Tackling Severe Maternal Morbidity

By: GE Healthcare

The material presented in this blog represents the opinion of the author(s) and not necessarily the views of Synova Associates. Synova Associates does not endorse any specific products or organizations but strives to connect its industry partners with leaders interested in product/educational innovation.

Each year, approximately 1,200 women across the United States die from pregnancy- or delivery-related complications1, with Severe Maternal Morbidity (SMM) affecting approximately 50,000-60,000 women annually2.

When it comes to preventing the serious health consequences that may stem from SMM, every second counts. Adequate risk assessment helps form the foundation of quality care needed to help reduce preventable maternal deaths3, allowing the care team to monitor at-risk patients and intervene early — before an event becomes life-threatening.

Mural™ Perinatal Care Solution can help. It pulls together clinical data from devices capable of exporting data in Standard Health Level 7 (HL-7) or XML Message format helping the team assess patients’ ongoing risks and enhances clinical decision support so the team can intervene to help prevent SMM. Read on to learn more about how Mural may help providers assess the risk of hemorrhage and hypertension across the unit — and how Mural’s data aggregation may support care pathway compliance.

Assess Hemorrhage and Hypertension Risk Assessment at a Glance

Hemorrhage and hypertension are among the most pressing concerns in the unit.  The Joint Commission’s Maternal Safety Standards for Hemorrhage and Hypertension now require that hospitals have a plan in place to minimize patient risk of both4. Mural’s hemorrhage and hypertension bundles aggregate patient information, which may help teams more easily view each patient’s risk.

Both bundles allow the team to use Mural’s Patient Snapshot tool to view detailed information on a patient’s status and care. Mural pulls data from multiple sources, including nursing documentation and devices across the unit, to display a more complete picture of a patient’s status at a glance. The team can quickly view key metrics — including cumulative blood loss and mean arterial blood pressure — to assess a patient’s risk, as well review the care they’ve received so far.

“Mural’s hemorrhage and hypertension bundles provide overall situational awareness,” explains Sara Harris, RNC-OB and Consulting Manager at GE HealthCare. “Anyone caring for that patient, whether it’s a nurse, nursing assistant, or anyone on the care team, can easily access patient information and offer more in-depth care for those most at risk. It gets that information out to the whole team quickly.”

Mural also allows the team to toggle between Patient Snapshot and Population Surveillance views, so they can both “zoom in” on a single at-risk patient or quickly assess potential risk across the entire unit. The Population Surveillance tool displays the highest-risk patients at the top of the screen, drawing providers’ attention to those who may need it most. For example, if a patient’s status changes with a rise in blood pressure to about 160/110, the display color changes to red for easy visibility for the care team to respond.

How MuralTM Offers Support Throughout a Patient’s Journey

Intake
MuralTM displays the results from each patient’s initial risk assessment to get the care team up to speed quickly.

Ongoing risk assessment and monitoring
Mural’sTM Patient Surveillance highlights the most at-risk patients to help focus the team’s care.

Action
MuralTM integrates with the hospital’s existing care pathways and policies to offer clinical decision support*.

Enable Unbiased Risk Assessment for Standardized Care

Organizations have become increasingly aware of how implicit biases affect perinatal healthcare, with these biases sometimes leading to disparities in outcomes for women in labor units5. “So there are beliefs that are sometimes unknowingly held by providers based on a patient’s race, ethnicity, socioeconomic level, age and more” explains Harris.

While often unconscious and unintended, implicit bias may have devastating outcomes for women from marginalized or historically disadvantaged backgrounds: Black women, for example, are three times as likely to die due to pregnancy-related complications than white women.6

Deploying data-driven methods of risk assessment can help the team standardize their care. “In Mural, a patient’s racial, ethnic or socioeconomic background is not taken into consideration,” says Harris. “All patients who are above a certain threshold are going to have the same algorithm and the same care pathway displayed to ultimately receive the same care.”

The Added Benefit of Care Pathway Compliance

In addition to facilitating unbiased risk assessment, Mural may help providers turn this insight into action through clinical decision support.

Mural integrates with the hospital’s existing policies and displays the appropriate next steps for patient monitoring and care, so the care team — including new and traveling nurses — can take the right action at the right time. This helps reduce latency, as the care team can find the appropriate next steps to take at a glance, rather than having to track down the hospital’s policies before taking action.

This also helps support staff in following the hospital’s policies, even in urgent situations that require the team to act fast. “Everything that’s displayed in Mural comes from existing documentation and nurses can see the hospital-defined next steps of the appropriate policy when events arise,” says Harris. “All of the timebound elements are in alignment with the policies the organization already has in place. By following the steps or responding to the alerts in Mural, staff can ensure they’re compliant with the hospital’s policies.”

Mural Also Keeps Providers in the Driver’s Seat

Although it suggests next steps, Mural doesn’t make decisions about a patient’s care. “We’re not dictating medicine, but we are the engine in the background prescribing providers’ policies and procedures through our aggregation of data,” says Melissa Martin, MSN-OB and Managing Director at GE HealthCare. “We’re taking how providers want to practice medicine, how they want their patients cared for, and we’re digitizing that.”

The Bottom Line

Data-driven insights may help standardize care across the Labor and Delivery Unit, helping the team focus on patients who may be most at risk while supporting care pathway compliance. Click here to learn more about GE HealthCare’s Mural™ Perinatal Care Solution or get in touch to learn more about how we can help you drive your maternal safety initiatives.

References and Disclaimers:

1https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm#
2https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/severe-maternal-morbidity-united-states-primer
3https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377107/
4https://www.jointcommission.org/-/media/tjc/documents/standards/r3-reports/r3-issue-24-maternal-12-7-2021.pdf
5https://journals.lww.com/greenjournal/Fulltext/2021/05000/Rethinking_Bias_to_Achieve_Maternal_Health_Equity_.26.aspx
6Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol 2017;130:366–73. doi: 10.1097/AOG.0000000000002114

Disclaimer: Mural Labor and Delivery is enabled by Decisio InsightIQTM – a standalone medical device and other applications. Hospitals define protocols to implement in Mural Solution based on their clinical experience and judgment. GE HealthCare does not recommend, review, or assess the clinical validity of any individual protocol.

Mural Perinatal Care Solution formerly known as Mural Labor and Delivery.

*Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered, or presented at appropriate times, to enhance health and health care. CDS does not make decisions on behalf of the clinician.

Learn more about GE Healthcare

Learn more about GE HealthCare’s Mural™ Perinatal Care Solution or get in touch to learn more about GE Healthcare can help you drive your maternal safety initiatives.