The Center for Peripartum Optimization: An Innovative Approach to Care Coordination
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Hospital length of stay
研究概览
简要总结
In January 2017 investigators started a Center for Peripartum Optimization (CPO) with the aim of optimizing a patient's clinical status in an outpatient setting to minimize unnecessary laboratory tests and studies, costly inpatient consultations, the likelihood of post-surgical adverse events, escalations in level of care, inpatient admissions and readmissions. This research project seeks to evaluate the impact of this innovative concept on patient outcomes during the last 12 months. Investigators will accomplish this by collecting retrospective data from patients' electronic medical records in the intervention group and comparing it to data gathered from a controlled group of patients with similar comorbidities but who were not evaluated at the CPO clinic.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- — 至 60 Years（Child, Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Records of all female, obstetric patients of child-bearing age who were evaluated in the Center for Peripartum Optimization during the period between January 2017 and January
- •Controlled group will include parturients with match high risk comorbidities or history of nonobstetric surgery during pregnancy who delivered at Johns Hopkins Hospital (JHH) during July 1, 2016 - Dec 31, 2016
- •Patients with any one or more of these high risk comorbidities:
- •Complex spine pathologies (Scoliosis, vertebral fusion, disc disease, spinal canal defects, neuropathies, and nerve disease, etc.)
- •Neurological pathology (Cerebral ischemia, tumor, increased intracranial pressure, cerebral vascular disease, etc.)
- •Cardiac disease (Congenital, valvular, pulmonary hypertension, cardiomyopathy, ischemic disease, arrhythmia, etc.)
- •Pulmonary disease (History of pulmonary embolism, interstitial lung disease, severe asthma, cancer, etc.)
- •Morbid Obesity (Obstructive Sleep Apnea, equipment considerations)
- •Hematologic Disorders (Thrombophilias, coagulopathies, patients on anticoagulation)
- •Abnormal placentation (Previa, accreta / increta / percreta)
- •Anesthetic concerns (Airway abnormalities, history of adverse anesthetic reactions or experiences (i.e. recall, anaphylaxis))
- •Fetal therapy patients requiring specialized management (Ex utero intrapartum treatment (EXIT), Fetoscopic endotracheal occlusion (FETO), Twin-to-twin transfusion syndrome (TTTS), Percutaneous Umbilical Blood Sampling (PUBS), etc.)
- •Chronic Pain
排除标准
- •Records of CPO participating parturients outside the specified timeframe.
- •Records of obstetric patients of child-bearing age without high-risk comorbid conditions described in inclusion criteria.
- •Records of patients seen in CPO clinic that did not deliver at our institution
结局指标
主要结局
Hospital length of stay
时间窗: 1 year
Total days of hospital admission
次要结局
- Number of admissions from outside hospitals(1 year)
- Patient satisfaction(1 year)
- Opioids use(1 year)
- Cost of outpatient care(1 year)
- Cost of inpatient admission(1 year)
- ICU admissions(1 year)
- Neonatal Intensive Care Unit (NICU) admissions(1 year)
- Hospital readmissions rate(1 year)