Collaboration for Antepartum Risk Evaluation
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/26/2018 |
| Start Date: | July 2016 |
| End Date: | September 2019 |
Interprofessional Perinatal Consults to Improve Communication Quality, Satisfaction, and Team Cohesion: A Randomized Trial of the Collaboration for Antepartum Risk Evaluation (CARE) Model
Perinatal outcomes in the US rank behind most other developed countries even though women in
the US utilize more maternity services. Current approaches to consultation and collaboration
among perinatal care providers, including nurse-midwives, obstetricians, and perinatologists,
fragment care resulting in communication errors and maternal dissatisfaction. The CARE study
will test an innovative interdisciplinary consult visit to improve communication, teamwork,
maternal satisfaction, and perinatal outcomes.
the US utilize more maternity services. Current approaches to consultation and collaboration
among perinatal care providers, including nurse-midwives, obstetricians, and perinatologists,
fragment care resulting in communication errors and maternal dissatisfaction. The CARE study
will test an innovative interdisciplinary consult visit to improve communication, teamwork,
maternal satisfaction, and perinatal outcomes.
Perinatal outcomes in the United States rank below many other developed countries. National
organizations, such as the American College of Obstetricians and Gynecologists, have called
for women to utilize the level and provider of maternity services that meet their personal
and medical needs. This leveled approach to care requires consultation and collaboration
among providers to ensure women receive appropriate services. While national and
international organizations have called for team-based maternity care, current models can
fragment services, increasing the risk of communication errors. Women can feel
disenfranchised by models that do not meet their needs and opt out of beneficial services
altogether.
Currently, there is not evidence on effective interdisciplinary models of maternity care. The
Collaboration for Antepartum Risk Evaluation (CARE) study will use a randomized design to
systematically test the effect of interdisciplinary consults on women and providers. The two
aims of the study are: (1) evaluate the effect of collaborative vs individual consults on
participant outcomes including communication quality (using the Communication Assessment
Tool, team version), maternal satisfaction (using a modified Satisfaction with Prenatal Care
measure), semi-structured interviews, adherence to the developed plan of care, and perinatal
outcomes; (2) evaluate the effect of the CARE clinic on providers using the Communication
Assessment Tool- team version, the Agency for Healthcare Research and Quality (AHRQ) Team
Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) questionnaire,
and semi-structured interviews.
The CARE study will provide valuable information on effective models for patient-centered
maternity care. The AHRQ K08 will allow Dr. Philippi to implement the CARE study and
facilitate her growth into a national leader in midwifery and health services research.
organizations, such as the American College of Obstetricians and Gynecologists, have called
for women to utilize the level and provider of maternity services that meet their personal
and medical needs. This leveled approach to care requires consultation and collaboration
among providers to ensure women receive appropriate services. While national and
international organizations have called for team-based maternity care, current models can
fragment services, increasing the risk of communication errors. Women can feel
disenfranchised by models that do not meet their needs and opt out of beneficial services
altogether.
Currently, there is not evidence on effective interdisciplinary models of maternity care. The
Collaboration for Antepartum Risk Evaluation (CARE) study will use a randomized design to
systematically test the effect of interdisciplinary consults on women and providers. The two
aims of the study are: (1) evaluate the effect of collaborative vs individual consults on
participant outcomes including communication quality (using the Communication Assessment
Tool, team version), maternal satisfaction (using a modified Satisfaction with Prenatal Care
measure), semi-structured interviews, adherence to the developed plan of care, and perinatal
outcomes; (2) evaluate the effect of the CARE clinic on providers using the Communication
Assessment Tool- team version, the Agency for Healthcare Research and Quality (AHRQ) Team
Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) questionnaire,
and semi-structured interviews.
The CARE study will provide valuable information on effective models for patient-centered
maternity care. The AHRQ K08 will allow Dr. Philippi to implement the CARE study and
facilitate her growth into a national leader in midwifery and health services research.
Inclusion Criteria:
- Adult pregnant women receiving prenatal care at the VUSN Nurse-Midwifery Faculty
Practice.
- Gestational age of pregnancy 4-40 weeks
- Needs a consultation with perinatologist for one of the following reasons:
Prior pregnancy with congenital abnormality History of fetal demise >20 weeks History of
preterm labor in previous pregnancy Current maternal drug or alcohol abuse Controlled
maternal condition (e.g. thyroid disorder) Mild abnormality of fetus or placenta on
ultrasound Idiopathic thrombocytopenia in pregnancy
- Can attend the collaborative care clinic
Exclusion Criteria:
- Unable to give consent for research participation - including age < 18 or impaired
mental function
- Urgent medical condition requiring immediate assessment including: ectopic pregnancy
or vaginal bleeding
- Medical conditions outside of scope of VUSN midwifery guidelines including:
Chronic maternal conditions requiring specialist involvement including: HIV, epilepsy,
uncontrolled asthma, and liver, renal, cardiac disease.
Multiple gestation > 2 previous cesarean births Rh isoimmunization Incompetent cervix Major
fetal or placenta abnormalities
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