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Dr. David Vallejo is a Board-Certified OB/GYN, OB Hospitalist with OB Hospitalist Group and Site Director of OB Hospitalists at a hospital in Illinois. Dr. Vallejo joined us on The Obstetrics Podcast to talk about the collaboration that occurs between OB hospitalists and the emergency department and how the collaboration improves maternal care.
Read highlights from the podcast episode with Dr. Vallejo:
“Early on, we had discussions with the emergency department regarding postpartum preeclampsia and when to call us so we can get involved early on in these cases. The emergency department team also contacts our team about ectopic pregnancies and other OB/GYN cases. The line of communication between the OB hospitalist team and the emergency department is quite open, which creates a good working environment and improves overall care for the patient.”
How OB Hospitalists work with the Emergency Department
“I’m talking about the obstetric emergency department (OBED) specifically at Joliet. Early on, we were trying to determine who should be seen in the OBED and specifically who should be seen still in the main emergency department (ED). One of the criteria that we came up with was determining the gestational age. Through discussions early on, we determined that patients who were 20 weeks and above with an obstetrical complaint should be seen by the OBED and the OBED is staffed by board certified Obstetricians and Gynecologists. And that is what we do. We’re there to serve these patients who are coming in with some sort of obstetrical complaint.
In terms of the ED, pregnant patients who are seen in the main ED would be those patients who are less than 20 weeks. They can still consult us if there some question as to what may be going on or, in some instances, we may feel that even though the patient is less than 20 weeks, she may be better served by seeing us in the OBED, and we would bring that patient up. So there is a lot of conversation between the emergency room physician and the on-call OB hospitalist about where is the patient going to be best served.”
Education, training and simulations
“We do simulations, especially for preeclampsia and postpartum preeclampsia. So reaching out to our ED counterpart, because these patients will be presenting initially to the ED when they sign in, and especially our postpartum patients. Postpartum preeclampsia is not an uncommon situation. One of the things that we try to really focus on with our ED counterparts is letting them know that high blood pressure for us is very different than high blood pressure for the rest of the population. We are looking for very specific numbers that are concerning to us. And I think initially, we opened some people’s eyes about blood pressure that they need to be concerned about. I think that education helps them really identify these patients quickly so that we can get involved in those cases early on. And sometimes we will tell them, she shouldn’t be waiting down there, bring her up. We’ll see her up here in the OBED and go from there.”
Summary
“At the end of the day, it’s about patient care and where is this patient going to be best served. So leaving those lines of communication open and trying not be too rigid with the workflows I think works best, at least in our situation, because a lot of the time there’s still a lot of gray areas. And so again, it’s about open lines of communication.”
Listen to the full podcast:
How OB Hospitalists Work With the Hospital Emergency Department to Improve Maternal Care