OB hospitalists play a vital role in managing obstetric emergencies, evaluating patients in the obstetric emergency department (OBED), covering labor and delivery, seeing unassigned obstetrical patients and backing up community providers. Especially in recent years, we’ve seen OB hospitalists’ scope of practice expand even further to include a greater focus on safety.
With growing pressures on hospitals to address maternal mortality and implement standard labor and delivery protocols, OB hospitalists are evolving to become the maternal safety champions of the entire labor and delivery unit. At OBHG, we recognize that our clinicians are uniquely positioned to recommend and implement proactive strategies not just for our own hospitalist teams, but in collaboration with hospital leadership and the entire organization’s labor and delivery clinicians (such as community OBs, nurses, CNMs, MFM specialists, surgeons, anesthesiologists and others). Given that OB hospitalists are in the hospital 24/7, OB hospitalists have the unique opportunity to positively impact the safety and care of all labor and delivery patients.
Benchmarking effort measures OB hospitalist involvement
In January 2021, OBHG kicked off a new benchmarking effort that showed that hospitals that “hard-wire” the involvement of OB hospitalists in patient care have a pervasive culture of team-based care and position OB hospitalists as the maternal safety champions of the entire labor and delivery unit. The assessment also revealed that there are opportunities to get OB hospitalists more actively engaged in all patient care on labor and delivery.
To assess the level of OB hospitalist engagement at OBHG’s hospital partner programs, OBHG’s onsite clinical leaders received completed an assessment named “HERAld” (a name inspired by Greek Goddess Hera’s role of protecting women in childbirth). The tool evaluated eleven behaviors, ranging from the level of participation in multi-disciplinary board rounds to the typical response times for significant changes in patient signs or symptoms. The results of OBHG’s benchmarking efforts were recently highlighted in the Journal of OB/GYN Hospital Medicine.
“Our data shows that two-thirds of risk and medical malpractice events on the unit occur when the OB hospitalist is not the primary physician or midwife,” said Dr. Mark Simon, OBHG Chief Medical Officer. “There is clear opportunity for OB hospitalists to become involved in care earlier to improve safety across the unit. In our HERAld assessment, the highest scoring hospitals consistently focus on patient care with the mentality that every physician, midwife and nurse on the unit share responsibility for patient outcomes. In these hospitals, OB hospitalists truly flourish and make a difference as the maternal safety champions of the entire labor and delivery unit.”
OBHG is using the benchmarking results to drive culture change at the hospital level. The assessment was repeated in early 2022, and we are looking forward to tracking year-to-year change using this important measurement tool. Click here to read the Journal of OB/GYN Hospital Medicine article to learn more about the process and results.