Use of an Obstetric Collaborative Council to Support Obstetric Services in a Multihospital Merger

Abstract

To support the obstetric service in the merger of three hospitals into a single high reliability organization (HRO)–based health care system. To create a three-hospital obstetric collaborative council to promote communication, protocol discussion, and process revision using the HRO core principles of leadership, situational monitoring, mutual support, and communication. Using a monthly meeting platform that was already in place at NYU Langone Health (Tisch), each hospital's core interdisciplinary obstetric group was invited to join the OB Collaborative Council. Merger timeframes were staggered: NYU–Brooklyn, February 2017, and NYU–Winthrop, June 2018. The OB Collaborative Council’s communication was ongoing, with in-person meetings, e-mails, and online conference preparation. Situational monitoring was present and trust and confidence evident initially through professional respect (invitation and accepted invitation) and then by familiarity. Mutual support was shown through active conversation in agenda-filled meetings, regular attendance, sharing expert experience, and brainstorming process change. Leadership was evidenced at the main campus ( NYU Langone–Tisch) initially and then leaders from all of the sites emerged. Physical meeting space, refreshments, agenda, and minutes preparation evidenced system supports. Professional objectives achieved included regular (three-hospital) attendance, regulatory clarification, three hospital–one health care system electronic protocol platform updates, Joint Commission Perinatal Care Certification, and colleague-supported electronic medical record–transition. Interpersonal professional relationships were forged and continue among the three-hospital health care system. The OB Collaborative Council continues to meet monthly. The OB Collaborative Council at NYU Langone Health was and continues to be instrumental in supporting a three-hospital, professional obstetric team within a single, HRO-based health care system. Nursing professionals are the planners and organizers of this interdisciplinary platform and can guide and support small as well as systemwide changes. Awareness of the core HRO principles of leadership, situation monitoring, mutual support, and communication is important to quality and safety in health care.