious uptick in cases of very young people, many of them babies or toddlers, suddenly becoming ill with neurological symptoms including muscle and limb weakness, breathing problems, difficulty swallowing, and, at worst, even paralysis.

What’s most scary is that the illness closely mimics polio, a scourge believed to be eliminated long ago in the wake of a life-saving vaccine. The illness certainly looks like polio, and lab techs soon found themselves receiving surprising requests to test saliva, feces, or spinal fluid for the polio virus. As it turned out, it is not polio.

Eventually, the Centers for Disease Control and Prevention (CDC) gave it a name — acute flaccid myelitis (AFM) — caused by enterovirus D68, or EV-D68. Within a five-month period in 2014, more than 1,100 cases of severe AFM were diagnosed in 49 states, 14 of them fatal. Frightening as it is, the incidence of EV-D68 infection remains extremely small (only 26 people tested positive for EV-D68 in 36 years), and the number of extreme cases involving paralysis are even more rare.

Other enteroviruses, West Nile virus, and adenoviruses all can cause AFM, so the CDC is not certain that all new AFM cases are associated specifically with EV-D68.

Dr. Benjamin Greenberg, a neurologist based in Dallas, Texas, has treated dozens of young children suffering the worst AFM symptoms of paralysis and the inability to breathe without ventilator assistance. “It’s worth noting that … the same virus can infect thousands, hundreds of thousands, or even millions of people with only a few individuals having catastrophic events from the virus, is true for almost every virus in human biology,” he said.

In Dr. Greenberg’s experience, patients can improve slowly, and some recover but not without some lasting muscular weakness or partial paralysis. Scientists theorize that these AFM-causing viruses travel to the spinal cord and irreversibly damage motor function.

To date, there is no vaccine for EV-D68, which is believed to be a mutation likely to mutate again. In addition, medical authorities maintain that EV-D68 does not pose a serious enough threat to invest in vaccine development at this time. EV-D68 usually causes mild symptoms, if any, and requires only supportive care. Most people are able to fight it off on their own with rest, hydration, and time — about 1-3 weeks.

The CDC is concerned enough about AFM to continue investigating the increased incidences in 2014 as well as additional increases in 2016, during which 138 people in 37 states were confirmed to have AFM. Though rare, AFM is a serious illness, and physicians who suspect a patient may have AFM are encouraged to contact their state and local health departments and collect appropriate samples for CDC testing. So far this year, there have been five (5) confirmed cases of AFM in the United States. The CDC is closely monitoring all occurrences of the disease.

If you are pregnant and worried about EV-D68 infection, there is good news. So far, no definitive evidence has linked non-polio enterovirus infection in pregnancy to an increased risk for birth defects, miscarriage, or other pregnancy complications. Pregnant women who become infected in the latter part of their pregnancies may pass the virus to their babies. However, these babies usually do fine. Furthermore, most pregnant women already have developed immunity by virtue of previous exposure to any number of non-polio enteroviruses. There are at least 64 non-polio enteroviruses capable of causing disease in humans.

The best way to prevent the acquisition or spread of EV-D68 is to practice good basic hygiene and take common precautions around people who may be sick. This includes:  frequent handwashing; not sharing utensils, cups, or dishes; periodically disinfecting keys, door knobs, toys, and other items we touch often during the day; avoiding kissing or hugging someone who may be sick; and avoiding touching eyes, nose, and mouth with unwashed hands.

If you have any symptoms of an EV-D68 infection, or if you are just concerned about enteroviruses during your pregnancy, direct questions to your physician.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

How a Dog and a Pigeon Can Help With Pregnancy Back Pain

By Kristine Hartvigsen on June 7th, 2017

It’s a common complaint in pregnancy, especially during the third trimester. Back pain.

Up to 80% of pregnant women experience back pain, and it often is associated with irritation or pressure on the sciatic nerve. Sciatica itself is less a diagnosis than a symptom of more serious underlying issues related to the spine, such as a herniated disc, bone spur, or narrowing of the spine (spinal stenosis).

For the most part, pregnancy itself does not actually cause sciatica. In fact, only about 1% of pregnant women have true sciatica. But lower back pain in pregnancy certainly mimics it and is related to the sciatic nerve, which is the largest nerve in the body and runs from the lower back to the buttocks and hips, and down the back of the legs to the feet. Along this course, it also happens to be positioned under the uterus, where it is privy to pressure from the growing fetus.

Pregnant women who are sedentary, obese, or who use tobacco carry a higher risk for severe back pain. Nevertheless, this type of pain is reported in the majority of pregnancies. For most, mitigating the pain is remarkably simple — targeted stretching associated with many yoga exercises.

Two of the most effective yoga poses for lower back pain are the well-known downward-facing dog and the pigeon pose. They are safe for women with uncomplicated pregnancies and focus on stretching the hamstrings and mildly twisting the torso.

The downward-facing dog helps extend the cervical spine and strengthen the midsection, and loosen tight hamstrings and lower back muscles. The pigeon pose helps open up the hips, stretch the torso, and relieve sciatic discomfort.

As a precaution, a pregnant woman always should consult her obstetrician before undertaking any yoga or exercise regimen. Most OB/GYNs recommend exercise in moderation and an active lifestyle. Fitness usually gives expectant women a significant advantage in keeping pregnancy pain at bay and enjoying a healthy, successful pregnancy.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG Partner St. Mary’s Hospital Making Headlines

By Kristine Hartvigsen on June 6th, 2017

We were delighted to see today’s article in The Daily Sentinel about St. Mary’s Hospital and Regional Medical Center in Grand Junction, Colorado. Kudos to our Team Lead Dr. Michael White, who explained some of the advantages of having highly qualified OB/GYN clinicians onsite around the clock to attend pregnant women presenting at any hour of the day or night.

“This is a unique model. There is always one of us physically present,” Dr. White told the newspaper. “Our response time is 30 seconds rather than the 15 minutes it might take a healthcare provider to get to the hospital from outside.”

The nursing staff also gives the OBHG team at St. Mary’s a thumb’s up.

“We have open communication, and the physicians treat everyone with respect,” said Shannon Stroeve, an RN in the maternity unit. “They keep the department moving with the most up-to-date evidence-based practices. And their bedside manner is truly exceptional.”

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CDC Now Recommends Zika Test Before Getting Pregnant

By Kristine Hartvigsen on June 5th, 2017

Because testing for the Zika virus has become increasingly complicated, officials from the Centers for Disease Control and Prevention (CDC) now are recommending that women who are planning to get pregnant and recently traveled to a Zika-prone locale have their blood tested for Zika antibodies before they conceive. That way, a baseline reading could help better interpret Zika test results conducted during pregnancy.

The CDC also is recommending that pregnant women who may be at risk for infection be tested with two different Zika tests at various stages of their pregnancies. In addition, the agency is advising physicians to test women once per trimester using a different test that detects genetic material from the Zika virus.

Approximately 1 in 10 U.S. women infected with the Zika virus last year had a baby with serious birth defects. Screening for Zika is difficult because many infected people don’t have any symptoms and, therefore, are not likely to seek testing.

Officials also are concerned about the lack of neurological imaging among Zika-exposed infants who had a normal head size and appeared to be healthy at birth. Additional research has found that such babies may have underlying brain abnormalities that are not apparent until later in life. The CDC is urging that physicians order a head ultrasound or CT scan of healthy looking Zika-exposed babies to look for any abnormalities. Because not all at-risk babies are scanned after birth, scientists fear the numbers of infants with Zika-related birth defects has been underreported. Currently, only 1 in 4 at-risk babies are receiving brain imaging after birth.

According to Zika infection data released this spring, nearly 1,300 pregnant women in 44 states showed laboratory-confirmed evidence of Zika infection in 2016. About 970 of those women gave birth; 77 reported pregnancy losses, and 51 babies were born with birth defects, including 43 with microcephaly or brain abnormalities.

In Related News

  • Brazil has declared an end to its national Zika virus emergency. The number of Zika cases declined by 95% between January and April 2017 compared to the same period in 2016. Scientists believe that “herd immunity” in the population has taken hold, and the virus cannot find enough unprotected people to continue transmission.
  • Researchers in April reported that a common backyard mosquito infected with the Zika virus can pass along the virus in its eggs. This is a concern because the Asian tiger mosquito — also known as Aedes albopictus — could hasten and expand the spread of the virus.
  • Scientists have begun a Phase 2 trial of a Zika vaccine. It is the first time an experimental Zika vaccine has gone beyond initial safety testing. The trial is expected to conclude in 2019.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Be Alert to Safety Hazards

By Kristine Hartvigsen on June 1st, 2017

Out of this nettle, danger, we pluck this flower, safety.
—William Shakespeare

Without careful direction and planning, it can be easy to get lost in the weeds. Perhaps this is what Shakespeare meant when he wrote the line above. Imagine the weeds are the safety risks that surround you daily. How do you stay out of the rough?

June is National Safety Month, created to raise awareness about preventing accidents by managing common safety and health risks. Here are some tips for keeping safe.

Prevent Accidental Falls

  • Identify tripping or falling hazards such as boxes, clutter, loose wires, standing water, and even open drawers obstructing walkways. Promptly remove these hazards. When possible, place non-skid area rugs or mats in slip-prone areas.
  • When using a ladder, be careful to place the ladder on a firm, level surface. If possible, have a helper hold the base of the ladder for you. Wear slip-resistant shoes, and avoid stepping on the top three rungs of the ladder.
  • Pregnant women, especially in the third trimester, may be vulnerable to falls because their weight has changed and center of gravity shifted. There should be little cause for alarm after a minor fall unless there is pain, bleeding, contractions, or the baby stops moving. In such instances, women should seek immediate medical attention.

Around the House

  • To prevent accidental fires, never leave candles or cooking materials unattended. Avoid overloading electrical outlets, and unplug small appliances when they are not in use. Teach children not to play with matches or lighters. Keep space heaters far away from drapes, clothing, or bedding.
  • Test smoke alarms regularly to ensure they’re working properly. Create a fire escape plan from every room in your home.
  • Be on the lookout for choking hazards around the house, such as button batteries, loose coins, toys with small detachable parts, uninflated balloons, or bottle caps.
  • Don’t allow children to climb on furniture or play near stairs or open windows. Where appropriate, install window guards. Keep babies strapped in to high chairs, infant carriers, swings, or strollers. Secure bookcases and large television sets to the wall so they are not at risk of toppling over.
  • Store cleaning products and household chemicals where children can’t access them. This includes the colorful liquid laundry or dishwasher detergent packets. Dietary supplements and medications also should be stored out of reach. Keep your local poison control number handy.
  • Never leave young children unattended around water, including the bathtub. Empty containers, buckets, and wading pools after use and store them upside down.
  • Store any guns unloaded in a locked cabinet, out of reach and out of sight of children. Store and lock up all ammunition someplace separate from where the guns are kept.

At Work

  • Make sure your workspace is ergonomically sound. Check the height of your chair and adjust or add lumbar support if needed. Take frequent breaks to stand, stretch your legs, and refocus your eyes to distant points.
  • If you are required to lift heavy things at work, be sure to wear a back-support belt and lift with your legs, not your back.
  • If there is a lot of loud noise on the job, consider using earplugs to protect against hearing loss.
  • Stay home if you are sick to avoid infecting others. Follow hygiene protocols such as proper hand-washing. Disinfect shared work items between uses.
  • Learn CPR. Many employers offer CPR training for employees.

On the Go

  • Either at home or traveling, keep doors and windows locked. Know who is at the door before opening it.
  • Be aware of your surroundings at all times.
  • Have your keys handy as you approach your car. Check under the vehicle as well as the backseat and floor before getting in. As soon as you get in your car, lock all doors and windows. After dark, park in well-lit areas.
  • Be sure to wear your seatbelt. If you’re pregnant, wear your seatbelt positioned low on the hipbones, below your belly.
  • If someone attempts to rob you, let them have what they want. Putting up a struggle can result in injury or even death. No purse or wallet is worth your life.
  • If you’re pregnant, the best time to travel is during the second trimester, because you’ll be more comfortable and this is the time of lowest risk. Schedule a checkup with your doctor before traveling.
  • While flying, try to get an aisle seat so you can get up easily to visit the bathroom or just to stretch your legs. Try to get up and move around every hour to help prevent blood clots. Bring prenatal vitamins and medications in your purse or carry-on. Drink plenty of water to stay hydrated.
  • If on a cruise ship, be wary of touching common surfaces such as food buffets and railings that can harbor highly contagious noroviruses. If you are prone to nausea, ask your doctor to prescribe an anti-nausea medication to take with you.

Safety is as simple as ABC — Always Be Careful. Have a safe and enjoyable summer.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG Shares Financial Risk for Evidence-Based Quality Performance

By Kristine Hartvigsen on May 22nd, 2017

Most of us recognize quality when we see it. But having good data increases our confidence in the quality of care we provide.

That’s why Ob Hospitalist Group (OBHG) is committed to providing robust and comprehensive data reporting on all elements of performance by our partner programs, including quality. OBHG collects, audits, and analyzes our partner hospital data on a quarterly basis to monitor performance and identify areas of opportunity.

We regularly provide customized data reports to our partner hospitals so they can see, in straightforward terms, exactly how we’re performing for them. These reports may include utilization performance, quality metric trending, facility and professional fee performance, and more, depending on the needs of our partners. It’s a way to hold us accountable for the value we deliver our partner hospitals in terms of obstetric unit operations and OB/GYN hospitalist care.

Established in 2006, OBHG today operates more OB hospitalist programs than all of our competitors across the nation combined. Our standards are so high, we consistently have outperformed our promises on safety metrics. In fact, OBHG outperforms the national average on all National Quality Forum (NQF) metrics that we track.

But we don’t stop there.

If we don’t achieve (or exceed) mutually agreed-upon quality goals, our partner hospitals will not pay for a percentage of their contract assigned to quality metric achievement. Guaranteed. No questions asked.

We understand the multi-faceted and complex nature of healthcare delivery in today’s environment. Our partners put their trust in us, and we feel it’s only fair to reciprocate by sharing some of the contract risk. In fact, most of our OBHG programs now include shared financial risk that is customized to the hospital’s goals and perinatal areas of quality improvement.

As healthcare in the United States moves toward risk-sharing, pay-for-performance, and other value-based payment models, OBHG recognizes the continued need to focus on quality metrics and outcomes to optimize the hospital’s revenue potential under the value-based system.

At OBHG, we are committed to quality improvement and transparent reporting on quality performance as a cornerstone of our programs. As such, we stand firmly behind our pledge to deliver on a hospital’s desired quality metrics.

No excuses. Just performance.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Grounded at 10,000 Feet

By Kristine Hartvigsen on May 19th, 2017

She much prefers the fresh air and sunlight to the indoors or the media spotlight. She doesn’t care who gets the credit, and she really doesn’t think her actions are that extraordinary. The humble Dr. Renee Lockey is refreshingly gracious, and her selfless deeds are, nonetheless, quite extraordinary.

The high-energy Team Lead at Memorial Hospital Central in Colorado Springs, CO, seems constantly in motion. When she’s off shift, she’s in the great outdoors mountain biking, snowboarding, camping, or road-tripping. Sun or snow, she commutes to and from work each day. It’s a lifestyle she truly loves.

 

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Upcoming Events 2017

By OBHG Marketing on May 17th, 2017

Ob Hospitalist will be attending the following meetings or conferences in the near future:

AWHONN GA
May 11-12; Atlanta, GA

NPSF
May 17-19; Orlando, FL

Michigan State Medical Society Perinatal Health Conference
May 18; Troy, MI

ACNM
May 21-24; Chicago, IL

PAC/LAC
June 1; Los Angeles, CA

ACOG Colorado
June 16 – 17; Vail Village, CO

AWHONN Annual Meeting
June 24 – 28; New Orleans, LA

AWHONN Florida
July 27 – 30; Ponte Vedra Beach, FL

APT (Arizona Perinatal Trust)
August 10 – 11; Flagstaff, AZ

ACOG Wisconsin
August 11 – 12; Sheboygan, WI

ACOG Florida District XII
August 11 -13; Orlando, FL

GOGS (Georgia Obstetrical & Gynecological Society)
August 24 -27; Amelia Island, FL

 


 

Going the Distance

By Kristine Hartvigsen on May 17th, 2017

Dr. James Murray readily admits that he was once “a typical overfed American physician.”

An OBHG hospitalist at Winchester Medical Center in Virginia, Dr. Murray said that he and his OB/GYN practice partner used to sit in their office and “talk about our poor cardiac family history and delude ourselves with thoughts about how it wouldn’t happen to us.”

After his partner passed away from a heart attack, Dr. Murray knew he needed to make some significant lifestyle changes, particularly with diet and exercise. So about five years ago, he began eating healthier and returned to the form of exercise he enjoyed most in his youth — running.

 

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Local Medical Association in CA Heralds OBHG Program

By Kristine Hartvigsen on May 16th, 2017

Central Coast Physicians magazine, a publication of the Central Coast Medical Association (San Luis Obispo and Santa Barbara, CA, counties), highlighted the Ob Hospitalist Group (OBHG) program at Sierra Vista Regional Medical Center in its Spring 2017 edition (p. 29).

Describing the Sierra Vista hospitalist program as “a new layer of safety for women who give birth at the hospital,” the article also noted that the facility now can accommodate vaginal birth after cesarean (VBAC), a procedure that is not available at most medical centers, especially those that lack fully staffed hospitalist programs.

 

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Motherhood and the Early Response Algorithm

By Kristine Hartvigsen on May 14th, 2017

Over time, experienced moms develop their own informal algorithms to prevent unwanted complications with their young ones. These internal systems help them decide whether or not they must immediately spring into action or continue making sandwiches.

For example, a toddler wants to wear cowboy boots and a Darth Vader costume to preschool. The mother’s mind goes through a series of pull-down menus:  Is it Halloween? No. Does the preschool have a flexible dress code? Yes. Is the ensemble compatible with the weather? Yes. Will wearing this outfit put my child’s life at risk? No.

Later that morning, as she waves goodbye to her diminutive dark lord, she has successfully avoided an exhaustive, time-consuming conflict with a determined child who is historically inclined to tantrum. She also has met her maternal obligation to keep her child alive.

On a more serious note, quick decision-making in the clinical sphere, likewise, is best achieved using a well-researched, fully vetted algorithm. Fortunately, hospitals across the nation are utilizing Maternal Early Warning Systems (MEWS) to ensure that rapid, life-saving intervention are taken should a medical crisis arise in the Labor and Delivery unit.

Studies have estimated that nearly half of maternal deaths in the United States are preventable and most likely the result of delays in recognition and treatment of hemorrhage, hypertension, infection, and venous thrombosis. In an effort to reduce maternal mortality, a panel of experts with the National Partnership for Maternal Safety identified a list of parameters to signal when urgent evaluation and escalation of care are needed. Characteristics the group recognized for its MEWS include:

• systolic BP  <90 or >160
• diastolic BP  >100
• heart rate; beats per minute  <50 or >120
• respiration; breaths per minute  <10 or >30
• oxygen saturation  <95%
• oliguria (low urine output); <30 mL
• maternal agitation, confusion, or unresponsiveness
• non-remitting headache or shortness of breath

A healthcare worker noticing that a patient is exhibiting abnormal vitals under these parameters must immediately report it to a senior physician or qualified clinician, who then should promptly conduct a bedside evaluation of the patient. At that time, any necessary emergency diagnostic and therapeutic interventions would be made.

A 2014 evaluation of the MEWS utilized at Columbia University Medical Center in New York found that the majority of alerts at CUMC — 80% — were from indications of:

• oliguria (low urine output), which can suggest renal failure or acute kidney injury
• severe hypertension
• tachycardia (abnormally fast heart rate)

It is fitting that National Women’s Health Week, May 14-20, 2017, begins on Mother’s Day. This year, we spotlight the MEWS as just one tool in our arsenal to ensure that pregnant women may have successful deliveries and enjoy many years of happy Mother’s Days.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

She Wrapped Him in Cloths and Placed Him in … a Baby Box?

By Kristine Hartvigsen on May 10th, 2017

As the Bible tells it, a virgin mother and her husband notably made due with just the modest means available to them to swaddle their newborn son. She wrapped him in cloths and placed him in a manger, because there was no guest room available for them. (Luke 2:7)

Not much was known in biblical times about prenatal care or safe sleep practices that can reduce the risk for Sudden Infant Death Syndrome (SIDS). Had he been born in modern times — in Finland, for instance — the baby Jesus may have been placed in a utilitarian cardboard box. Rather than gold, frankincense and myrrh, the gifts of the Magi more likely would have been diapers, wipes, and onesies.

Some 80 years ago, in order to address its record high infant mortality, the government of Finland began providing “baby boxes” to families with newborns. Expectant mothers in Finland have to meet just one condition before receiving the free boxes. They have to have at least one prenatal examination within the first four months of their pregnancies.

The coveted, cheerful boxes contain a manner of necessities for a baby’s first year of life, including clothing, hooded bath towel, bib, teething toy — and a thin foam mattress shaped to the box that can serve as a bassinet for the baby in its first few months.

The baby boxes continue to be a huge success in Finland, which now has achieved one of the lowest infant mortality rates in the world. And the practice is beginning to catch on in places like the England and the United States. So far, New Jersey, Ohio, and Alabama are among the first states to implement their own safe sleep box programs based on the Finnish model. In general, the states are using the program less as a prenatal incentive and more to educate families about safe sleep practices.

According to the Centers for Disease Control and Prevention (CDC), more than 3,500 babies are lost to sleep-related syndromes every year. The risk of SIDS is greatest between the ages of 2-4 months. Many parents, particularly in lower-income families, often sleep with their baby in the same bed with them, a practice that experts strongly discourage. These parents may not be able to afford a crib or bassinet, or they simply may not know about the risks that bed-sharing, or co-sleeping, poses to their infants. Safe sleep boxes are portable and more affordable than cribs. They are an excellent tool for educating parents about safe sleep practices and good parenting.

So far, feedback on the free boxes in the U.S. has been positive. Women who have received a baby box have expressed appreciation. One told National Public Radio: “You don’t have to research; you don’t have to text a friend. You just know it’s a safe place” to put your newborn to sleep.

As the practice continues to gain support, we may one day see safe sleep baby boxes delivered to celebrate every family’s blessed event.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

A Hospital Is …

By OBHG Marketing on May 8th, 2017

Just as we hope we’ll never need a hospital, we are immensely grateful it is there. A hospital represents safety. It represents trust. It provides comfort like knowing your mom is running behind you the first time you ride a bike without training wheels, ready to catch you before you fall.

A hospital is much more than bricks and mortar. A hospital is community. It’s the people who work there. It is every individual who touches the life of a patient.

Childbirth is the leading reason for hospitalization in the United States, accounting for more than 10% of hospital stays. The very nature of OB/GYN hospitalist work places our clinicians exclusively in the hospital setting. At Ob Hospitalist Group (OBHG) partner hospitals, the quality of Labor and Delivery care and the level of patient satisfaction are undeniably connected with our hospitalists. 

In 2016, OBHG clinicians attended 317,457 patients in the hospital setting, of which 118,618 were considered high-risk. They handled 34,899 life-saving emergent interventions, and delivered 27,483 babies. That’s a lot of opportunities to touch lives in the most meaningful way.

These patients are discharged home, into their close-knit communities, with a unique perspective that is directly linked with their childbirth experience. A positive perspective endears families to the hospital, and they are more likely to return to or recommend the hospital as future healthcare needs arise.

As we observe National Hospital Week (May 7-13, 2017), we salute every hospital worker, from the dietician, the administrator, and the lab technician to the physician, the nurse, and the unit clerk. Every individual in the hospital setting touches the life of a patient. Continuing clinical excellence and thoughtful humanity together help make the U.S. healthcare system the best in the world.

The maxim that patients don’t care how much you know until they know how much you care has never been truer. OBHG clinicians ultimately demonstrate how much they care through their sincerity and compassionate touch. As part of the greater hospital team, we extend warm thanks to everyone in the hospital setting who works diligently every day to provide patients with the highest-quality care and the best hospital experience possible.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Today, And Every Day, Thank A Nurse

By Kristine Hartvigsen on May 5th, 2017

Her name is Nanush Shakernia.

Had it not been for TV host Jimmy Kimmel’s recent monologue viewed by millions around the world (he is pictured here with his family and the new baby), no one may have heard of the attentive, quick-thinking nurse from Cedars-Sinai Medical Center in Los Angeles.

“Nanush,” as Kimmel informally calls her, was on duty the day William “Billy” Kimmel arrived in an otherwise routine birth at the hospital. The delivery had been nearly textbook perfect.

A few hours later, as the family gathered to coo at the new arrival, the observant nurse detected a heart murmur and noticed an unusual purple hue to the infant’s skin, an indication he was not getting enough oxygen in his blood. She immediately took action, calmly taking the baby to the Neonatal Intensive Care Unit for further evaluation.

After a series of tests, the NICU team concluded that the baby boy had a serious congenital heart defect called Tetralogy of Fallot (TOF). That diagnosis led to a transfer to Children’s Hospital Los Angeles, where the baby underwent successful surgery and, after some follow-up surgery and treatment, is expected to be fine.

Kimmel understandably chokes up when he tells the story. In his monologue, he gratefully recites the names of doctors and other members of his son’s care team. But the one name he most often and fondly references is Nanush.

Thanks to Nanush’s discerning eye and alert intervention, the days-old infant now has a favorable prognosis and outlook. “If it was a girl, we would have named her Nanush,” Kimmel gushed. “We really would have.”

National Nurses Week begins each year with National Nurses Day on May 6 and ends on May 12, which is Florence Nightingale's birthday. This year’s theme is “Nursing: The Balance of Mind, Body, and Spirit.” Stories like Kimmel’s abound, but they seldom go viral. Across the country every day, non-celebrity families quietly thank the nurses who have had such a powerful impact on their love one’s care. This is the time to celebrate and acknowledge their contributions. Nurses carry an enormous amount of responsibility, too often with little recognition. Together, let’s change that.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

The Versatility of Midwives

By Kristine Hartvigsen on May 5th, 2017

Despite centuries of development and increasing sophistication, midwifery remains a misunderstood profession by much of society. First, a midwife’s scope of service is not restricted to pregnancy and childbirth, as is commonly believed.

The American College of Nurse Midwives (ACNM) has long maintained that nurse midwives in reality are primary care practitioners. That’s because most midwives, working along a spectrum of skills and certifications, are trained to care for their patients in diverse settings across the lifespan.

In addition to attending births, most midwives are able to provide holistic wellness care, gynecological and sexual health care, family planning services, preconception care, postpartum care, and even healthy infant care.

Ideally, midwives maintain relationships with their patients from cradle to grave. In this context, they provide more than clinical care. According to the ACNM, they also support their patients who may be struggling with cultural, socioeconomic, or even psychological issues. They are trusted advocates for their patients while also offering a reassuring sense of peace and intimacy.

The popular PBS series “Call the Midwife” reflects a growing interest in the profession and fascination with its roots. As significant healthcare workforce shortages are anticipated, particularly in the area of OB/GYN, this is an opportune time to consider and embrace the services of talented midwives.

Where the industry has been examined, research consistently indicates that midwifery care encourages and increases breastfeeding among their patients and generally produces lower rates of cesarean births.

May 5 is International Day of the Midwife (IDM), an opportunity to express appreciation for midwives around the world and raise awareness about the wide spectrum of quality care they provide. Fittingly, the 2017 theme for IDM is “I Believe in Partnership.”

Ob Hospitalist Group proudly employs Certified Nurse Midwives (CNMs) to work collaboratively with the highly skilled obstetric teams in its partner hospitals. Without question, CNMs play a pivotal role in OBHG’s mission to elevate the standard of women’s healthcare.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

It Sometimes Starts With a Bad Headache

By Kristine Hartvigsen on May 4th, 2017

The fact that it may develop suddenly and quickly escalate to life-threatening levels is one reason preeclampsia is so feared. Because it is statistically uncommon (occurring in about 10% of pregnancies), many women don’t think it will happen to them. But you can be sure their OB/GYNs are monitoring for signs of preeclampsia during their prenatal visits.

Preeclampsia is a serious complication of pregnancy that is characterized by high blood pressure, proteinuria (excess protein in the urine), and edema (swelling of extremities). Unchecked, it could lead to liver or renal failure, future cardiovascular issues, stroke, and even death.

Preeclampsia most often occurs after the 20th week of pregnancy, and the only cure is delivery of the baby.

To monitor for signs of preeclampsia, OB/GYNs will check blood pressure and urine levels during every prenatal visit. They also may order blood tests to check for kidney or clotting functions.

In their article, “Management of Hypertensive Crisis for the Obstetrician/Gynecologist,” in the December 2016 issue of Critical Care Obstetrics for the Obstetrician and Gynecologist, Drs. Jamil ElFarra and James N. Martin Jr. write that a blood pressure at or greater than 160/110 mm Hg lasting longer than 15 minutes constitutes an emergency requiring swift attention and intervention.

Whenever possible, physicians want preeclamptic women to bring their pregnancies to term, but sometimes early delivery is indicated because of fetal distress. Preeclampsia can inhibit blood flow to the placenta and deprive the baby of oxygen and important nutrients.

Where the mother’s and baby’s condition allows it, prolonged bed rest until delivery may be ordered. Some women may be prescribed medication to control their blood pressure for the duration of their pregnancies.

In addition to elevated blood pressure, early symptoms of preeclampsia include severe headache, blurred vision, fatigue, rapid weight gain, swollen hands and feet, excess protein in urine or reduced urine output, shortness of breath, or nausea. Some women have no symptoms at all, so routine monitoring during prenatal visits is critical. Women should continue to be monitored for preeclampsia for 6 weeks postpartum because preeclampsia can emerge after childbirth. It’s called “late postpartum preeclampsia.”

Risk factors for preeclampsia include:

• first pregnancy
• history of gestational hypertension
• multiple-birth pregnancy
• preexisting hypertension or kidney disease
• obesity

Though there is no foolproof way to prevent preeclampsia, it is important that expectant women follow their doctor’s guidance about diet and exercise to keep risk as low as possible. Most OB/GYNs recommend that their patients reduce salt intake, drink plenty of water, avoid junk food, get adequate rest, do moderate exercise regularly, and reduce or avoid caffeine intake.

May is Preeclampsia Awareness Month. To help raise awareness and understanding, women across the country are bravely sharing their experiences with preeclampsia and related complications. Remember that most women can deliver a healthy baby if preeclampsia is detected early and treated with regular prenatal care. Vigilance is key.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Pregnant Women with Lupus Need Careful Monitoring

By Kristine Hartvigsen on May 1st, 2017

Without question, lupus can be debilitating. Many in the general public know little about the disease, and some believe women with lupus can’t have children. That’s absolutely not true.

With certain precautions, there is no reason a woman with lupus should not be able to have a normal pregnancy and healthy birth. Lupus pregnancies, however, are considered high-risk. In consultation with her doctor, a woman with lupus who is considering pregnancy is advised to plan carefully and, if possible, try to conceive after her lupus has been dormant (no flare-ups) for at least 6 months.

Lupus is a chronic, inflammatory autoimmune disease characterized by extreme fatigue, joint pain, facial rash, skin lesions, fever, headaches, or memory loss. It occurs when the body’s immune system goes awry, attacking its own healthy tissues and organs.

What causes lupus is unknown, though researchers are exploring the impact of hormones, genetics, and environment. Because 90% of lupus sufferers are women, scientists suspect the disorder may be related to the hormone estrogen. Researchers also have identified more than 50 genes associated with lupus.

Women with lupus are 50% more likely to give birth prematurely. They also have a higher risk for miscarriage and pre-eclampsia.

A number of medications treat the symptoms of lupus, and it’s important that women consult with their physicians on the pregnancy safety of the medications they are taking. If the prescriptions are not safe for pregnancy, they can be slowly weaned off of them and switched to a substitute medication that can alleviate symptoms and is safe for pregnancy.

Among medications commonly prescribed for lupus, corticosteroids have been considered safe in pregnancy in low doses. Further research on corticosteroid safety in pregnancy is still needed. One recent study found an increased risk for serious infections among pregnant women using high-dose steroids. Ultimately, the study concluded that pregnant women who receive high-dose steroids should be closely monitored.

Women with lupus who are hoping to conceive and give birth should be sure to be thoroughly evaluated prior to conception, be monitored throughout their pregnancies, and continue monitoring for up to 6 months after giving birth, because childbirth and breastfeeding can exacerbate lupus symptoms.

In observance of Lupus Awareness Month in May, supporters are encouraged to wear purple. In fact, May 19 is national Wear Purple Day. So don that purple dress, scarf, tie, or hoodie and express your support of lupus sufferers everywhere.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Introducing the ‘Pregnancy Medical Home’

By Kristine Hartvigsen on April 27th, 2017

Since the Institute for Healthcare Improvement introduced its “Triple Aim” initiative as an approach to health system improvement, it has become part of the industry lexicon.

Triple Aim proposes to 1) improve patient care experience, 2) improve the health of populations, and 3) reduce the per capita cost of healthcare. A commonly proposed approach to achieving those goals is the patient-centered medical home (PCMH), a system that manages the care of the patient ideally from cradle to grave, coordinating care across services and specialties as well as tracking individual patient progress over time.

A handful of states, including Texas, North Carolina, and Wisconsin, have implemented pilot programs that adapt this model specifically to maternity care. In fact, such a Pregnancy Medical Home (PMH) model tested in Texas was spotlighted at the Society for Maternal-Fetal Medicine (SMFM) annual meeting earlier this year in Las Vegas.

Study presenters concluded that Medicaid-covered women and their newborns who received perinatal care through a PMH had fewer emergency department visits and fewer inpatient stays — both before and after delivery — which resulted in significant savings to the state’s health insurance plan.

“The decreased need to use these services resulted in an estimated annual savings of over $800,000 for pregnant women and over $1.6 million for newborns,” explained Lisa Hollier, M.D., professor of obstetrics and gynecology for Baylor College of Medicine and one of the authors of the study. “We believe this model can readily serve as a national model for improved health care, substantial savings and improved outcomes.”

The study was published in the January 2017 issue of the American Journal of Obstetrics and Gynecology (AJOG).

North Carolina was among the first states to implement the PMH model. One result of the program was a reduction in NC low birthweight infants of 6.7% between 2011 and 2014. Among patients in the PMH program, an estimated 17% received same-day appointments, and 40% began their prenatal care in the first trimester.

The PMH model characteristically mirrors an integrated care model in terms of assigning a care coordinator (sometimes called a “nurse navigator”) to monitor and manage maternity care across multiple specialties at a single site. In addition to OB/GYN, this might include maternal fetal medicine, behavioral health, laboratory, and pharmacy.

Though the PMH model is relatively new, the concept is gaining momentum as a viable quality-enhancing, cost-reducing strategy for maternal health.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

  ©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

OBHG Presence Enriches Residency Programs

By Kristine Hartvigsen on April 24th, 2017

No resident wants to be thrown into the deep end of the pool. Teaching hospitals and their faculty don’t want that either. But in the fast-paced real world of a teaching hospital — when staffing levels can become strained and the care team is pressed for time — OB/GYN and family practice residents sometimes may feel like they struggle to stay above water. These are the times when service-oriented OB/GYN hospitalists provided through Ob Hospitalist Group (OBHG) can allay supervisory concerns at teaching hospitals, enrich residency education, and enhance safety and quality.

A critical component of our mission to elevate the standard of women’s healthcare is improving the skill set of any practitioners who may find themselves unexpectedly in an OB care situation. Nearly one-third of OBHG partner hospitals have OB/GYN or family practice residency programs. OBHG clinicians support these residency programs by fostering, facilitating, teaching, advising, and mentoring. They are committed to helping our partner hospitals sustain optimal residency programs by providing the time, expertise, and platform to share knowledge and technical skills.

The presence of OBHG clinicians improves residency program quality and reach as well as enhances patient care and the clinical scope of residency-sponsoring hospitals in the following ways:

Residency Faculty Extenders

OBHG hospitalists working in full-time programs are present 24/7 to provide additional onsite supervision of primary care residents. They impart evidence-based best practices and enable residents to obtain valuable hands-on clinical experience. Their presence provides residents access to high-risk, emergent OB/GYN expertise while relieving some of the clinical burden placed on faculty so they have more time for outpatient clinical practice, planning, research, or special projects.

Our physicians set up small group settings for teaching, lectures, and group case studies. They also coordinate with university academics to evaluate residents and provide feedback upon request. OBHG clinicians can provide guidance on managing OB triage and allow residents to participate in some uncomplicated deliveries.

Onsite Clinical Consultation

With an OBHG hospitalist onsite around the clock to give OB/GYN consultations, faculty members and community physicians can enjoy some needed relief from this constant on-call responsibility.

Quality Improvement and Patient Safety

Bringing with them the collective knowledge of a national network of more than 530 clinicians in over 100 hospitals, our highly skilled OBHG hospitalists help improve the safety and quality of both the care they provide and the resident care they supervise. Our risk management platform, SAFE, lowers overall hospital medical malpractice risk through an enterprise approach to risk reduction, quality improvement, and regulatory compliance. OBHG requires all of its hospitalists regularly to complete rigorous clinical and safety education bundles. They are always trained in the latest, proven medical knowledge.

Communication and Collaboration

OBHG hospitalists and residents participate daily in interdisciplinary rounds during shift change and patient handoff, a critical juncture when clear professional communication of each patient’s condition, diagnosis, and treatment plan is imperative.

Recruitment and Retention

The clinical safety net OBHG clinicians provide for hospital nurses and support staff reduces stress, improves morale, and enhances training. As a result, these professionals tend to stay on the job, strengthening retention prospects as well as attracting new staff who want to practice in this highly supportive and open teaching environment. In addition, having access to OBHG’s expertise in high-risk, emergent OB/GYN care is a strong magnet for new residents seeking OB/GYN subspecialty experience.

With OBHG supporting your residency program, the deep end of the pool will look less like a daunting challenge and more like a well of opportunity.

Learn more about the benefits and advantages OBHG brings to a hospital’s OB/GYN or family practice residency program. To speak to an OBHG representative, email Programs@OBHG.com or phone 800.967.2289. Download this document.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Understanding Infertility

By Kristine Hartvigsen on April 24th, 2017

Did you know that 1 in 8 couples in the United States struggles with infertility? As we observe National Infertility Awareness Week (NIAW, April 23-29), new information adds to the body of knowledge surrounding how some diseases — and the treatments to combat them — impact fertility.

A study published recently in the Proceedings of the National Academy of Sciences (PNAS) Journal suggests that a contraceptive agent, Müllerian inhibiting substance (MIS), may one day help preserve a woman’s fertility while she is receiving chemotherapy to treat various forms of cancer or serious autoimmune disorders.

Pregnant female mice in the study that received MIS during chemotherapy maintained higher ovarian reserves, meaning that the MIS temporarily prevented pregnancy during chemotherapy while preserving more ovarian follicles, which form eggs for possible later fertilization. Without MIS, those follicles would have been depleted to the point of infertility.

The Mayo Clinic estimates and one-third of infertility cases involve the male, one-third involve the female, and one-third either involve both or occur for unknown reasons. Age affects the fertility of both sexes. As we get older, particularly after age 35, we naturally begin to lose fertility. Other risk factors include obesity and smoking.

The theme for this year’s NIAW is “Listen Up,” because sometimes the best support you can offer those coping with infertility is to listen.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader has a medical concern, he or she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

A Full-Time Hospitalist’s Presence Benefits Laboring Mothers

By Kristine Hartvigsen on April 19th, 2017

Put yourself in a pregnant woman’s shoes. Would you rather give birth at a facility that has an OB/GYN hospitalist onsite around the clock to mitigate any possible childbirth complications or take your chances and hope a doctor can be summoned quickly by phone when you check in with full labor contractions at 3 a.m.?

There are major advantages to having a full-time obstetric hospitalist (often called laborist) onsite 24/7 in the Labor and Delivery unit (or Obstetric Emergency Department [OBED] if your hospital has one). Nearly 10% of births develop complications. While that may seem statistically small, it certainly looms large if you are one among the 10%.

A study published in the American Journal of Obstetrics and Gynecology (AJOG) examined data from a 550,000 cases and concluded that the employment of full-time hospitalists/laborists is associated with a fewer labor inductions and spontaneous preterm births. Preterm births remain this country’s leading cause of infant death. The advantage of having a hospitalist on hand is that the clinician’s sole focus is on the L&D unit without distractions or competing duties. This around-the-clock presence supports a natural progression of labor in uncomplicated pregnancies.

“The potential reduction in inductions could result from changes in practice behavior secondary to continuous coverage and less pressure to schedule deliveries for convenience because of office hours or personal conflicts,” the study’s authors wrote. It is important to note that labor inductions increase the risk for cesarean delivery. The study found that full-time hospitalists experienced about 5% fewer cesarean deliveries compared with traditional staffing models. Labor inductions in the United States have been on the rise, increasing from 9.5% in 1990 to 22.1% in 2004.

Overall, the study concludes that the hospitalist/laborist model shows promise and could lead to fewer adverse obstetrical outcomes and costs.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

How Our Legacy Lives On

By Kristine Hartvigsen on April 16th, 2017

There is always a hush in the delivery room until we hear the infant cry. That first breath confirms the miracle of life.

As Christians throughout the world celebrate the miracle of the resurrection this weekend, we are reminded how very precious and exquisitely beautiful life truly is.

Ob Hospitalist Group clinicians are thankful every day for the privilege of ushering new life into the world.

It is only appropriate that Easter comes in springtime, when colorful new buds awaken and reach out to greet the sun, when honey bees begin their dance of pollination, and the greening of fields and forests commences.

Despite our mortality, we are constantly reborn through our children. The gifts we bestow on them are carried forward long after we have gone. Our children, in turn, experience life anew through the eyes of their children. And the cycle of rebirth continues, generation after generation.

Ob Hospitalist Group wishes everyone a bright and joyous Easter holiday.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

To Burp or Not to Burp

By Kristine Hartvigsen on April 13th, 2017

Pediatrician Chad Hayes, MD, raised an interesting question on the KevinMD.com website earlier this year. Is it really necessary to burp a baby after feeding?

“Well, this is baby number three for me, and I’ve learned a thing or two from other people’s kids as well,” Dr. Hayes wrote. “I certainly wasn’t worried. But it did make me wonder if burping a baby does anything.”

Turns out, actual scientific research has been conducted on the subject.

Two researchers from the National Institute of Nursing Education compared the efficacy of burping versus not burping among 71 mothers and babies in the community setting. They focused on documenting incidences of colic and regurgitation between the burping and non-burping sample groups.

“Although burping is a rite of passage, our study showed that burping did not significantly lower colic events and there was significant increase in regurgitation episodes in healthy term infants up to 3 months of follow-up,” the researchers concluded.

While the sample size was small and probably warrants further investigation, the mere fact that any research on this subject exists astonished Dr. Hayes. He and his spouse decided to cease burping their youngest baby and see what happened.

“For what it’s worth, we stopped burping our baby three days ago. It saves us about 16 minutes per day. She hasn’t exploded or spontaneously combusted. She doesn’t seem any fussier than before. And while I’m not sure if she spits up less, it’s certainly no worse than before.”


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

Autism Diagnosis Remains an Inexact Science

By Kristine Hartvigsen on April 11th, 2017

April is Autism Awareness Month. In the past, there were many definitions and diagnoses for autism. Now all forms of autism are collectively diagnosed under Autism Spectrum Disorder (ASD). ASD is a developmental disability that impedes a person’s ability to communicate and interact with the world. As suggested by the word spectrum, symptoms can vary widely among those diagnosed.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 68 U.S. children have ASD. The exact causes of autism are not clear, but it occurs more often in boys than in girls. The CDC estimates that most children with autism have at least average intelligence; in fact, 46% have above-average intelligence.

While there is no cure for autism, it is treatable with therapy and, sometimes, medication.

Symptoms include difficulty communicating with others, inconsistent eye contact, isolation, repetitive behaviors (also known as “stimming”), the inability to be spontaneous or stray from routine without becoming upset, failure to respond when being summoned by name or gesture, repeating words and phrases heard without context, unusual or flat tone of voice, and difficulty understanding other people’s point of view or a seeming lack of empathy. Many with ASD also have hypersensitivity to light, color, and external stimuli.

Diagnosing ASD is an inexact science. So far, there is no medical or blood test for it. However researchers working to develop one. For now, healthcare providers generally observe a child’s behavior and development to make a diagnosis. Most children are diagnosed by age 4, and many show symptoms by age 2.

This month, as we raise autism awareness, it’s a good time to reach out to families coping with autism and offer your love and support.


This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader has a medical concern, he or she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.

UNC REX Hospital Shares OBED Success Story

By Kristine Hartvigsen on April 7th, 2017

Ob Hospitalist Group (OBHG) partner UNC REX Hospital in Raleigh, North Carolina, recently shared a website video conveying a happy story from its Obstetric Emergency Department (OBED). The video (at the bottom of the webpage) highlights the life-saving benefits of having an OB/GYN hospitalist onsite around the clock to handle all pregnancy-related situations, including this one involving a rare emergent complication called umbilical cord prolapse.

A month shy of her due date, Cameron Medlin woke up to use the bathroom. Almost immediately, she sensed that her umbilical cord had descended prematurely. Because the umbilical cord carries vital nutrients and oxygen to the baby, a prolapse can compress the cord, interrupting critical oxygen and blood flow and endangering the baby. Both Cameron and her husband, Daniel, knew it was an emergency and rushed to the OBED at UNC REX Hospital.

OBHG Hospitalist Dr. James Kendall was onsite that night and assisted Cameron’s private physician, Dr. Amy Groff, with the emergency C-section to deliver baby Wyeth. OBHG Team Lead at the hospital, Dr. James Hardy, appears in the video. “Every patient sees a physician here, just like in the Emergency Department,” Dr. Hardy said. “I think it adds an element of superior patient care.”

The Medlins could be any family seeking care at the OBED in the middle of the night. Their story is just one of many where a medical crisis was stabilized by expert, highly skilled clinicians on duty 24/7 in the OBED.

This blog provides general information and discussion about healthcare-related subjects. The content and linked materials provided are not intended and should not be construed as medical advice. If the reader is an expectant mother with a medical concern, she should consult with an appropriately licensed physician or healthcare provider.

 

©2017. Ob Hospitalist Group, Inc. All rights reserved. View our linking and republishing policies.