Created in 1998, the Women and Newborns Clinical Program was Intermountain Healthcare's second clinical program. Within the program, during the last 11 years, many teams have been formed to improve patient care, processes, outcomes, and cost in the following clinical areas:
- Prenatal care, particularly high-risk obstetrics (maternal-fetal medicine)
- Labor and delivery
- Postpartum and well nursery
- Newborn intensive care unit (NICU)
- Benign gynecologic care
Women and Newborns is unique among Intermountain's clinical programs, in that while the program's processes constitute four of the top six diagnoses for inpatient care system-wide, most of the care provided is focused on uncomplicated delivery, postpartum, and newborn care. There are relatively few "high tech" and costly interventions. As such, the Women and Newborns Clinical Program can focus on finding and implementing ways to provide best care at the lowest reasonable cost.
By standardizing our processes and leveraging our purchasing position—particularly on supplies used most to manage the 32,000 average annual births at Intermountain facilities—Intermountain can achieve significant improvements in the quality and cost of care. (See Chart B below. The resources that go into providing that care are measured in Relative Resource Units and illustrate the "low tech/high touch" nature of care in Women and Newborns services.)
Some examples of the Women and Newborns Clinical Program's process improvement initiatives include:
- Elective inductions: reducing elective inductions at less than 39 weeks gestation
- Elective inductions with a Bishop's score of 10 or greater in first-time moms
- Universal bilirubin screening in well newborns
- Respiratory management processes in NICU
- Central line infections in NICU
- Staffing standardization for Labor & Delivery, Mom-Baby, and NICU units
The Women and Newborns Clinical Program has also put enormous emphasis on service excellence and communication. Often, childbirth is a woman's first significant encounter with hospital care. Research indicates that women make about 70% of the healthcare decisions for their families.
So, because the majority of patients have low-risk pregnancies—it is a planned healthcare experience—an outstanding clinical and service experience in Women and Newborns services can positively or negative affect perceptions of other clinical areas. (If a woman receives caring, quality care, she'll be more likely to opt for care at an Intermountain facility on other occasions or refer friends and relatives.)
To focus on service excellence, the program uses such Intermountain tools as the six Dimensions of Care and the Healing Connections principles, which emphasize compassion, concern, and commitment to providing excellent care.