Total 623 words used.
Background:
Emirates Health Services (EHS) UAE has evidence-based policies and best practice protocols that guide all caregivers to follow a process of optimal, comprehensive care for their patients seeking women’s health services across their network.
EHS implemented a High-Risk Pregnancy management program through their EMR (Wareed) that aims to improve maternal health outcomes, standardize care practice, enhance end user experience, and create a positive impact on the overall healthcare quality. The approach employed to execute this program was based on a framework of Identify and Notify which encapsulates the various elements utilized in designing this project.
This is an effort to identify early risks related to pregnancy and guide the physician on the management of the maternity patients based on their risk profiling. The program can help manage situations related to high risk or critical pregnancies by guiding on the next course of action based on the identified risks for effective management and care of the patient.
Design:
The program has been designed after thoroughly analyzing patient antenatal journey and EHS protocols. It has the following major design elements:
- Risk Assessment: A form has been created for risk factor documentation. This form is updated according to latest EHS guidelines and includes a large number of antepartum risk factors.
- Risk Stratification: Clinical Decision Support Rules have been created that automatically generate a risk category for the patient based on their risk factors documentation by the physicians. The patients are categorized in different risk levels based on the presence or absence of risk factors. (Critical/High/Medium/Low/None)
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- Adherence to practice: A rule has been created in the EMR that mandates reviewing of Risk Factors form on every antenatal visit of the patient. This helps to ensure that patient’s risk is being assessed on every visit, their category has not changed from their previous visit, and they are still eligible to receive the appropriate management and care based on their risk profile.
- Risk profiling. Once a risk has been documented for a patient, their risk profile gets created on the system. There is a rule in the system that automatically adds the identified risk in the patient’s problem list.
- Risk Notification: Once risk has been identified in a pregnant patient, the information is visible to all clinicians accessing this patient’s chart for prompt notification. Every instance where the patent chart is opened, the Physicians will be alerted on the current pregnancy risk category of the patient. The risk profile is stored in the patient’s file, and it can be seen by all clinicians across different EHS venues like Emergency Department and Labor/Delivery Room for the ongoing management and care of the patient.
- Risk Protocol implementation: the system has smart cues and prompts to incorporate the risk management protocols at EHS. When high risk pregnant patients are admitted to Emergency department, based on their latest risk stratification, an icon will be automatically triggered in the ED Tracking shell. These icons can provide a clear view to any care provider about the risk category of the patient. This step ensures that high risk pregnancies are prioritized, and right protocols are followed based on the individual risks. Along with the icons, the system has clinical rules to notify the ED providers if they are opening any high risk or critical risk patient’s file.
- Patient registry: All information documented for patient risk profiling becomes a part of antenatal patient registry system. This includes patient demographics, risk profile, their antenatal journey and other relevant information.
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Benefits:
1-Universal Antenatal risk screening: Smart algorithms ensured 100% compliance to risk screening for all outpatient antenatal visits at EHS primary care facilities.
2-Early risk identification
3-Prompt notification
4-Proactive management
5-Standardization of EHS protocols
6-Improved patient safety
7-Improved patient experience
8-Improved clinician experience
9-Discrete data availability for insights
