Lakeland Health Targets Hemorrhage Risk in Labor and Delivery
Feb 24, 2017 Share

(ST. JOSEPH) – In response to the top two preventable causes of maternal morbidity in the United States –hemorrhage and preeclampsia – Lakeland Health recently implemented four innovative technology initiatives focused on improving obstetric patient care through the use of their electronic health record (EHR).

A hemorrhage risk assessment flow sheet was built into the EHR which begins documentation in the primary care office and promotes assessment of the risk throughout the continuum of care during the pregnancy. Order sets were revised to ensure Pitocin is readily available for administration after delivery of the shoulder of the baby or the placenta, which decreases the risk of hemorrhage. A Quantitative Blood Loss Calculator (QBL) was created which allows a nurse to document the wet weight of each surgical item used during delivery which is then automatically subtracted from the dry weight of the item providing an accurate blood loss volume. In addition, an obstetrics emergency narrator was built in to the EHR allowing for more rapid administration and documentation of medications and blood products during obstetrics emergencies.

“One of the underlying reasons why we chose this project is that patient safety is a number one priority at Lakeland, well above everything else,” said Assistant Vice President of Information Systems and Chief Information Officer, Robin Sarkar, PhD, Lakeland Health. “The clinical team had a vision to improve the care for the obstetric patient. The Information Technology/EHR analyst team took that vision and developed creative ways of building, modifying, and enhancing the EHR to provide the tools needed to improve patient care.”

As a result of the initiatives, Lakeland Health has optimized the usage of necessary blood supply as needed by new mothers. Before implementation in January 2015, the OB department used 37 units per 1,000 patients. In May 2016, the department used 24.8 units per 1,000 patients. As of May 2016, 82 percent of obstetric patients had a completed hemorrhage risk assessment and 98 percent of patients had blood pressure taken within 15 minutes of arrival and, of those with elevated blood pressure, care providers were notified 100 percent of the time upon the patient’s arrival. Lakeland Health’s work to improve maternal health was worthy of semifinalist status in Healthcare Informatics’ 2017 Innovator Awards Program.

“These efforts stitch together multiple strings of data, process and protocols to give care providers the right information, at the right time, helping them make the right decision, to ensure perfect patient care, the first time,” said Tammy Jerz, RN, Manager of Patient Care Services, BirthPlace in Niles and St. Joseph. “Minutes can save lives, and we want to be ahead of the game every chance that we get.”

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