The Geisinger leadership looked to improve its perinatal care program because of the differences in delivery that were impacting care at its varied locations. “Some are large hospital-based sites and some are small community practices with limited services and limited access,” Mateer said. “There was a large variation in how we were handling [perinatal] care, even at the same hospital. The hospital system worked to improve efficiency and process reliability,” he said.
Establishing standardization across the women’s service line was a key element to improve the program, Mateer said. That included everything from smoking cessation programs, initial prenatal and postpartum visits, postpartum screening, and patient education in each trimester. Significant improvements to perinatal care were wrapped around “delegating work to nursing and advanced practice providers, work that didn’t have to be done by physicians,”
said Ruth Nolan, PhD, RNC, vice president of operations, women’s health service line, for the Geisinger Health System. “We automated work, and we wanted to make it uniform throughout the system.”
In the process, hospital officials “encouraged staff to identify barriers that prevent meeting best practice standards.” They challenged the medical team to “think creatively” and “ask yourself if the team will follow the work flow.”
“It’s also about tailoring care specific to each patient. That helps us to avoid waste. We don’t just throw a blanket out there and try to do the same thing for everyone,” Nolan added.
Through the EMRs, Geisinger has been able to work with patients to manage diabetes in an effort to prevent them from being insulin dependent during pregnancy, Mateer said.