Protection for births through 24/7 obstetrics partnership

For St. Mary’s Medical Center

Nature does an amazing job of ensuring most births take place as planned. Dr. Michael White knows this better than most.

But, as an OB hospitalist who has assisted at thousands of births, he also knows that things can go wrong quickly, and unexpectedly. Every minute can count.

That is why White and his medical group of five OB hospitalists have contracted with St. Mary’s Hospital to have an OB/GYN in St. Mary’s maternity unit around the clock. These physicians can be at a bedside within seconds in an emergency. If a mother, or her baby, is in trouble, the hospitalists can whisk that patient into a surgical room located on the maternity floor without delay. They can handle a crisis or help with a delivery until a mother’s own healthcare provider arrives.

“This is a unique model. There is always one of us physically present,” White said. “Our response time is 30 seconds rather than the 15 minutes it might take a healthcare provider to get to the hospital from outside.”

St. Mary’s began this service December 2014 after negotiating with White, who was representing the OB Hospitalist Group a partnership of more than 500 OB/GYNs that contract with about 100 hospitals in 27 states to provide care to maternity patients. White was splitting his time between being medical director of the OB Hospitalist Group and working on the clinical side delivering babies in southern California when St. Mary’s began considering using the OB Hospitalists Group for aroundthe- clock coverage.

When St. Mary’s contracted with the group, it prompted White to make a shift in his career and lifestyle. He moved his wife and two children and his parents from the Newport Beach area to homes in Glade Park. He began practicing as an OB/GYN hospitalist and the local leader for the OB Hospitalist Group. A year ago, he set up Monument Women’s Health Care, a group of five OB/GYNs who rotate shifts to provide the 24/7 coverage at St. Mary’s. The group also includes two midwives.

It was a ‘coming home’ transition for White. He is a Colorado native and had been wanting to return to his home state. He grew up in Colorado Springs and met the girl who would become his wife while attending a youth camp. He and his wife spent time visiting friends in Palisade and found they really enjoyed the area.

White earned his undergraduate degree at Colorado State University and completed medical school at the University of Colorado. After finishing his residency and working at larger hospitals in Chapel Hill, North Carolina and in Southern California, he was ready for the Colorado mountains again. The outdoor opportunities around the Grand Valley, and the chance to practice at the Western Slope’s largest hospital, put a bullseye on Grand Junction.

“We love it here,” said White, who spends his leisure time camping and backpacking with his family.

White’s choice of St. Mary’s included other important components: He said he found that St. Mary’s had the right pieces already in place to help ensure safer deliveries for mothers and newborns. There is a blood bank on site if transfusions are needed. There is a neonatal intensive care unit connected to the maternity ward. The maternity unit contains an emergency surgical suite. Partners at the University of Colorado Hospital partner with St. Mary’s for consultations on fetal cases that involve neurological or certain cardiac problems.

“After working at larger centers, I can say the quality of care at bigger centers is not what it is here,” White said. “It’s not that we have every new cutting edge thing here. But there is a real dedication here to standards and best practices. And the nurses here are phenomenal.”

White attributes much of that to the maternity nursing staff and the teamwork they have developed with the OB/GYN hospitalists.

“We collaborate as a team, and every member of that team can voice concerns, White said.

The mutual admiration between the OB hospitalist physicians and the nursing staff has led to strong teamwork — a good thing to have, especially in complicated births where two or more physicians, several delivery nurses and a cadre of neonatal intensive care nurses are standing by at a mother’s bedside.

Shannon Stroeve, a registered nurse in the maternity unit, confirmed that teamwork in a maternity unit is important.

“We have open communication, and the physicians treat everyone with respect,” she said. “They keep the department moving with the most up-to-date evidence-based practices. And their bedside manner is truly exceptional.”

Stroeve pointed out that the pace in a busy maternity ward like St. Mary’s can go from relaxed to full-speed at any time, and that having a physician right there “is wonderful.”

Some of the things that can, and do, happen quickly in deliveries include a dropping heart rate that can sometimes necessitate an immediate delivery.

Another problem requiring immediate help is a placenta that pulls away from the walls of the uterus. This problem, called a placental abruption, happens very quickly and can deprive a baby of oxygen and cause heavy bleeding in a mother. In those cases, the hospitalist on duty in the maternity ward can whisk the patient to the maternal operating room with no damaging delay.

When there is no emergency and deliveries are taking place as nature intended, the OB hospitalists — the only ones on the Western Slope — offer an education component to delivering mothers, and an element of comfort.

“We can give lots of TLC. If patients have questions, we can stop in and chat,” White said. “The doctor is always here.”



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