Development of a Collaborative Partnership to Improve Communication and Access to Obstetric and Pediatric Patient Care Information for High‐Risk Referrals

Abstract

<h2>Poster Presentation</h2><h3>Purpose for the Program</h3> In a multihospital, high‐risk obstetric (OB) service with 3600 births annually, coordinating high‐risk consultations and having those consults available for review by more than 150 OB and pediatric providers in a semicomputerized system has presented many challenges. This program was developed to surmount the challenges of identifying high‐risk mothers and newborns, making patient care information available to OB and pediatric providers in a timely manner, and spanning the gaps created by two different health care organizations caring for obstetric and neonatal patients. <h3>Proposed Change</h3> An interdisciplinary task force of obstetric, pediatric, nursing, and administrative support staff met to discuss the issues related to identifying referred high‐risk newborns, communicating the plan of care and expected delivery dates, and making all consultations regarding mother and fetus available to all providers caring for those patients. These maternal and fetal referrals are generated by the OB and pediatric providers based on criteria that require care at a tertiary obstetric and/or Level‐III neonatal unit. A comprehensive plan was developed to address the gathering of patient care information, such as prenatal records, maternal/fetal medicine ultrasounds, pediatric subspecialty consults, and patient plans of care into one central, computerized document depository. This required obtaining necessary administrative approvals at both health care organizations, having the required computer application uploaded in appropriate areas, and providing continued support for access and informational issues. <h3>Implementation, Outcomes, and Evaluation</h3> The plan was implemented in December 2013 with education being provided to the OB and pediatric providers, nursing staff, and administrative staff. Multiple venues for education and assistance were offered. The administrative approvals, Health Insurance Portability and Accountability Act (HIPPA) compliance issues and computer application work in the two health care organizations proved time consuming but were finally completed. Because those hurdles were surmounted, the OB and pediatric providers have increased their utilization of the process and made several suggestions to further improve communication and access to patient care information. <h3>Implications for Nursing Practice</h3> Perinatal regionalization and access to tertiary levels of perinatal and neonatal care have improved outcomes and the survival rates of our mothers and newborns. The communication and collaboration fostered between these two separate health care organizations has played a key role in improving the quality of care for our obstetric and neonatal patients. This partnership between OB and neonatal staff has improved communication, improved relationships, and encouraged a new outlook on our shared patients.