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Get Ahead of the Policy-Reinforce Quality Maternal Care

June 2nd, 2022
June 2nd, 2022

This blog post is taken from a recent webinar moderated by HealthStream’s Beth Pfeifer. The webinar featured Tanesha Riley, MS, RNC-OP, CCE and Ashley Inman, BSN, Solution Executives for HealthStream’s Child and Maternal Health Portfolio. As nurses and mothers, both Riley and Inman are personally and professionally committed to child and maternal health issues.
 
The Centers for Medicare and Medicaid Services (CMS) recently announced additional details on the “Birthing-Friendly” Hospital Designation. The initiative is part of the Biden-Harris Call to Action to reduce maternal mortality and morbidity. The designation is intended to assist consumers in choosing hospitals that have demonstrated a commitment to maternal health through implementation of best practices that advance health care quality, safety, and equity for pregnant and postpartum patients.

The Need for Improvement

Both Riley and Inman point to the now familiar, but still shocking statistics around maternal morbidity and mortality. “The United States remains in last place of all developed, high-resource countries,” said Riley. “In addition, 74% of all obstetrical claims are related to poor clinical judgement and 34% of maternal deaths and injuries are due to inadequate monitoring,” she added.
 
The “Birthing-Friendly” Hospital designation will put a spotlight on hospitals that are performing well on key obstetrical metrics – and those that are not. “The Biden-Harris administration, in partnership with CMS, plans to invest $3 billion in new maternal health funding as part of the Build Back Better Act,” explained Inman.
 
The time to act on improving key obstetrical outcomes is now. So where should hospitals start?

Solutions To Get Ahead of the Policy

HealthStream’s Quality OB Program can help hospitals get ahead of this policy with a powerful data-driven program that will help maximize team-based performance in obstetrics. Each module includes a pre-assessment, a post-test and microsimulations that help clinicians develop their critical thinking skills. The program is based on an incremental, high-frequency approach to learning. The Quality OB program includes content that addresses the following six key competencies:

  • Electronic Fetal Monitoring (EFM) – The EFM series was developed using the latest science in alignment with the National Institute of Child Health and Human Development (NICHD), the American College of Obstetricians and Gynecologists (ACOG) and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). It includes content that is appropriate for beginner, intermediate and advanced clinicians and because it is based on an adaptive learning process, the timeline to competence is shorter than you might expect. 
  • Hypertension in Pregnancy – Modules in this section help learners to define and identify the different risk factors for hypertension in pregnancy. Nurses will also learn how to assess patients and identify the appropriate management and treatment for these patients.
  • Postpartum Hemorrhage – This section will help learners understand the leading causes of postpartum hemorrhage, as well as how to use risk assessment and stratification to equip nurses to intervene early before a situation becomes critical.
  • Shoulder Dystocia – This section addresses the pre-existing conditions that contribute to shoulder dystocia, maneuvers to release shoulder dystocia and what to do after shoulder dystocia. It also addresses charting and communication strategies that will help protect patients, nurses and providers.
  • Trial of Labor After Cesarean (TOLAC) – Modules in this section address when and why Cesarean-sections may be necessary, and the risks and benefits associated with vaginal birth after cesarean section (VBAC). It also includes material on communication to help the clinical team discuss the issue amongst each other as well as with patients and families.
  • Effective Communication and Disclosure – Modules in this section address barriers to communication and strategies for overcoming those barriers as well as best practices on disclosing adverse events. Communication between caregivers as well as communication between caregivers and patients is covered in this section.

 
In addition to these six topics, there is a behavioral health bundle that will help providers address the increasing incidence of opioid abuse in the maternal population. This bundle has content that will help providers recognize and treat neonatal abstinence syndrome (NAS) as well as how to recognize the signs and symptoms of maternal depression and anxiety. It can also help address some of the underlying biases that may be held by providers when dealing with opioid-dependent maternity patients.

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