Maternal mortality and severe maternal morbidity rates continue to rise in the U.S., especially among women of color. According to ACOG, the goal of establishing maternal levels of care is to reduce maternal mortality and morbidity “by encouraging the growth of systems for the provision of risk-appropriate care specific to maternal health care needs.”
Ob Hospitalist Groups’ (OBHG) hospital partner Baptist Health South Miami Hospital was recently named a Level IV Maternal Care Verified Facility by The Joint Commission’s Maternal Levels of Care (MLC) Verification program. South Miami Hospital is the fourth unit in the U.S. and second in Florida to receive a Level IV designation.
To support the hospital’s 4,200 annual births, South Miami Hospital’s OBHG hospitalist program includes an obstetric emergency department (OBED), along with an in-house 24/7 OB/GYN clinician and a 24/7 Certified Nurse Midwife to accommodate the area’s growing population.
Achieving the Level IV verification
OBHG Site Director Dr. Theresa Buckson talks about the hospital designation and how OBHG’s OB hospitalist program supports the hospital at this highest level of maternal care.
“We try to be consistent with seeing patients in a timely fashion within a 20-minute mark. That’s important when you’re talking about a Level IV center,” said Dr. Buckson. “People expect that we can deal with the most complex medical, surgical, or obstetrical conditions that are associated with high risk, which are terminal mortality and morbidity. You can’t do that if you’re not seeing the patient in a timely fashion. That’s very important for the OBED. So that’s one key factor.
We also work with a maternal fetal medicine unit and have several maternal fetal medicine physicians on staff and rounding on their patients. There’s not a time that we can’t get one of them on the phone for a consult and talk to them about a patient.
It’s also important to address obstetrical emergencies. As the OB hospitalists, we are there for the emergencies. When doctors who practice at different hospitals have a patient who needs immediate attention, we get the phone call and must make that call to take them to the OR and emergently deliver a patient.
The level four designation says that you can manage the most complex patients and manage them effectively and efficiently and have good outcomes.”
“We are proud to partner with Ob Hospitalist Group and bring our community this advanced level of care,” said Elizabeth Barrera, R.N., patient care manager, Labor and Delivery at South Miami Hospital. “Together, we ensure every OB patient receives exceptional care with the best outcomes possible.”
Rapid response team – “Code Crimson”
For patients experiencing signs and symptoms of a maternal hemorrhage, South Miami Hospital’s hospital-wide rapid response team, called “Code Crimson,” responds. This team is supported around the clock by key departments. “Within three minutes of the Code Crimson being called, everyone that we need to save the patient’s life is there,” said Dr. Buckson. This includes anesthesia, respiratory, radiology, ultrasounds, laboratory and blood bank services (in addition to OB/GYN). “Code Crimson allows us to get a patient promptly to the operating room to manage the hemorrhage. The level four designation shows our commitment to keeping pregnant women safe and the level of care that we can provide.”
Collaboration between departments
The MLC Verification program provides an objective assessment of a facility’s capabilities and verifies that a hospital has the expertise, equipment and resources in place for a patient’s specific needs and risk level.
At South Miami Hospital, the collaboration between departments is a key success factor. “The ICU is prepared for obstetrical patients. And whenever an obstetrical patient is in the ICU, there is a perinatologist following them along with an OB/GYN physician and an ICU doctor,” said Dr. Buckson.
The hospital’s emergency department, not just obstetrical emergency department, is also prepared for obstetrical emergencies (such as postpartum preeclampsia). “We make sure that postpartum patients are aware that when they come to the emergency department they can skip the line, walk to the front desk and say, ‘I delivered five days ago,’ so they’re seen right away. Postpartum obstetrics can be an emergency.”
South Miami Hospital and OBHG celebrated six years of partnership in 2023.