PQCNC SIVB2 LS2 Keys to High Performing Teams
Transcript of PQCNC SIVB2 LS2 Keys to High Performing Teams
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WhoisVidantHealth?
VidantHealthSystemsisanetworkof10hospitalsacrosseasternNorthCarolina
VidantMedicalCenter(formerlyPi@CountyMemorialHospital)- 861licensedbeds- AffiliatedwithEastCarolinaUniversityBrodySchool
ofMedicine
- Theregionalteraryreferralcenterfor29counesineasternNC
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WomensServicesatVMC
ProvidelowriskObstetricandhigh-risk
Maternal-FetalMedicineservices
Approximately3800deliveriesannually
Environment:- 11LDRPs- 12LaborRooms - 4OperangRooms- 2bedPACU- 3bedTriage- 12bedAntepartumUnit- 28bedMother/BabyUnit- 16bedConvalescentNewbornNursery- 50bedNICU
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VidantChildrensHospitalSummer2013
OpeningnewChildrensHospital
Summer2013
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OurProviders
ECUBrodySchoolofMedicine Maternal-FetalMedicineSpecialists Ob/GynPhysicians CNMs
Pediatricians Neonatologists NeonatalNursePraccioners FamilyMedicinePhysicians FamilyNursePraconers PediatricSubspecialistssuchassurgery,urology,
oncology,etc
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- Privatepraccecommunity Obstetricians Pediatricians CNMs FamilyNursePraconers
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WomensServicesPrograms
- LactaonConsultants7daysaweek- MaternalExpressionsBreaseedingBouque
- OutpaentLactaonSpecialistsconsultaons
- BreaseedingSupportGroup- PerinatalandNeonatalOutreach
- HopefulBeginningsPostpartumSupportProgram
- VolunteerDoulaProgram
- Classesandtours
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Someachievements
FamilyCenteredMaternity-NewbornCare
(mother/babycoupletcaremodel)
BantheBagsAward-2009
BreaseedingFriendlyWorkplaceAward-2011
LactaonCareAward-2011
ReceivedBabyFriendlyHospitaldesignaon-December,2011
NCMaternityCenterBreaseedingFriendlydesignaon-
December,2011
InvolvementwithPQCNC-NICUandWomensServices
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SIVBTeamMembers
ElaineClark,PerinatalClinicalNurseSpecialist Dr.JimdeVente,ObMedicalDirector
DawnArnold,L&DInformacsRN
KimberlyHarper,PerinatalOutreach
MicheleMusella,L&DManager
AngelaSll,Administrator
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Wheredowestart?
- 39weeksiniavewasmucheasier- SupportforIntendedVaginalBirth
notsomuch!
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Takealookinthemirror
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Clinicalcourage
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TeamMeengs
InialTeammeeng TeamparcipatesinSIVBWebinarstogether A@endSIVBLearningSessionstogether
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PracceChanges
LaborSupport- PrivatepracceDoulas
- ImplementedavolunteerDoulaprogramonweekends,DOVE
- Doulasprovidedinformaonatourskillsday
- Encourageduseofbirthingballandhydrotherapy- L&DManagerhasaPhDinIntegraveMedicine
andusesrelaxaon,Reiki,andaromatherapywith
paents
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- Purchasedremotefetalmonitorequipmenttoincreaseambulaoninlabor
- ImplemenngAWHONNPerinatalStaffingGuidelinestoareatthebedside
- Useofpeanutballforpaentswithepidurals
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ThePeanutBall?
BannerGoodSamaritanMedicalCenter,Phoenix
- Paentswithepiduralswhousedthepeanutballdecreasedthefirststageoflaborbyalmost90minutesandthesecondstageby23minuteswhen
comparedtothecontrolgroup
- C-seconratewas13%lessforthepaentswithepiduralswhousedthepeanutballcomparedtothosewhodidnot
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InduconofLabor
ChangedtheInduconofLaborGuidelinefornulliparouspaentsto40-41weeksgestaon
DistributedPQCNCposterstoproviderofficesandplacedinTriage
Providedtalkingpointsforprenatalproviderssuchas:- Ifptisatleast4cmdilatedonadmissiontoL&D,thereisa
1in10chanceofaC-secon
- Ifaptisinducedthereisa1in3chanceofaC-secon
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DataEntryandDistribuon
ElectronicBirthLog- DawnArnoldentersdatafor40chartspermonth- Eitherusefirst15daysofthemonthorlast15daysofthe
month
Dataisshared- ObExecuveCommi@ee- Ob/GynDeptMeengs- Staffmeengs- VidantHealthWomensClinicalIntegraon- PerinatalOutreach
P t d i@ d i l b
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Paentsadmi@edinlaboraverage46%(130of285)
O ll C t
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OverallC-seconrateaverage-22%(63of285)
C t f t d i@ d i l b
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C-seconrateofptsadmi@edinlaboraverage-10%(13of130)
C t f t d i@ d t i l b
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C-seconrateofpaentsadmi@ednotinlaboraverage-32%(49of155)
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PrimaryindicaonforC-secon
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OverallC-seconrateandpayor
C-Section Rates Overall and By Payor
0
5
10
15
20
25
30
35
40
45
Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12
SampleSize
0%
10%
20%
30%
40%
50%
60%
Rates
Sample (N=285)
All Payors (n=62)
Private (n=20)
Other (n=13)
Medicaid (n=29)
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NextSteps
- Researchstudyusing
PeanutBall
- EncourageuseofDOVEprogram
- ConnuepursuitofmeengAWHONN
staffingguidelines
- Monitorinducons- Connueevaluaonofdata