From Reactionary to Safer, Efficient Obstetrics Care
Blessing Hospital’s labor and delivery model was reactionary. When an OB patient arrived, a nurse performed an assessment and called to report to one of the eight community OBs. Typically, the OB would not come to the hospital unless it was a catastrophic situation. There was no real structure or consistency to this model, nor was policy that physicians had to see the patients. In December, Blessing implemented a full-time, Type A obstetric emergency department. Now, nurses feel more supported and confident, the community OBs experience fewer disruptions during the day knowing there is an OB physician in house and patients are receiving a consistently high standard of care.
Featured Speaker:
In Jamie’s seven years of nursing leadership, she has been on the leading edge of growth in women’s health services at Blessing Hospital. She and her team successfully launched the Women and Children’s Service line in 2020, bringing together OB, Pediatrics, and Women’s health into a streamlined service to optimize growth and serve the community. Jamie served as team lead when Blessing Hospital implemented a new OB Hospitalist program and new OBED in 2020, bringing safety to patients by including a board certified OB/GYN in labor and delivery 24 hours a day as part of the care team. The implementation of the OBED provided an additional layer of safety and peace of mind to every pregnant patient who presented to Blessing Hospital, affording every woman the ability to see a physician within minutes of arrive to the hospital. As a result of the OB Hospitalist program, the hospital has seen a reduction in the overall C-Section rate of nearly 4% and a successful Vaginal Birth after Cesarean (VBAC) rate of 80% within the first year.
Jamie Kane, RN, MSN, MBA
Jamie Kane is a Registered Nurse with a passion for leadership and advocacy. Jamie is the nurse manager for Maternal-Child Services at Blessing Hospital in Quincy, Il; with leadership in Labor & Delivery, OB Emergency Department (OBED), OB Hospitalist program, Postpartum, Nursery, Pediatrics, and Women’s Health. Her clinical background is in Labor & Delivery, where she has supported, and continues to support women in their birthing experience. Jamie has a Masters in Business Administration and a Doctorate of Nurse Practice in Executive Leadership.In Jamie’s seven years of nursing leadership, she has been on the leading edge of growth in women’s health services at Blessing Hospital. She and her team successfully launched the Women and Children’s Service line in 2020, bringing together OB, Pediatrics, and Women’s health into a streamlined service to optimize growth and serve the community. Jamie served as team lead when Blessing Hospital implemented a new OB Hospitalist program and new OBED in 2020, bringing safety to patients by including a board certified OB/GYN in labor and delivery 24 hours a day as part of the care team. The implementation of the OBED provided an additional layer of safety and peace of mind to every pregnant patient who presented to Blessing Hospital, affording every woman the ability to see a physician within minutes of arrive to the hospital. As a result of the OB Hospitalist program, the hospital has seen a reduction in the overall C-Section rate of nearly 4% and a successful Vaginal Birth after Cesarean (VBAC) rate of 80% within the first year.
Transcription:
From Reactionary to Safer, Efficient Obstetrics Care
Prakash Chandran: In December of 2020, Blessing Hospital of Quincy, Illinois, partnered with OB Hospitalist Group and launched a type A obstetrics emergency department. Their partnership with OB Hospitalist Group has added one important note to a large network of obstetrics care nationwide, and is an invaluable resource that elevates the standards of women's healthcare.
We're going to talk about it today with Jamie Kane, Maternal Child Services Nurse Manager of Blessing Hospital in Quincy, Illinois. This is the Obstetrics Podcast from OB Hospitalist Group. My name is Prakash Chandran. So Jamie, really great to have you here today. Maybe let's get started by you providing me with an overview of your patient population and your labor and delivery unit.
Jamie Kane: Sure. Well, thanks for having me. I'm happy to share a little bit about what we're doing here. So we are a hospital, a level 2 hospital, like you said, in Quincy, Illinois. We're kind of tucked in what we call the belly button of Illinois. We're kind of in a tri-state area, kind of tucked right in the corner between Iowa, Missouri, and Illinois. So we pool from a tri-state area. We do about just a little under 1100 deliveries a year from a pretty diverse population of patients. We see just a little bit of everything. Getting to see a little bit more higher acuity patients. Like much of the country, we're seeing a lot more addiction especially as we've seen the pandemic come up. So definitely seeing a lot more high acuity patients, a lot more comorbidities, which really sparked our interest in even more need for a program and interest in creating a partnership with OBHG. So we were excited about starting a partnership.
So like I said, we see all kinds of patients here. Predominantly, we deliver patients 34 weeks and greater here at our hospital. Anything prior to 34 weeks, we'd like to send off to our tertiary care centers, which are just about two hours away from us and St. Louis and Springfield, Illinois. So, with that kind of a distance, it's really important that we have a really great team of providers here on staff and some really exceptional nursing care which we have here with our staff and our partners at OBHG and our community physicians.
Prakash Chandran: Yeah, makes a lot of sense. And you started touching on this already, but what really prompted you to look for an outside partner to provide labor and delivery coverage? You know, you mentioned a couple of things, but maybe unpack that for us a little more.
Jamie Kane: Sure. So actually, this has been kind of a three-year dream, honestly, for me personally in wanting to do better for our patients, for our community, as far as women's health go. We knew that we could do more with our program and we could do better for our patients. One of the kind of unique things about being a rural hospital is we didn't have providers here in-house. That provided us the opportunity to have our nurses do a lot of their care here. And while that's wonderful and our nurses have done a fabulous job throughout the years, providing care to our patients, we knew that as our patients had greater comorbidities and became more acutely ill and presented with different things, and the need for care became greater and the access to care became more difficult for some of our patients. We knew that the need for our patients to see providers was going to become greater.
So we knew we wanted more. We began to having conversations about how we can meet those needs. And at about the two-year mark, we got more serious about how we could make that happen and afford opportunities for how we could make that happen internally. And we just couldn't come to a good agreement and we couldn't find a program that made sense for us internally. So we started looking at outside resources and we came across Scott with OBHG and it just really came together beautifully.
OBHG was able to present to us a package that just made sense for our community. It made sense for our providers, for our staff. It made the best sense for our patients. They were able to help us build a program that fit our needs, that could keep our patients safe, that could help us build a program that could help us deliver the safety that we were looking for to meet the needs of our patients. And we couldn't be more pleased with what they've helped us build for our patients.
Prakash Chandran: You know, one of the things that I wanted to ask was you were implementing this new program in the midst of the COVID-19 pandemic. What was that like?
Jamie Kane: Implementing anything in a pandemic is scary. And I think this was extra nerve-wracking. We didn't know what we were going to come into. Implementing in the middle of the pandemic was scary enough, but we still didn't know so many things just about the disease process of COVID-19 and what the implications of the disease process were on pregnant women, what it was for our staff when they got sick and our providers. And we're going to be able to successfully launch the program where we're going to have enough providers to staff it. We're going to be able to get licensing in place for our providers. What was going to happen to our patient population? Were they going to get sick? Whether we're going to be able to take care of them?
So there was a lot of anxiety around just launching a new program in and of itself, but then throwing the pandemic on top of it was definitely interesting. Getting people trained was a challenge. I think a lot of the things that normally you would do when you launch a new program, you would do in person. We had to improvise and do things virtually, so that presented a unique opportunity. All in all, I think it went very well. I don't feel like anything was hindered in the process. It just invited us to do things a little bit differently and we improvised and made it work. We made it.
Prakash Chandran: Yeah, absolutely. Now, you started speaking to this earlier, but let's talk about what impact this partnership has had. You know, maybe let's just start with patient safety and anything else that you want to bring up that's notable.
Jamie Kane: Right. So we'll start with the OB emergency department. So prior to implementation of our OBED and our relationship with OBHG and our hospitalist program, all of our nurses were doing all of our triages for our patients that walks in off the streets. So many of our patients when they came in were not being seen by a physician. They were being seen solely by our nurses. While they're wonderful and they're very skilled and they did a great job taking care of our patients, we all know there's a certain liability in that. And, you know, in the year 2021, we can do better. And we should be doing better. We wanted to give our patients more and our patients want more. They want to know when they're coming to a hospital they want to be seen by a provider and we want it to be able to give them that.
So with the implementation of our OBED, we went through all the processes and all the steps to create a licensed and registered OB emergency department with the state of Illinois. So now every patient that comes into our facility is registered with our OB emergency department and is seen by one of our OB hospitalists within a very timely timeframe and is assessed and then works collaboratively with our community physician and is able to be seen promptly. And we are getting really great feedback from our patients. They feel very well cared for. They really feel listened to, and we're able to promptly take care of them. And that's gone very, very well. It's been very well received by the community.
One of the other really great things that our community has been extremely excited about is the ability to be able to -- due to lack of VBAC here at our hospital, previous to the program, that's not something that we offered here. With the implementation of the program, now that's something that we electively do here in our organization, which is great. These women were leaving our community, traveling, you know, two, three hours from here to be able to do something that we all know is good for them to be able to deliver vaginally after a C-section for the right person. So we are thrilled that we're able to safely offer that here with the support of OBHG and our hospitalists here in the hospital. So that has been a wonderful addition to our hospital and to our community. And it's wildly accepted and talked about in our community and they're thrilled to be able to stay home and do that here.
Prakash Chandran: I love that. Yeah, that sounds amazing. What about the impact on your nurses or your community of OBs? Is that something that you can speak to?
Jamie Kane: Sure. I will tell you from a nursing standpoint, our nurses have never felt more confident and safe practicing in our organization. You look at nursing turnover and retention. We don't have that issue here in our organization any more because they feel supported. They know that they have providers here in the hospital who are working with them collaboratively, who are discussing patients with them who are looking at fetal monitoring tracings with them, who are working with them together to make sure that our patients are safely taken care of, who know that they are supported and they can reach out to them for assistance and who are working with them together. And that makes a difference. It takes that anxiety away.
Our community physicians know that they have support anytime of the day or night. You know, they're visiting the office, "Hey, can you help me with this?" They have the help. "Hey, I need to do a section. Can you help me?" "Hey, this looks really awful. Can you help me?" You know, "We have a hemorrhage." You know, we've had a couple instances, several instances actually, where, you know, things aren't well, and it's an emergency. And without hesitation, our hospitalists are jumping in and, you know, we've had some really great patient saves because a hospitalists have been here and I've been able to intervene immediately before our community physician can even get here. And that's something we've never had before. And you can't put a price on that and that's an amazing save for the program. And that's something that our physicians appreciate beyond measure and our staff. It's you can't put a price on that. It's amazing.
Prakash Chandran: I was just going to ask you have there been any big wins as a result of this program that you'd like to share. And it sounds like you've had a couple of life saves. Is that something you want to speak to?
Jamie Kane: Multiple. Yeah. We've had actually several postpartum hemorrhages and even intrapartum hemorrhages where our hospitalists have been here and have been able to intervene. Immediately start those hemorrhage protocols. You know, start the massive transfusion protocols. Get those bleeds under control.
I remember one case in particular, a footling breech came in. We were able to get that patient safely delivered. Obviously, that's something a nurse doesn't want to be in a position with. And we had a very experienced physician here. Our hospitalist was able to help with that.
Also, this is not necessarily a save, but one of our hospitalists, Dr. Colton has been able to bring the Jada system and helped us bring that in, which is a really amazing postpartum hemorrhage device that's really going to change the way that we treat hemorrhage here at our hospital. It just changes the whole treatment algorithm for hemorrhage. And, you know, we may not have done that if he hadn't been here. So it just changes the entire way that we're able to intervene and take care of our patients by having physicians here in house all the time. I just cannot say enough great things about it. We are so incredibly happy with our program and what we've been able to do for our patients here.
Prakash Chandran: Well, Jamie, I can tell you that it is always amazing to hear when a partnership has gone as well as it has for you. So just as we close here today, is there anything else that you would like to share with our audience regarding this partnership with OBHG?
Jamie Kane: It's just been an amazing journey. It's something that is so essential and the things that you're able to do with your patients when you work collaboratively with your providers to do what's best for your patients. It changes the game for your patients. It changes the game for your staff. And it's amazing and I'm almost speechless. It's just I wish we'd had done this so long ago.
Prakash Chandran: Yeah. Well, I think that is the perfect place to end. I really appreciate your time today, Jamie.
Jamie Kane: Thank you so much. I appreciate taking the time to talk with you.
Prakash Chandran: That's Jamie Kane, Maternal Child Services Nurse Manager of Blessing Hospital in Quincy, Illinois. To learn more about how to elevate care in your hospital's labor and deliver unit, visit obhg.com/hospital-leaders. Thanks for checking out this episode of the OB Hospitalist Group Podcast series. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.
My name is Prakash. Thanks again for listening, and we'll talk next time.
From Reactionary to Safer, Efficient Obstetrics Care
Prakash Chandran: In December of 2020, Blessing Hospital of Quincy, Illinois, partnered with OB Hospitalist Group and launched a type A obstetrics emergency department. Their partnership with OB Hospitalist Group has added one important note to a large network of obstetrics care nationwide, and is an invaluable resource that elevates the standards of women's healthcare.
We're going to talk about it today with Jamie Kane, Maternal Child Services Nurse Manager of Blessing Hospital in Quincy, Illinois. This is the Obstetrics Podcast from OB Hospitalist Group. My name is Prakash Chandran. So Jamie, really great to have you here today. Maybe let's get started by you providing me with an overview of your patient population and your labor and delivery unit.
Jamie Kane: Sure. Well, thanks for having me. I'm happy to share a little bit about what we're doing here. So we are a hospital, a level 2 hospital, like you said, in Quincy, Illinois. We're kind of tucked in what we call the belly button of Illinois. We're kind of in a tri-state area, kind of tucked right in the corner between Iowa, Missouri, and Illinois. So we pool from a tri-state area. We do about just a little under 1100 deliveries a year from a pretty diverse population of patients. We see just a little bit of everything. Getting to see a little bit more higher acuity patients. Like much of the country, we're seeing a lot more addiction especially as we've seen the pandemic come up. So definitely seeing a lot more high acuity patients, a lot more comorbidities, which really sparked our interest in even more need for a program and interest in creating a partnership with OBHG. So we were excited about starting a partnership.
So like I said, we see all kinds of patients here. Predominantly, we deliver patients 34 weeks and greater here at our hospital. Anything prior to 34 weeks, we'd like to send off to our tertiary care centers, which are just about two hours away from us and St. Louis and Springfield, Illinois. So, with that kind of a distance, it's really important that we have a really great team of providers here on staff and some really exceptional nursing care which we have here with our staff and our partners at OBHG and our community physicians.
Prakash Chandran: Yeah, makes a lot of sense. And you started touching on this already, but what really prompted you to look for an outside partner to provide labor and delivery coverage? You know, you mentioned a couple of things, but maybe unpack that for us a little more.
Jamie Kane: Sure. So actually, this has been kind of a three-year dream, honestly, for me personally in wanting to do better for our patients, for our community, as far as women's health go. We knew that we could do more with our program and we could do better for our patients. One of the kind of unique things about being a rural hospital is we didn't have providers here in-house. That provided us the opportunity to have our nurses do a lot of their care here. And while that's wonderful and our nurses have done a fabulous job throughout the years, providing care to our patients, we knew that as our patients had greater comorbidities and became more acutely ill and presented with different things, and the need for care became greater and the access to care became more difficult for some of our patients. We knew that the need for our patients to see providers was going to become greater.
So we knew we wanted more. We began to having conversations about how we can meet those needs. And at about the two-year mark, we got more serious about how we could make that happen and afford opportunities for how we could make that happen internally. And we just couldn't come to a good agreement and we couldn't find a program that made sense for us internally. So we started looking at outside resources and we came across Scott with OBHG and it just really came together beautifully.
OBHG was able to present to us a package that just made sense for our community. It made sense for our providers, for our staff. It made the best sense for our patients. They were able to help us build a program that fit our needs, that could keep our patients safe, that could help us build a program that could help us deliver the safety that we were looking for to meet the needs of our patients. And we couldn't be more pleased with what they've helped us build for our patients.
Prakash Chandran: You know, one of the things that I wanted to ask was you were implementing this new program in the midst of the COVID-19 pandemic. What was that like?
Jamie Kane: Implementing anything in a pandemic is scary. And I think this was extra nerve-wracking. We didn't know what we were going to come into. Implementing in the middle of the pandemic was scary enough, but we still didn't know so many things just about the disease process of COVID-19 and what the implications of the disease process were on pregnant women, what it was for our staff when they got sick and our providers. And we're going to be able to successfully launch the program where we're going to have enough providers to staff it. We're going to be able to get licensing in place for our providers. What was going to happen to our patient population? Were they going to get sick? Whether we're going to be able to take care of them?
So there was a lot of anxiety around just launching a new program in and of itself, but then throwing the pandemic on top of it was definitely interesting. Getting people trained was a challenge. I think a lot of the things that normally you would do when you launch a new program, you would do in person. We had to improvise and do things virtually, so that presented a unique opportunity. All in all, I think it went very well. I don't feel like anything was hindered in the process. It just invited us to do things a little bit differently and we improvised and made it work. We made it.
Prakash Chandran: Yeah, absolutely. Now, you started speaking to this earlier, but let's talk about what impact this partnership has had. You know, maybe let's just start with patient safety and anything else that you want to bring up that's notable.
Jamie Kane: Right. So we'll start with the OB emergency department. So prior to implementation of our OBED and our relationship with OBHG and our hospitalist program, all of our nurses were doing all of our triages for our patients that walks in off the streets. So many of our patients when they came in were not being seen by a physician. They were being seen solely by our nurses. While they're wonderful and they're very skilled and they did a great job taking care of our patients, we all know there's a certain liability in that. And, you know, in the year 2021, we can do better. And we should be doing better. We wanted to give our patients more and our patients want more. They want to know when they're coming to a hospital they want to be seen by a provider and we want it to be able to give them that.
So with the implementation of our OBED, we went through all the processes and all the steps to create a licensed and registered OB emergency department with the state of Illinois. So now every patient that comes into our facility is registered with our OB emergency department and is seen by one of our OB hospitalists within a very timely timeframe and is assessed and then works collaboratively with our community physician and is able to be seen promptly. And we are getting really great feedback from our patients. They feel very well cared for. They really feel listened to, and we're able to promptly take care of them. And that's gone very, very well. It's been very well received by the community.
One of the other really great things that our community has been extremely excited about is the ability to be able to -- due to lack of VBAC here at our hospital, previous to the program, that's not something that we offered here. With the implementation of the program, now that's something that we electively do here in our organization, which is great. These women were leaving our community, traveling, you know, two, three hours from here to be able to do something that we all know is good for them to be able to deliver vaginally after a C-section for the right person. So we are thrilled that we're able to safely offer that here with the support of OBHG and our hospitalists here in the hospital. So that has been a wonderful addition to our hospital and to our community. And it's wildly accepted and talked about in our community and they're thrilled to be able to stay home and do that here.
Prakash Chandran: I love that. Yeah, that sounds amazing. What about the impact on your nurses or your community of OBs? Is that something that you can speak to?
Jamie Kane: Sure. I will tell you from a nursing standpoint, our nurses have never felt more confident and safe practicing in our organization. You look at nursing turnover and retention. We don't have that issue here in our organization any more because they feel supported. They know that they have providers here in the hospital who are working with them collaboratively, who are discussing patients with them who are looking at fetal monitoring tracings with them, who are working with them together to make sure that our patients are safely taken care of, who know that they are supported and they can reach out to them for assistance and who are working with them together. And that makes a difference. It takes that anxiety away.
Our community physicians know that they have support anytime of the day or night. You know, they're visiting the office, "Hey, can you help me with this?" They have the help. "Hey, I need to do a section. Can you help me?" "Hey, this looks really awful. Can you help me?" You know, "We have a hemorrhage." You know, we've had a couple instances, several instances actually, where, you know, things aren't well, and it's an emergency. And without hesitation, our hospitalists are jumping in and, you know, we've had some really great patient saves because a hospitalists have been here and I've been able to intervene immediately before our community physician can even get here. And that's something we've never had before. And you can't put a price on that and that's an amazing save for the program. And that's something that our physicians appreciate beyond measure and our staff. It's you can't put a price on that. It's amazing.
Prakash Chandran: I was just going to ask you have there been any big wins as a result of this program that you'd like to share. And it sounds like you've had a couple of life saves. Is that something you want to speak to?
Jamie Kane: Multiple. Yeah. We've had actually several postpartum hemorrhages and even intrapartum hemorrhages where our hospitalists have been here and have been able to intervene. Immediately start those hemorrhage protocols. You know, start the massive transfusion protocols. Get those bleeds under control.
I remember one case in particular, a footling breech came in. We were able to get that patient safely delivered. Obviously, that's something a nurse doesn't want to be in a position with. And we had a very experienced physician here. Our hospitalist was able to help with that.
Also, this is not necessarily a save, but one of our hospitalists, Dr. Colton has been able to bring the Jada system and helped us bring that in, which is a really amazing postpartum hemorrhage device that's really going to change the way that we treat hemorrhage here at our hospital. It just changes the whole treatment algorithm for hemorrhage. And, you know, we may not have done that if he hadn't been here. So it just changes the entire way that we're able to intervene and take care of our patients by having physicians here in house all the time. I just cannot say enough great things about it. We are so incredibly happy with our program and what we've been able to do for our patients here.
Prakash Chandran: Well, Jamie, I can tell you that it is always amazing to hear when a partnership has gone as well as it has for you. So just as we close here today, is there anything else that you would like to share with our audience regarding this partnership with OBHG?
Jamie Kane: It's just been an amazing journey. It's something that is so essential and the things that you're able to do with your patients when you work collaboratively with your providers to do what's best for your patients. It changes the game for your patients. It changes the game for your staff. And it's amazing and I'm almost speechless. It's just I wish we'd had done this so long ago.
Prakash Chandran: Yeah. Well, I think that is the perfect place to end. I really appreciate your time today, Jamie.
Jamie Kane: Thank you so much. I appreciate taking the time to talk with you.
Prakash Chandran: That's Jamie Kane, Maternal Child Services Nurse Manager of Blessing Hospital in Quincy, Illinois. To learn more about how to elevate care in your hospital's labor and deliver unit, visit obhg.com/hospital-leaders. Thanks for checking out this episode of the OB Hospitalist Group Podcast series. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you.
My name is Prakash. Thanks again for listening, and we'll talk next time.