RWJBarnabas Health System: System-wide Obstetrics Collaborative. The Clinical, Research and Teaching Implications and Benefits

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PURPOSE:The eight perinatal hospitals in the RWJBarnabas health care system, with ∼25,000 deliveries annually, utilize bi-monthly interdisciplinary meetings to update all sites on quality outcomes, evidence-based best practice, research initiatives and education. This model trains Ob/Gyn residents, as well as the entire health care team on an overall approach to maternity care.BACKGROUND:In 2015, the perinatal practices at each of the hospitals were functioning independently, which resulted in variation in clinical practice and outcomes, scant research and different approaches to patient care models for resident education. The RWJBarnabas Health leadership recognized the benefit of a systematic approach to optimize this service and to best utilize the strengths and experience of all its health care obstetrical providers. This would also translate into a stronger model to enhance resident education. This approach was promoted by Dr. Asch who stated in the September 23, 2009 JAMA that the best function Ob-Gyn attendings in NY and FL came from residency programs that emphasized the best-practice of evidence-based medicine in a culture of patient safety. Thus, creating a win-win scenario for quality patient care and resident education.METHODS:Supported by corporate leadership the RWJBarnabas Health Ob Collaborative was initiated. The obstetrical department chairs and the Ob nursing administrators from each site met bi-monthly to review pooled data, develop clinical bundles and institute standards of practice at each medical site based on a common EMR. From the pooled data, clinical practice changes and research ideas were also introduced that the health care team and the learners could initiate/participate in.RESULTS:This model has been very effective in improving patient satisfaction, quality and patient safety. This is especially notable in Pain Management, the reduction of SSI and C/Section rates and increased TOLAC/VBAC rates. In addition, medical education for residents includes utilization of standardized evidenced based practices developed by the collaborative across all the sites. The specifics of the data collection will be discussed.DISCUSSION:Not only have there been benefits in the core missions of clinical care, teaching and research, but this model has inspired a joint effort by others within the health care system to further improve outcomes through collaborative educational venues.

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