Council of District Chairs honors Utah Section

Dr. W. Lawrence WarnerW. Lawrence Warner, MD, Utah Section chair

The Utah Section won a Council of District Chairs Service Recognition Award for its outreach initiative to rural hospitals. The award is given to an ACOG district or section in recognition of an outstanding activity it has contributed to the field of ob-gyn.

Two years ago, Utah Section leaders recognized a need to improve communication with ACOG members in the state. We began sending emails to members about various clinical and legislative issues. One of our goals was to promote the principles of standardization and minimization of variation among practitioners, as these concepts have shown to improve clinical outcomes. 

We soon realized that greater than 50% of the counties in Utah do not have an ACOG Fellow practicing in their communities. We felt a need to reach out to the dedicated and hard-working family physicians and certified nurse-midwives who provide needed obstetric care in rural areas. We contacted the nursing director of obstetrics at 18 rural hospitals throughout Utah and set up an email contact system with them. An introductory letter was sent to them to explain our intentions, and we asked the nursing directors to present this letter and future communications to their obstetric providers, both physicians and nurses.

Since the initial outreach, we have sent out 11 emails covering various patient safety subjects and standardized clinical protocols. We have sent handouts on the standardized terminology and management of fetal heart rate tracings, the standardized management of hypertensive disorders in pregnancy, a chorioamnionitis protocol, and other recommendations based on ACOG resources. The nursing directors forward this information to their obstetrics staff, and we encourage them to discuss the topics and attached materials at a joint physician-nurse meeting to see if there are areas they can improve and standardize.

To date, I have personally visited 15 of the 18 hospitals and have given lectures on patient safety initiatives and the importance of standardization with minimization of variation. The feedback has been overwhelmingly positive. We hope that our rural maternity providers feel they now have a resource for current obstetric information.

The Utah Section has started working on a third component of its outreach and communication efforts. We are compiling a list of the obstetrics department chairs at each of the other, non-rural hospitals in Utah and are obtaining permission to send the communications we send to individual section members directly to them as well. This contact will facilitate these topics being discussed at their department meetings and help further our efforts to reach all obstetric providers in the state. We will continue to encourage each site to work toward standardization of protocols within their facility to reduce physician and nursing errors that result from having multiple ways to care for a particular condition.

We are also promoting the concept of each hospital labor and delivery unit having an Emergency Physician Reference Notebook with multiple divider tabs where they can place all of their policies, protocols, order sets, and check lists for quick and easy reference.

Copies of the documents we have created and used in our outreach efforts will be available soon on the District VIII website.