Jami Walker is the Vice President of Maternal Health Access Solutions (MHAS) at Ob Hospitalist Group (OBHG). With 25 years of experience in healthcare operations, spanning both outpatient and inpatient settings, Jami was instrumental in launching the MHAS program two and a half years ago. The program focuses on providing customized healthcare solutions for hospitals and clinics nationwide, particularly in rural areas where access to care can be challenging.
In this blog post, Jami shares insights into the inception and functioning of the MHAS program, highlighting its flexible approach to scheduling, the variety of providers involved, and the unique challenges and successes encountered in rural healthcare settings. Through her personal experiences and professional expertise, Jami illustrates how MHAS is making a significant impact on maternal health access and improving care for women in underserved communities.
You have been with Maternal Health Access Solutions since its inception. How and why did MHAS come to be?
This topic is very dear to my heart. I grew up in a small town in Southern Illinois with a population of about 600 people. We had just a few bars, a gas station, a church, and no stoplight. Our community relied on a single critical access hospital, which made rural healthcare a deeply personal issue for me.
About two and a half years ago, OBHG was approached by a hospital in Louisiana with challenges that could not be addressed by our traditional 24/7 OB hospitalist model. We needed to find a flexible solution that was both cost-effective and tailored to their specific needs, so my team and I connected with our leadership team to see if we could think about our traditional program in a new way.
Around that same time, we were coming out of the COVID-19 pandemic, which had significantly impacted our workforce. While many physicians had joined us during the pandemic for stability, they began returning to their previous roles. When a physician becomes an OB hospitalist, it typically means giving up the GYN side of the service line, and many physicians prefer roles where they can use their full skill sets. With MHAS, we created a hybrid model where clinicians can continue practicing both OB and GYN. This approach helps maintain their skills, offers better work-life balance, and supports clinician retention. It was about adapting to the evolving needs of both the hospitals and the healthcare professionals serving them.
Logistically speaking, how does one of these programs function?
Traditionally, rural healthcare relies on a model where OB/GYNs must live close to the hospital to be on call, often requiring them to uproot their families and commit long-term. This schedule, which includes working in the clinic Monday through Friday and being on call every few days, can be a significant personal and professional sacrifice. The Maternal Health Access Solutions program challenges this dynamic by using flexible block scheduling, allowing physicians to come in for dedicated periods rather than moving permanently. This approach offers more work-life balance and ensures continuity of care, which is vital for building trust with patients.
MHAS programs also expand clinic hours, increasing access to care for women in rural areas. Physicians dedicated to specific blocks of time can fully immerse themselves in the community, offering high-quality care without the distractions of a traditional, overburdened schedule. This block system includes call time, ensuring that both clinic and hospital needs are met seamlessly. Overall, MHAS offers a hybrid model that balances the structure of a hospitalist role with the responsibilities of a generalist, providing tailored support that benefits both healthcare providers and the communities they serve.
How do you select the right mix of clinicians for an MHAS program, and how does the process differ from staffing a traditional OB hospitalist program?
Our approach is boutique-style, meaning we tailor each program to address the unique challenges a hospital is facing. The mix of clinicians varies widely because each solution is customized to the specific needs of the hospital. This can include a range of providers like nurse practitioners, certified nurse midwives (CNMs), family practice OBs, and OB/GYNs. There is no standard template; we take a holistic approach to customize each program based on the local needs, hospital bylaws, and clinic goals. In contrast, OB hospitalist programs are more standardized, typically featuring 24-hour in-house shifts with OB/GYNs as the core staff, though they might also include midwives or nurse practitioners.
Recognizing the program is new, are there any early success stories you can share?
Yes, there have been some significant successes. For instance, we helped a hospital in Danville, Illinois, reopen its labor and delivery unit after it had been closed for nine months. Our partnership was key in getting them the state approval needed to reopen. When a neighboring hospital closed just a few months later, we were able to help them pick up a lot of volume from that hospital, too.
Our involvement not only ensures that hospitals can continue serving their communities but also provides a much-needed safety net and reassurance for local residents and emergency services.
How has your background of living in rural communities been helpful for your role in leading the MHAS initiative?
Living in a rural area has significantly shaped my approach at OBHG. I currently live about an hour and a half outside of Houston, and while I enjoy the space, it can create real barriers to healthcare access. For instance, flooding from a recent hurricane turned a 30-minute drive to the nearest hospital into 90 minutes, highlighting the critical need for close-to-home care. Rural and smaller community hospitals are incredibly resourceful, often having to get creative with limited resources. I once called a hospital team “scrappy,” a term the CEO appreciated because it reflects their nimbleness and ability to pivot quickly.
This “scrappy” spirit is essential in rural settings, where handling a lot with limited resources is the norm. On snowy days, even the CEO might step in to help with tasks like passing trays. This hands-on mindset is unique to these hospitals. When recruiting, we seek physicians ready to take on various roles and think independently, unlike those who might prefer a more structured urban hospital environment. They need to be comfortable working with limited support and making quick decisions, while still having a network to lean on. Flexibility is key in these roles.
What do you hope to achieve in your role?
I am focused on preventing the closure or diversion of hospital departments and ensuring hospitals do not have to defer or turn away patients. I want to create a brand so recognizable that we become the top choice for this kind of partnership. I also want to gain a deeper understanding of federal funding to help hospitals navigate this process effectively, making it easier for them to apply for and utilize financial support.
The ultimate goal, though, is simply to improve access to care for women. Many women put their own health on the back burner because we’re juggling responsibilities, managing everyone else’s appointments—partners, kids, sometimes even pets—before our own. Obviously, OBHG is an obstetrical organization, but with MHAS, we aim to think bigger and wider. This program is really about making care accessible to women at every stage of their life, and I think that’s incredibly important.
Need a solution to ensure consistent care for your OB/GYN patients? Learn more about how OBHG’s MHAS program can help streamline operations and elevate patient outcomes at your hospital.