Impact of an Obstetrical Hospitalist Program on the Safety Events in a Mid-Sized Obstetrical Unit.

OBJECTIVE: Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit. METHODS: From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor. A full-time OB hospitalist program was implemented in October 2014. RESULTS: From October 2014 to December 2016, there was 1 safety event associated with labor and delivery. CONCLUSION: It has been speculated that implementation of an OB hospitalist model would be associated with improved maternal and neonatal outcomes; our regional OB referral hospital demonstrated a statistically significant decrease in OB safety events after the OB hospitalist program implementation.

Postpartum Contraception Use Rates of Patients Participating in the Centering Pregnancy Model of Care Versus Traditional Obstetrical Care.

OBJECTIVE: To examine whether postpartum contraceptive rates are higher in the CenteringPregnancy population as compared to patients who choose to participate in traditional prenatal care. Centering Pregnancy is a model of obstetrical care that allows for enhanced contraceptive education. STUDY DESIGN: All patients who were delivered within the Florida State University College of Medicine Obstetrics and Gynecology residency from October 31, 2010, to October 31, 2011, were included in the study. A retrospective chart review was undertaken to compare the postpartum contraceptive use of patients in traditional obstetric care versus patients in CenteringPregnancy. RESULTS: A total of 472 obstetrical charts were reviewed, with 350 women participating in traditional care and 122 women in CenteringPregnancy. Using Fisher's exact test, the 2 groups' postpartum contraceptive use was compared. Analysis revealed that 57.4% of CenteringPregnancy patients returned for postpartum contraception, vs. 37.7% of traditional prenatal care patients. Furthermore, 24.5% of CenteringPregnancy patients chose long-acting reversible contraception as compared to only 8.28% of traditional patients. CONCLUSION: Centering Pregnancy leads to an increase in use of postpartum contraception when compared to traditional prenatal care. Long-acting reversible contraceptive usage rates were also significantly higher among CenteringPregnancy patients and were the most frequently chosen method of family planning.

Interconception Care Opportunities for Mom and Baby.

IMPORTANCE: Interconception care provides an irreplaceable opportunity to address existing chronic disease and correct maladaptive health behaviors. OBJECTIVE: Utilizing the postpartum visit as an opportunity to improve interconception health and provide education to patients will not only improve the patient's life, but also impact any future offspring. EVIDENCE ACQUISITION/RESULTS: Optimization of interconception health has the potential to improve population wellbeing and reduce the societal burden poor birth outcomes. Evidence-based recommendations are described.

Centering Pregnancy: practical tips for your practice.

IMPORTANCE: With increased access to care, current health delivery systems will need expansion to meet higher demands and needs. PURPOSE: To define Centering Pregnancy and practical tips for implementation into both private and academic practices. METHODS/EVIDENCE ACQUISITION: Evidence was gathered through literature reviews. RESULTS: It was found that Centering Pregnancy offers a patient-centered, evidence-based approach to helping with access issues, as well as improving outcomes. CONCLUSIONS: This article describes the benefits of Centering Pregnancy to the practice, the provider, and the patient. RELEVANCE: Practical implementation tips will be offered, with suggestions for negating common implementation barriers.