Perinatal Outcomes Workgroup Education and Research (POWER)

powerIn April, 2016, UAMS hosted the Arkansas Perinatal Outcomes Workgroup at the Rockefeller Institute. This outreach event was open to all hospitals in Arkansas that provide obstetric services. The purpose of the event was to brainstorm ways to optimize perinatal outcomes across Arkansas. Through small group discussion, the facility representatives identified topics or areas of patient care that could be improved.

As the Arkansas Perinatal Outcomes Workgroup evolved, our Chair of Obstetrics at UAMS, Dr. Curtis Lowery, suggested updating the group’s name to Perinatal Outcomes Workgroup Education and Research (POWER) to more completely encompass the group’s purpose.

Identified Categories of Improvement

After the workgroup, UAMS ANGELS and the Center for Distance Health staff evaluated the responses and grouped them into categories. One category that stood out was evidence-based policies and procedures. One particular area was mentioned by several facilities: oxytocin administration and related fetal monitoring.

A pilot group was formed to share and review oxytocin administration policy, procedure, orders and any other related requirements from each facility. The group uploaded the documents to Box and was allowed time to review and make comments. There will be video conferencing to discuss identified best practices and to form an evidence-based generic oxytocin administration policy, which can then be disseminated statewide.

It is hoped that every facility in the state will consider adopting the Arkansas Oxytocin Administration Guideline to ensure that each obstetric patient in the state experiences the same obstetric care regardless of the area of the state in which she lives. To correspond to the oxytocin administration guidelines, a generic electronic fetal heart monitoring guideline will be created using the same process.

The national recommendations for electronic fetal monitoring are very specific related to the patient’s medical condition and state of labor. By standardizing the administration of oxytocin and Arkansas Electronic Fetal Heart Monitoring Guideline will standardize the assessment and documentation required by the nurses caring for these obstetrics patients.

Another category identified was barriers to accomplishing change within a facility. Moving forward, the POWER group will strive to identify barriers facilities face when implementing proposed improvements.

POWER hopes to educate facility representatives on breaking down barriers and putting proposed improvements in place. POWER will assist Arkansas hospitals to continue to collaborate and provide the most efficient evidence-based care to achieve the optimum outcomes for the mothers and babies of Arkansas.