Before launching the program, hospital officials weren't satisfied with performance of their perinatal program. "There was a lot of variability in the system," Mateer said. "We decided we had to redesign, from the ground up, all aspects of provider workflow." The Geisinger system handles about 5,000 pregnancies and 4,500 annually, with 75 clinicians at 24 clinic sites.
Under the Perinatal ProvenCare model, at least 100 "evidence-based elements of care are incorporated, measured and tracked for compliance," according to Mateer. That includes EMR. For instance, the hospital system created a record system known as eForms that enable nurses and providers to complete documents that reflect care coordination, for instance, Mateer said.
"It's about tailoring care specific to the patient. That also helps us avoid waste. We don't just throw this blanket out there and try to do the same thing for everyone," Nolan said.
The hospital system has increased patient safety, reduced documentation redundancy, streamlined patient education and reduced costs, Mateer said. Implementing improved education programs, one of the Geisinger hospitals, the Geisinger Wyoming Medical Center, Wilkes-Barre, PA, reduced caesarian section deliveries by 32% from 2008 to 2010.
Generally, to improve care, health systems need to initiate change, but it's not easy, Nolan said. "It's about doing things very differently than what we have done in the past," she said. "Another unfortunate truth in healthcare is the assimilation of best practices is painfully slow."