January 23, 20131/23/2013
Northeast Georgia Medical Center (NGMC) was recently selected to be “blueprinted” by VHA Inc. for its success in addressing early elective deliveries (EEDs) of newborns. An EED is an induction of labor or Caesarean Section initiated without medical reason before 39 weeks gestation. Through the blueprinting process, VHA tracks the clinical performance of VHA member hospitals over consecutive quarters and identifies the leading performers. VHA then conducts a site visit and participates in direct observation of all care practices to capture important factors that influence better care. These blueprints are then shared with member hospitals to help increase the quality of care of all member hospitals.
While many hospitals nationally are at a 15% or higher EED rate, NGMC’s rate is below 5%. It is the first hospital in the nation within the VHA membership to be blueprinted for successful reduction of EEDs.
NGMC reduced its EED rate through a physician-led initiative of universal agreement among providers and consistent education of patients to achieve success.
The reduction of EEDs is important for the wellbeing of newborns, says Holt Harrison, MD, an OB/GYN with Northeast Georgia Physicians Group Heritage OB/GYN and one of the physician champions of the program.
“A baby’s brain, lungs and liver are still developing in the last few weeks of pregnancy,” says Dr. Harrison. “Studies show that delivering before 39 weeks can put babies at risk for problems such as respiratory difficulties, feeding issues, jaundice, temperature instability and low blood sugar. These conditions can mean additional testing, monitoring and therapy for babies and in some cases, admission to the neonatal intensive care unit. By encouraging mothers to wait to deliver until at least 39 weeks, we can help avoid these health risks for newborns.”
In the final weeks of pregnancy, many mothers grow more and more uncomfortable and become anxious to deliver. Some also prefer a scheduled delivery for planning reasons with family. In years past, many physicians were agreeable to elective inductions in the final weeks of pregnancy because in many cases, babies still were born healthy.
“However, as more research has been conducted, we’re seeing that while rates of these problems may be small on a practice or hospital level, when looking at them across the country, we’re seeing large numbers of babies dealing with unnecessary complications due to early delivery,” says Dr. Harrison. “Plus, even small statistics make a difference when your child is the one with problems. If there’s no medical necessity, why take the risk?”
National organizations are promoting this practice as well through community education, including the Association of Women's Health, Obstetric and Neonatal Nurses’"Go the Full 40" campaign, launched in January 2012, and the March of Dimes’ Healthy Babies are Worth the Wait campaign. These educational campaigns are designed to help women understand the many reasons it’s important for a mom to carry her baby to term—to cross that important finish line. NGMC provides links to these educational materials through their website, www.nghs.com/women. But more importantly, says Sara Dyer, RNC, director of Women & Children’s Services at NGMC, the physicians and midwives on staff at NGMC are committed to providing this education one-on-one in their offices.
“Our ability to achieve such a low EED rate is due in large part to the work of our physicians and nurse midwives, as they guide the discussion of an elective delivery with their patients,” she said. “Their support and leadership, along with the work of our staff, has made this possible, which is a great accomplishment for our hospital, and more importantly, our patients.”
The effort to reduce EEDs was led by a physician and clinical staff team. In addition to Dr. Harrison and Dyer, members included Greg Martin, MD, an OB/GYN with Northeast Georgia Physicians Group Lakeside OB/GYN and chair of the OB/GYN Department; Suzanne Jackson, CNM, a certified nurse midwife with the Center for Women’s Health at The Longstreet Clinic; Bridgette Schulman, RNC, Labor & Delivery nurse educator; Heather Standard, RNC, manager of Labor & Delivery; and Candice Hollified, RNC, CPN Administrator.
During the VHA Blueprinting process, a VHA team visited NGMC and met with the EED committee members. Through a series of interviews and presentations by the NGMC physicians and clinicians, VHA mapped out, or blueprinted, the process to visually display the steps that allowed NGHS to achieve success. These blueprints are now available on VHA’s website for use by other member hospitals.
“We are honored to be chosen by VHA as a national model for reduction of EEDs,” says Dr. Martin. “This is a testament to the dedication of our physicians, midwives and clinical staff to the very best care for our patients – even if that position might not always be the most popular. Our ultimate goal is a healthy mom and a healthy baby, and we’re doing everything we can to help achieve that goal. We’re proud that VHA has recognized us as a leader in obstetric care.”
For more information about obstetric services at NGMC and educational information about reducing EEDs, visit www.nghs.com/womenor call 770-219-1495.