The Center for Peripartum Optimization

NCT03522909 | Completed DMC

• 1 other identifier: IRB00163559
• Study Type: observational
• Target: 250
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

High Risk Pregnancy; Multidisciplinary Communication; Communication; Obstetric Complication

Keywords

obstetric anesthesia; telemedicine

Outcome Measures

Primary Outcomes (1)

• Hospital length of stay

  Total days of hospital admission

  1 year

Secondary Outcomes (8)

• Number of admissions from outside hospitals

  1 year

• ICU admissions

  1 year

• Opioids use

  1 year

• Neonatal Intensive Care Unit (NICU) admissions

  1 year

• Patient satisfaction

  1 year

Study Arms (2)

Study

We will be reviewing records of parturients seen at Johns Hopkins Hospital in the Center for Peripartum Optimization (CPO) clinic between January 2017 to January 2018

Other: Seen in clinic

Control

A matched controlled group patients not seen at the CPO clinic

Interventions

Seen in clinic OTHER

We will be doing a retrospective chart review of patients seen in the Center for Peripartum Optimization to look for: 1. Primary outcome variable. \- Hospital length of stay 2. Secondary outcome variables. * Number of admissions from outside hospitals * Adverse outcomes * Intensive Care Unit admissions * Opioid use * NICU admissions * Patient satisfaction * Cost of inpatient admission * Cost of outpatient care * Hospital readmissions rate

Study

Eligibility Criteria

• Age: Up to 60 Years
• Gender Eligibility Details: Pregnant patients
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

This will be a retrospective study design utilizing the Johns Hopkins Hospital (JHH) electronic medical record system (EMR) "EPIC". We will be reviewing records of parturients seen at JHH in the Center for Peripartum Optimization (CPO) clinic between January 2017 to January 2018 and comparing outcome data with a matched controlled group patients not seen at the CPO clinic. This matched controlled parturient group will be identified utilizing the JHH EMR and ICD-10 comorbidity codes. These patients will be female of child-bearing age that fits into the inclusion criteria.

You may qualify if:

• 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 2018.
• 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)
• Cancer
• 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

You may not qualify if:

• Records of CPO participating parturients outside the specified timeframe.
• Records of patients seen in CPO clinic that did not deliver at our institution

Sponsors & Collaborators

• Johns Hopkins University: lead

Study Sites (1)

Johns Hopkins Hospital

Baltimore, Maryland, 21287, United States

Location

MeSH Terms

Conditions

Communication

Interventions

Ambulatory Care Facilities

Condition Hierarchy (Ancestors)

Behavior

Intervention Hierarchy (Ancestors)

Health Facilities; Health Care Facilities Workforce and Services

Study Officials

• Jamie D Murphy, MD

  Johns Hopkins University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 1, 2018
• First Posted: May 11, 2018
• Study Start: January 1, 2017
• Primary Completion: January 1, 2018
• Study Completion: December 1, 2020
• Last Updated: September 13, 2021

Record last verified: 2020-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)