Jennifer A Callaghan-Koru, Nirvana Manning, James P Selig, Hari Eswaran, Stacy Tiemeyer, Sarah J Rhoads
{"title":"远程医疗MOM研究:产后护理远程医疗多成分优化模型(MOM)的随机对照试验方案。","authors":"Jennifer A Callaghan-Koru, Nirvana Manning, James P Selig, Hari Eswaran, Stacy Tiemeyer, Sarah J Rhoads","doi":"10.1016/j.cct.2025.108085","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This cross-sectional study of hospital emergency departments (EDs) in Arkansas sought to: 1) assess ED experiences and capabilities related to obstetric emergencies, and; 2) characterize the differences in ED practices for pregnant and postpartum patients between hospitals with and without obstetric services.</p><p><strong>Methods: </strong>Online survey invitations were distributed to department managers at hospital EDs across Arkansas in August 2023. The 40-question survey collected hospital characteristics, ED experiences with and capacity to manage obstetric emergencies, and staff training history and interest. Responses were descriptively analyzed, and differences in proportions between hospitals with and without obstetric services were tested.</p><p><strong>Results: </strong>Managers for 51 (61 %) of the 84 eligible EDs responded. Seventy-one percent of EDs (35/49) had an urgent transport of a pregnant or postpartum patient, and 43 % (20/47) had a birth in the prior 12 months. EDs in hospitals without obstetric services were less likely to have a birth (27 % v. 56 %), to have capacity to perform some obstetric procedures such as administering uterotonic drugs (58 % v. 100 %), and to require assessment of postpartum status in the electronic health record (0 % v. 33 %). The majority (19/35; 54 %) of responding ED managers had not offered obstetric emergency training to staff in the last two years.</p><p><strong>Conclusions: </strong>While obstetric emergencies are not uncommon in the Arkansas hospital EDs represented in this study, many EDs have gaps in their preparedness to identify and manage these cases. Key opportunities for improving preparedness in this sample include training staff and requiring assessment of both pregnancy and postpartum status for women of reproductive age.</p><p><strong>Bottom line: </strong>There is limited data on Emergency Department (ED) practices related to obstetric complications. We conducted a cross-sectional survey with managers of 51 (61 %) hospital-based EDs in Arkansas to assess EDs' experiences with, and capability to manage, obstetric emergencies. During the prior year, a precipitous birth occurred at roughly 1 in 3 EDs, and an urgent transport of a pregnant or postpartum patient occurred at 2 in 3 EDs. Key opportunities to improve ED practices include implementing consistent assessment of postpartum status and providing staff training on obstetric topics.</p>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":" ","pages":"108085"},"PeriodicalIF":1.9000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The telehealth MOM study: Protocol for a randomized controlled trial of the telehealth multi-component optimal model (MOM) of postpartum care.\",\"authors\":\"Jennifer A Callaghan-Koru, Nirvana Manning, James P Selig, Hari Eswaran, Stacy Tiemeyer, Sarah J Rhoads\",\"doi\":\"10.1016/j.cct.2025.108085\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This cross-sectional study of hospital emergency departments (EDs) in Arkansas sought to: 1) assess ED experiences and capabilities related to obstetric emergencies, and; 2) characterize the differences in ED practices for pregnant and postpartum patients between hospitals with and without obstetric services.</p><p><strong>Methods: </strong>Online survey invitations were distributed to department managers at hospital EDs across Arkansas in August 2023. The 40-question survey collected hospital characteristics, ED experiences with and capacity to manage obstetric emergencies, and staff training history and interest. Responses were descriptively analyzed, and differences in proportions between hospitals with and without obstetric services were tested.</p><p><strong>Results: </strong>Managers for 51 (61 %) of the 84 eligible EDs responded. Seventy-one percent of EDs (35/49) had an urgent transport of a pregnant or postpartum patient, and 43 % (20/47) had a birth in the prior 12 months. EDs in hospitals without obstetric services were less likely to have a birth (27 % v. 56 %), to have capacity to perform some obstetric procedures such as administering uterotonic drugs (58 % v. 100 %), and to require assessment of postpartum status in the electronic health record (0 % v. 33 %). The majority (19/35; 54 %) of responding ED managers had not offered obstetric emergency training to staff in the last two years.</p><p><strong>Conclusions: </strong>While obstetric emergencies are not uncommon in the Arkansas hospital EDs represented in this study, many EDs have gaps in their preparedness to identify and manage these cases. Key opportunities for improving preparedness in this sample include training staff and requiring assessment of both pregnancy and postpartum status for women of reproductive age.</p><p><strong>Bottom line: </strong>There is limited data on Emergency Department (ED) practices related to obstetric complications. We conducted a cross-sectional survey with managers of 51 (61 %) hospital-based EDs in Arkansas to assess EDs' experiences with, and capability to manage, obstetric emergencies. During the prior year, a precipitous birth occurred at roughly 1 in 3 EDs, and an urgent transport of a pregnant or postpartum patient occurred at 2 in 3 EDs. Key opportunities to improve ED practices include implementing consistent assessment of postpartum status and providing staff training on obstetric topics.</p>\",\"PeriodicalId\":10636,\"journal\":{\"name\":\"Contemporary clinical trials\",\"volume\":\" \",\"pages\":\"108085\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Contemporary clinical trials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cct.2025.108085\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contemporary clinical trials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cct.2025.108085","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
The telehealth MOM study: Protocol for a randomized controlled trial of the telehealth multi-component optimal model (MOM) of postpartum care.
Objectives: This cross-sectional study of hospital emergency departments (EDs) in Arkansas sought to: 1) assess ED experiences and capabilities related to obstetric emergencies, and; 2) characterize the differences in ED practices for pregnant and postpartum patients between hospitals with and without obstetric services.
Methods: Online survey invitations were distributed to department managers at hospital EDs across Arkansas in August 2023. The 40-question survey collected hospital characteristics, ED experiences with and capacity to manage obstetric emergencies, and staff training history and interest. Responses were descriptively analyzed, and differences in proportions between hospitals with and without obstetric services were tested.
Results: Managers for 51 (61 %) of the 84 eligible EDs responded. Seventy-one percent of EDs (35/49) had an urgent transport of a pregnant or postpartum patient, and 43 % (20/47) had a birth in the prior 12 months. EDs in hospitals without obstetric services were less likely to have a birth (27 % v. 56 %), to have capacity to perform some obstetric procedures such as administering uterotonic drugs (58 % v. 100 %), and to require assessment of postpartum status in the electronic health record (0 % v. 33 %). The majority (19/35; 54 %) of responding ED managers had not offered obstetric emergency training to staff in the last two years.
Conclusions: While obstetric emergencies are not uncommon in the Arkansas hospital EDs represented in this study, many EDs have gaps in their preparedness to identify and manage these cases. Key opportunities for improving preparedness in this sample include training staff and requiring assessment of both pregnancy and postpartum status for women of reproductive age.
Bottom line: There is limited data on Emergency Department (ED) practices related to obstetric complications. We conducted a cross-sectional survey with managers of 51 (61 %) hospital-based EDs in Arkansas to assess EDs' experiences with, and capability to manage, obstetric emergencies. During the prior year, a precipitous birth occurred at roughly 1 in 3 EDs, and an urgent transport of a pregnant or postpartum patient occurred at 2 in 3 EDs. Key opportunities to improve ED practices include implementing consistent assessment of postpartum status and providing staff training on obstetric topics.
期刊介绍:
Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.