News: PQI Profiles

Improving Perinatal Health Care in Arkansas During A Pandemic

Friday, August 14, 2020  
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By Lauren Hamilton


Dawn Brown BSN, RN is the clinical program director for the Perinatal Outcomes Workgroup through Education and Research (POWER) at the University of Arkansas for Medical Sciences (UAMS) in the UAMS Institute for Digital Health & Innovation (IDHI). She is also the Institute for Perinatal Quality Improvement’s (PQI) Arkansas State Coordinator.



She recently spoke at and helped develop POWER’s annual spring workshop, an event that had to be completely reimagined due to the COVID-19 lockdown. “Normally it’s a two-day workshop where everyone comes together and gets away from work. We have the opportunity to network and gain information through speakers and breakout sessions, but due to COVID we were unable to do that this year. However, since we are a digital health institute, it only made sense to move forward with a virtual event. We made adjustments, surveyed all the hospitals on how they would like to hold the workshop and we were able to still have both keynote speakers participate. The feedback we’ve received has been very positive, which makes us excited that this format worked,” said Ms. Brown.


She said she and her colleagues worried that the shift to a virtual workshop would result in less engagement because participants wouldn’t physically be present, but by the end of day two, it was clear people were involved. “We were really happy to see how many people attended and asked questions which showed us they were tuned in. Even when we had technical difficulties on our end, the participants showed patience, remained interested, and continued to join us. I’m glad they embraced the new format and our use of technology.”


According to Ms. Brown, they had 94 in attendance, joining from the comfort of their offices or homes over two half-day workshops. Her department was encouraged by the high participation rate, as one of their goals is to increase the use of this technology with clinicians in birthing hospitals across Arkansas. They’re hoping not to just offset the inconveniences created by social distancing, but to aid hospitals during an emergency as well as provide smaller rural hospitals with 24/7 access to a specialist. “It’ll help us change our footprint by being there in a more real way, whether it’s providing additional virtual education, simulation or resources--there’s a lot of options. I think COVID-19 has shown us that it can be done,” Brown said.


UAMS developed a toolkit designed to help providers transition from an in-person clinical practice to a virtual practice, which benefits both moms and babies. The virtual platform had no negative impact on the topics they were able to cover. They addressed obstetrical emergencies, statewide programs impacting and improving patient care, and POWER’s mission to reduce the maternal mortality rate in Arkansas, which is the fifth highest in the nation.


“Through the UAMS POWER program we do both an outreach and educational piece with the delivering hospitals throughout the state. We help them roll out safety bundles such as the Hypertension and Postpartum Hemorrhage bundles. We provide education to hospitals that don’t have a Neonatal Resuscitation Program (NRP), S.T.A.B.L.E. instructor or the ability to access the AWHONN fetal monitoring courses so they can stay current in their certifications. We also provide simulation drills to help OB staff have a robust education program, especially in small hospitals where budgets are too small to fund such programs. We’re trying to bring everyone to the same level playing field,” Brown said.


In her talk, Ms. Brown opened with sobering “state of their state” data, noting that it is more unsafe to give birth in the U.S. than it is in any other advanced nation. Arkansas, with a preterm birth rate of 11.6%, received an F on the March of Dimes report card. Brown went on to emphasize the racial disparity among black women who are at a 47% higher risk of preterm birth than all other women in Arkansas. After highlighting the social determinants causing these numbers such as maternal circumstances, maternal health systems and post birth care, Brown outlined state recommendations as well as what UAMS is doing to address current gaps in care. The work Ms. Brown and her colleagues are doing in POWER is good news for Arkansas. Through their outreach and education efforts, results have been promising, including fewer complications for high-risk mothers and babies.


“What I, along with the other presenters tried to highlight was that the UAMS Institute for Digital Health and its high-risk pregnancy program are helping hospitals and clinicians provide better care and improve outcomes,” said Brown. “And it can be done remotely.”


Dawn Brown’s advice to other perinatal healthcare providers adapting to technology during COVID-19:


  • Find creative ways to continue to work to reduce perinatal morbidity and mortality. We can’t let the pandemic stop dissemination of needed information.
  • Engage nurses from all over the state in virtual education sessions.
  • Partner with telehealth programs that offer 24/7 support to provide more consistent care to women and babies throughout the state.
  • Support education among clinicians working in rural areas by providing them with instructors and virtual education
  • Push perinatal leaders to continue efforts to ensure all women and newborns receive high-quality, safe, evidence-based, and equitable perinatal care regardless of their race and ethnicity.

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