“As everyone knows, in one-third of cases the decision-to-incision time in an emergency c-section is not met. The lawyers know that, too. You, more than any other person in the hospital, can decrease the decision-to-incision time,” he told the hospitalists.
“You can also really help in obstetric triage. Triage is a very expensive place. In our hospital a patient could be there 3-6 hours before being seen. But if hospitalists routinely adopted the use of transvaginal cervical length measurement and/or fetal fibronectin, it would really shorten the stay at triage,” predicted Dr. Chauhan, director of maternal-fetal medicine and professor of ob.gyn. at Eastern Virginia Medical School, Norfolk.
Dr. Frost, the SHM president-elect, shared five key lessons he believes to be essential in building a hospitalist medical society from scratch, based upon the SHM experience: focus keenly on quality improvement; seek to be recognized by external stakeholders as health care reform facilitators, not obstructionists; respect the power of 'branding” as hospitalists; define your members' uniqueness; and be an inclusive “big tent” organization rather than exclusive in terms of membership.
ACOG District VIII Chair Dr. Kopelman urged SOGH members to make their viewpoint heard at ACOG by becoming active at the section and district level, then applying for one of the roughly 50 new committee appointments made each year. Natural fits for SOGH members might be the Committee on Patient Safety and Quality Improvement, the Committee on Obstetric Practice, the Committee on Professional Liability, and the Council on Resident Education in Obstetrics and Gynecology. He also urged SOGH leaders to enroll in ACOG's Robert C. Cefalo National Leadership Institute.
SOGH leaders urged their members to seriously consider belonging to both ACOG and SHM, two organizations having the ear of health policy makers.
Dr. Rob Olson said at present there are 143 ob.gyn. hospitalist groups spread throughout the country, typically with four to six hospitalists each.
Source Courtesy Ianthe Andress
'It can be a wild ride sometimes, but … it has been nothing short of profoundly gratifying.'
Source DR. FROST
Rough Draft of Core Competencies
Obstetric triage
Emergency medical examination
Outpatient prenatal care
Management of labor
Fetal heart rate interpretation
Labor ultrasound
Vaginal delivery and laceration repair
Management of obstetric complications including eclampsia, shoulder dystocia, breech presentation, twins, and postpartum hemorrhage
Operative deliveries
Surgical skills entailed in tubal ligation, cesarean section, and immediate postpartum hemorrhage
Gynecologic competencies including deep vein thrombosis prevention, diagnosis, and management; the gynecologic examination including the pelvic exam; and postoperative hemorrhage management.
Source: SOGH