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Bringing Consistency to the 9-Month Episode of Care

Jim Molpus, for HealthLeaders Media, August 26, 2013

By redesigning the care model using uniform best practices borrowed from surgical procedure, leaders at Geisinger Health System reduced perinatal variability.

This article appears in the July/August issue of HealthLeaders magazine.

The women's health physician and leadership team at Geisinger Health System started with a challenge: Could they take the core fundamentals of the health system's ProvenCareTM model of best practices from a surgical procedure such as a coronary artery bypass graft and apply those to perinatal care?

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Geisinger's model—which combines a uniform set of best practices with accountable systems to make certain the right care is followed at the right time—had demonstrated results in surgical procedures. But could it work in an episode of care that is nine months long?

Harry O. Mateer Jr., MD, director of obstetrics and gynecology at Geisinger Medical Center, says despite some obvious differences between perinatal care and a surgical procedure, delivering consistent care involves the same elements.

"The basis behind ProvenCare is that we know that for certain procedures, whether it's a surgical procedure or a complex nine-month ordeal such as pregnancy, that there are certain aspects of care that should be offered to all patients at various points during the procedure," Mateer says. "So if it's a surgical procedure, all individuals should be offered certain things prior to the surgery, during the surgery, and then after the surgery, and those are usually called best practices in most modern health literature. Most physicians know what they have to do. It's just really making sure that it does get done."

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