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Teamwork is the watchword on the Labor and Delivery units in OBHG partner hospitals, and at UCHealth’s Memorial Hospital Central in Colorado Springs, the facility and hospitalist team have extended that teamwork mentality to their community’s midwives.
Amber Rossman, RN, nurse manager at Memorial Hospital Central’s Birth Center, has cultivated positive relationships with community midwives and other providers for nearly two years. Rossman and Dr. Renee Lockey, OBHG team lead at Memorial Hospital Central, spoke about the success of the outreach program.
Laying a foundation
The hospital began the collaboration with the goal of creating a safe transfer environment for patients who had not originally planned for a hospital birth experience, says Rossman. “Varying types of birth services in a community intersect during crucial times for a mother and unborn child."
She notes that hospitalists are uniquely positioned to partner with the hospital and community maternity care providers to serve all patients. There is no perception of competition, since OBHG is dedicated to providing inpatient services only.
“This improves the ability of the hospital to build solid relationships with the community midwives," she says.
Inclusion and respect
The hospital team initially solicited midwives’ input through a questionnaire and later through dialogue and feedback, says Lockey.
UCHealth Memorial Hospital Central holds bi-annual informational meetings for community midwives and up to 18 community providers attend each session, says Rossman. There are now 35 community midwives on the contact list. Connecting with these midwives is important because the hospital’s location, El Paso County, has the highest rate of home births in Colorado.
Lockey says midwife involvement in planning the transfer standards and the treatment their patients receive has resulted in a favorable opinion of UCHealth Memorial Hospital Central’s Labor and Delivery program. The hospital used the Homebirth Summit’s best practice guidelines for transfer from a planned home birth to the hospital to develop the standards.
“We do not make any statements on whether we agree or disagree on any particular kind of care. We make sure that when a client is brought to our doorstep, we treat everyone respectfully, we are welcoming, and we provide the best care to that patient,” says Rossman.
Lockey adds that UCHealth and Ob Hospitalist Group share a mission to be compassionate and nonjudgmental recipients for all patients.
The hospital consistently receives positive feedback about birth experiences from the transferred patients, Rossman notes. In addition, the community clinicians are invited to share their recent transfer stories at the hospital-hosted meetings.
“We continue to hear positive feedback that they were well-received, they were heard, and their clients’ wishes were respected," she says. "They’re coming to us for interventions and those interventions are being discussed in a positive direction and consent is being obtained."
The outreach effort has created a favorable perception, allowing some longtime community midwives to overcome past hospital transfer experiences, says Lockey. The area has three hospitals offering Labor and Delivery services and the local midwives deliberately choose Memorial Hospital Central. Lockey credits this trend in part to hospital outreach efforts and “the reputation we are achieving in providing good, safe, and respectful care.”
"As this round table builds trust that client's requests and birth wishes will be respected and heard, it in turn supports good clinical judgment decisions on transfer," says Rossman. "Our community midwives are 100 percent accountable for their transfer decisions and the hospital is 100 percent accountable for providing safe and effective receiving environment." “They see the respect offered to the patients and are often quicker to transfer when help is needed."
“Patients appreciate that we function as a united team when a patient arrives and we assume their care,” says Lockey.
Extending the benefits
Treating these transfer patients is prompting the Labor and Delivery unit to look at how it can make changes in maternity services at the hospital, including postpartum care, says Rossman.
“This population of patients challenges us as providers to practice in an evidence-based way,” Lockey adds. "They are often well-educated and in favor of alternative or more natural practices. Patients who were anticipating a home birth experience challenge the hospital team to consider if our practices really are best practices, and to explain the rationale behind what, when, and why we do what we do. Overall, I believe this moves us in a good direction for the safety of both mom and baby."
Lockey hopes that other hospitals will consider similar initiatives. “It’s a win overall for women to collaborate with this group,” she says. “I give kudos to UCHealth for leading in this area. It’s satisfying to be a part of something collaborative and cooperative that is creating a positive change in our city.”
Photos: above right: Dr. Renee Lockey, middle: Amber Rossman, below: the Memorial Hospital Central campus