21 Feb

Congratulations Healthgrades Best Hospitals

Heatlhgrades Best Hospitals

Kudos to PeriGen clients who

made this year’s Healthgrades

Top Hospitals List!

Healthgrades, a top healthcare research company, today released its list of top hospitals for 2017.  The list is based on clinical quality data focused largely on the outcomes of the most common procedures and conditions using Medicare data.

The following PeriGen clients are included in this year’s Best Hospital List from Healthgrades:

  • Good Samaritan of Lafayette, CO
  • Lutheran Medical Center of Wheat Ridge, CO
  • Saint Joseph Hospital of Denver, CO (also made top 50 list)
  • Carle Foundation of Ubana, IL (also made top 50 list)
  • Indiana University Health Arnett Hospital of Lafayette, IN
  • Indiana University Health Methodist Hospital of Indianapolis, IN (included in top 50 list)
  • Indiana University Health University Hospital of Indianapolis, IN (included in top 50 list)
  • Mercy Hospital of Iowa City, IA (a top 50 hospital)
  • Medstar Franklin Square of Baltimore, MD (a top 50 hospital)
  • Baystate Health of Springfield, MA (a top 50 hospital)
  • Morristown Medical Center of Morristown, NJ (a top 50 hospital)
  • Overlook Hospital of Summit, NJ
  • Legacy Salmon Creek Hospital of Vancouver, WA

We’re so impressed with the hard work, dedication and focus that go into achieving the level of quality needed to be awarded a Top Hospital designation by Healthgrades!  Congratulations!

14 Feb

First CE Webinar Scheduled

Rebecca Cypher, PeriGen Chief Nursing OfficerPeriGen Now Offering Online Continuing Education

PeriGen has provided a date for the first in a series of free online continuing education webinars.  The series, featuring Chief Nursing Officer Rebecca Cypher, MSN, PNNP, will offer educational topics related to fetal monitoring, patient safety, and multidisciplinary care in the perinatal setting. Sessions are intended to assist clinicians in translating and incorporating evidence-based information into daily clinical activities.

The first webinar will cover uterine activity and is scheduled for March 8th, noon – 1:00 PM ET.  Titled “Power & Passenger: Understanding Uterine Activity,” this session is designed to examine nomenclature and definitions associated with uterine activity, etiologic principles of uterine tachysystole and tachysystole’s impact on fetal heart rate.

Registration is now open and, since the event is free and awards continuing education hours, is expected to fill fast

08 Feb

Reserve C-Section / NICU Research

cesarean research

Pick up your copy at
AWHONN CA Convention

PeriGen is proud to be supporting this year’s AWHONN California Section Conference, scheduled for February 17th and 18th at the DoubleTree by Hilton at the Berkeley Marina. Rebecca Cypher, PeriGen’s CNO, will be launching the pre-conference with a presentation on “Advanced Monitoring Concepts for Clinical Practice” and also greeting attendees at the PeriGen table.

We’re also offering a limited number of copies of our clinical research team’s latest work, published by Becker’s Hospital Management, “HIT & Clinical Synergy: A decade of decreasing NICU admissions & stabilizing cesarean rates.” This research summary outlines how one system combined leadership commitment, process improvement strategies and advanced technology to lower NICU rates and extraordinary resuscitation and control c-section rates. The work serves as a blueprint for those systems looking to achieve similar results.

To reserve your copy, for pick up at the PeriGen exhibitor table, please complete the form below:

About the research

“HIT & Clinical Synergy: A decade of decreasing NICU admissions & stabilizing cesarean rates” is co-authored by PeriGen’s Clinical Research leader Emily Hamilton. It appeared in Becker’s Hospital Management earlier this year.

The research uses retrospective analysis of 78,000 singleton births from a health system serving Maryland. The research uses a before-and-after comparison to identify factors leading to a statistically significant reduction in three metrics: NICU admissions, the use of newborn resuscitation, and the rate of cesareans.

24 Jan

Steamboat Perinatal Conference

Inventor of PeriGen advanced fetal monitoring

Once again, PeriGen’s Senior Vice President of Clinical Research, Dr. Emily Hamilton, and Chief Medical Officer, Dr. Thomas Garite, presented at the annual Steamboat Perinatal Conference in Colorado.  Dr. Garite’s presentation titled “The New Labor Guidelines: Benefit or Harm” incited much discussion as did Dr. Hamilton’s review of the importance of precision when looking fetal heart rate deceleration area.

Dr. Hamilton’s presentation, titled “Fetal Heart Rate Deceleration Area: Size Matters,”  reviewed the literature related to both the widespread inconsistency in fetal heart rate assessments, the impact this has on outcomes, and the many challenges associated with “typing” decelerations.  Much of her paper focused on a suggested, alternative methodology using deceleration area/time.

Her presentation slides are now available by clicking here

The annual Steamboat Perinatal Conference, now in its 32nd year, addresses current and controversial topics in perinatal care.  The faculty is drawn from both active practitioners and clinical researchers.  Although, like most conferences, the event centers around scheduled lectures, the Steamboat Perinatal Conference is best known for the animated discussions among faculty and attendees that happen during and after sessions.

04 Jan

Words to live by when leading change

Advice from leading IT transformation and change managers

Five key thoughts for those leading changeFive key thoughts for those leading system change

“People who have low psychological ownership in a system and who vigorously resist its implementation can bring a ‘technically best’ system to its knees.”

Nancy M. Lorenzi, PhD & Robert T. Riley, PhD
Managing Change: An Overview
Journal of the Medical Informatics Association

Practical implications of a study on IS change management: “…management should aim to increase the perceived value of change and organizational support for change to reduce user resistance.”

Hee-Woong Kim & Atreyi Kankanhalli
Investigating User Resistance to Information System Implementation: A Status Quo Bias Perspective
MIS Quarterly, Vol. 33, No 3, Sept 2009

“Lead your organization to a successful outcome, and speed up the process by treating your staff as customers first.”

Claire McCarthy, MA & Douglas Eastman, PhD
Change Management Strategies for an
Effective EMR Implementation

“In his article, “Leading Change: Why Transformation Fails,” John Kotter of Harvard Business School lists the major reasons for the failure of large-scale change initiatives (such as HIT systems): lack of a sense of urgency, no strong coalition, lack of a clear vision, missing frequent, clear communication, dis-empowerment of staff, no creation of short-term ‘wins’ to build momentum, and lack of ‘anchors’ for a change culture.”

Gloria L. Austin, Stephen Klasko, MD & William B. Leaver
The Art of Health IT Transformation

“In other words, recognize that you are not done at go-live; you’ve just started achieving technology adoption and changing behavior to get value from your investment.”

David E. Garets, FHIMSS
Change Management Strategies for an
Effective EMR Implementation

21 Dec

Why EFM trends are important

The importance of longer EFM views

Inventor of PeriGen advanced fetal monitoringby Emily Hamilton, MD CM
Senior Vice President, Clinical Research

Labor and delivery clinicians use EFM to identify fetal intolerance to labor to guide intervention and prevent hypoxic fetal injury. This task requires not only assessing the past and current degree of tracing abnormality and but projecting what is likely to happen in the near future. There is good evidence that tracing abnormalities generally evolve over hours (1-3). In addition, intervention guidelines usually recommend evaluating fetal response to supportive interventions over 30 to 60 minutes before resorting to cesarean delivery (4, 5). Thus long term assessments are essential. Standard computerized displays provide views of only 8 -10 minutes of tracing. Short term “snapshot” views can contribute to a failure to appreciate duration of tracing abnormality and the likely evolution.

PeriCALM Checklist analyzes EFM tracings in a consistent fashion. Its displays show long term trends over several hours, color coding regions of abnormality according to the criteria set by the institution. Such displays help clinicians see if a problem is intermittent or persistent, improving or deteriorating, stable or changing rapidly. A view of EFM trends may assist with situational awareness and helps clinicians in acute care settings more accurately project what is likely to happen and institute appropriate care. Checklist techniques and methods are especially pertinent in acute care settings during night time work when large amounts of data must be processed by the care givers over many hours. (6,7)

1. Vintzileos AM, Smulian JC. Decelerations, tachycardia, and decreased variability: have we overlooked the significance of longitudinal fetal heart rate changes for detecting intrapartum fetal hypoxia? Am J Obstet Gynecol. 2016 Sep;215(3):261-4.
2. Elliott C, Warrick PA, Graham E, Hamilton EF. Graded classification of fetal heart rate tracings: association with neonatal metabolic acidosis and neurologic morbidity. Am J Obstet Gynecol. 2010 Mar;202(3):258.
3. Clark SL, Hamilton EF, Garite TJ, Timmins A, Warrick PA, Smith S. The limits of electronic fetal heart rate monitoring in the prevention of neonatal metabolic acidemia. Am J Obstet Gynecol. 2016 Oct 14. pii: S0002-9378(16)30872-9. doi: 10.1016/j.ajog.2016.10.009. [Epub ahead of print]
4. Clark SL, Nageotte MP, Garite TJ, Freeman RK, Miller DA, Simpson KR, Belfort MA, Dildy GA, Parer JT, Berkowitz RL, D’Alton M, Rouse DJ, Gilstrap LC, Vintzileos AM, van Dorsten JP, Boehm FH, Miller LA, Hankins GD. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol. 2013 Aug;209(2):89-97.
5. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009 Jul;114(1):192-202.
6. Chapter 46. Fatigue, Sleepiness, and Medical Errors. AHRQ. (accessed December 2, 2016) https://archive.ahrq.gov/clinic/ptsafety/chap46a.htm
7. Fioratou E, Flin R, Glavin R, Patey R. Beyond monitoring: distributed situation awareness in anaesthesia. Br J Anaesth. 2010;105:83-90.

20 Dec

How one health system used HIT to control rate of Cesareans


Cesareans stabilized, NICU admissions and resuscitation decline after implementation of PeriCALM® Patterns™

Becker’s Hospital Review just released the results of 10-year study on the impact of process improvement and the use of PeriCALM on the rate of cesareans, NICU admissions and CPR/ventillation/intubation.

The study, authored by Sam Smith MD and Lynette Philip RN of MedStar and Adi Zmiri MD, Emily Hamilton MD CM, and Thomas Garite MD of PeriGen, looked at data for 78,459 births for Cesarean rates, NICU admissions, and the use of extraordinary fetal resuscitation procedures before and after the introduction of a management focus on care processes and staff training combined with the use of PeriCALM Patterns.

Following is a summary of the results published by Becker’s:

  • Despite an increase in factors associated with rates of cesarean sections, the rate of cesareans remained stable after the introduction of PeriCALM and advanced management strategies.
  • NICU admissions declined by more than half after PeriCALM and the process improvement steps were introduced.
  • The number of babies requiring unusual resuscitation measures in the delivery room decreased from 5.2% to 2.4%.

Click to access the Becker’s article providing full results and details

13 Dec

Build-a-Bike Challenge Trivia Quiz

A few of the trivia questions asked

during last week’s PeriGen team-building event

Here are a few of the questions we asked the PeriGen team as part of last week’s ‘Build-a-Bike Challenge.’  Teams that answered them correctly were awarded a point each and received a part of the bike they were building.

To see the answers, simply click on the questions. And, please, let us know how you do!

  • What is a DAS?
  • At what university was Patterns originally invented?
  • In what state is it illegal to kill mice without a hunting license?
  • Emily Hamilton's recent analysis of birth data indicates that cesarean rates did what since PeriCALM Patterns was installed at MedStar 10 years ago?
  • What is an example of a standard interface?
  • What were the wheels of the smallest adult bicycle made of?
  • Covered California, the state's health insurance program, indicates that they will remove hospitals based on what childbirth metric?
  • For WatchChild, what does BAM stand for?
  • In what city was Patterns first tested in a hospital?
  • Name the world's largest ocean.
  • What is the WatchChild database storage requirement?
  • What chess pieces can only move diagonally?
  • What WatchChild solution allows caregivers to monitor patients at any network-enabled location within the hospital (e.g., ED/ICU) and external locations such as physician offices?
  • How did the 17th president of the US, Andrew Johnson, start his career in Raleigh, NC ?
  • Which PeriGen client often provides Emily Hamilton with historic birth data (depersonalized) for clinical data analysis?
  • Name an EMR with which both WatchChild and PeriCALM can integrate?
  • According to a recent AJOG article co-authored by Emily Hamilton, when are ACOG first stage arrest criteria most applicable?
A store and forward device
McGill University
Ohio
Cesarean rates stayed the same despite an increase in risk factors associated with cesareans
ADT, LAB, pharmacy, outbound vitals/annotations
Silver dollars
The annual percentage of cesarean sections
Baby and Mother
Montreal
The Pacific
10MB per patient per day (uncompressed)
Bishops
Mobile Fetal Monitoring
He was a tailor’s apprentice
MedStar
Epic, Meditech, Allscripts, Cerner
After dilation has reached 6 CM