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"In our OBED every woman is now seen by a trained physician. Care has improved and we are capturing revenue that we weren’t before."
Between 2012 and 2014, cases of congenital syphilis tripled in California, with many clustered around the Central Valley and Kern County area. The staff at Bakersfield Memorial Hospital found that most women who gave birth to babies with congenital syphilis had no personal physician and received very little or no prenatal care before presenting to their hospital. Their understaffed Labor and Delivery triage unit often was the first and only caregiver these women had seen.
As a first line of defense against the disease, Bakersfield Memorial worked with Ob Hospitalist Group to establish full 24/7 Labor and Delivery triage coverage to ensure that a Board Certified OB/GYN physician is on hand around the clock to evaluate every at-risk pregnant woman and test her for syphilis (as required by California law upon first prenatal visit). If positive for syphilis, the OB hospitalist can prescribe antibiotics for the woman and prevent the disease from developing in her newborn. In an abundance of caution, OBHG’s hospitalists also test high-risk women for syphilis in the third trimester and at delivery.
“Previously we had lackluster coverage in OB for unassigned patients and drop-ins. … We had a lot of nurse deliveries,” said Dr. Rodney Root, Vice President and Chief Medical Officer at BMH. That is no longer the case.
When St. David’s North Austin Medical Center (NAMC) began experiencing upward-spiraling costs and a surge in uninsured and unassigned maternity patients, combined with a shortage of OB/GYN physicians, it aggressively pursued the most fiscally sustainable way to maintain and elevate the quality and safety of its women’s healthcare line.
After thorough vetting, NAMC officials in 2008 decided to partner with Ob Hospitalist Group (OBHG), the nation’s largest dedicated provider of OB/GYN hospitalists and the original architect of the Obstetric Emergency Department (OBED), to implement an on-site hospitalist program. OBHG’s highly skilled, Board Certified OB/GYNs now staff a dedicated OBED at NAMC 24 hours a day, 365 days a year.
Since its inception, the OBHG program at NAMC has enhanced the quality of its women’s healthcare in a number of ways, including recording fewer unattended births, increasing capacity in Maternal Fetal Medicine services, and improving postpartum hemorrhage protocols.
New York has seen a slow but steady downward trend in births for more than a decade. Currently, births statewide are down 7%, and births in the northeastern region of the state (where BWC is located) are down 11%. This situation has created intense competition for a shrinking patient pool among area hospitals that offer maternity care services. BWC officials wanted to maintain the hospital’s delivery volume in the midst of this extraordinarily competitive birth market.
OMC highly values its admitting physicians and in 2011 began seeking ways to further improve provider satisfaction and loyalty. In addition, hospital managers found themselves facing familiar challenges recruiting and retaining OB/GYN physicians as well as arranging for obstetric coverage in both the Labor and Delivery unit and the Emergency Department.
SHHP has a longstanding university-affiliated OB/GYN residency program. In 2014, the program needed to add faculty to ensure that residents continued to have exposure to quality, hands-on patient care. At the same time, because of some adverse events, the hospital’s OB risk profile was not meeting expectations.
“We had some serious safety events that were the direct result of physicians not being in the right place at the right time,” said Dr. Julie DeCesare, OB/GYN Residency Program Director at Sacred Heart. Dr. DeCesare had been providing stipends to private practice physicians to take OB call on nights and weekends. “Staffing a unit 24/7 is hard.” It wasn’t working well, plus the non-faculty doctors were not eligible to satisfy the program’s academic supervision requirements.
“One of the primary reasons we were brought in was bad outcomes,” explained Addie Taylor, Ob Hospitalist Group (OBHG) Director of Hospital Operations (DHO). “Before OBHG came into the picture in October 2014, Sacred Heart had on-call OB coverage but experienced more adverse outcomes than was optimal.”
Located on a spacious 94-acre campus, Palms West Hospital is a 204-bed facility that offers high-quality care for a full complement of healthcare services. Its women’s healthcare services include the New Life Center, a state-of-the-art obstetrics unit that features a Ob Hospitalist Group (OBHG) Type A Obstetric Emergency Department (OBED) staffed around the clock by OB/GYN hospitalists. Palms West is an HCA East Florida Affiliate.
With an already healthy regional lead in birth volume, St. Mary’s delivers approximately 2,200 babies per year. Its nearest competitor just three miles away, Community Hospital had stopped delivering babies in 2000 but recently completed construction on a new $50 million campus with an eight-bed Labor Delivery Recovery and Postpartum (LDRP) unit called The Birth Place, which began operating in 2016. Offering L&D services where it didn’t before in a shiny new facility, Community Hospital set out to challenge St. Mary’s regional dominance, and hospital leaders needed a strategy to maintain and grow their competitive edge.
St. David’s South Austin Medical Center (SDSAMC) is a 316-bed acute care facility that offers full-service maternity and newborn care with an NICU as well as Level I and Level II nurseries. Part of HCA Healthcare, SDSAMC logs more than 1,600 deliveries a year and is the community’s leader in maternity care.
An independent OB/GYN group planned to leave Willow Creek Women’s Hospital in northwest Arkansas, taking over 50 percent of the hospital’s deliveries with them. Hospital leadership knew they needed to make a change or else the hospital was at risk of closing. They enlisted the help of Ob Hospitalist Group to take over the obstetric emergency room coverage and to grow and retain volume.
We invite you to discover more about OBHG and the advantages that our customized programs deliver to our partner hospitals, physicians and patients. An OBHG representative would be happy to answer any questions you have as well.