From siloed to shared: How a collaborative model is keeping OB care safe and local in rural America

The Client Challenge

Memorial Health System (MHS), a critical access hospital in rural Kansas, had to place its obstetric (OB) program on diversion due to staffing challenges. Unfortunately, MHS is not alone. OB care is at risk across rural America as more than 198 rural OB programs have closed since 2011. MHS and its affiliated system Salina Regional Health Center (SRHC) engaged Chartis to conduct a program assessment and develop a sustainable model for rural OB care.

PUTTING THE OB PROGRAM ON DIVERSION WOULD:

Decrease continuity of care for patients
Limit physician response time to patients after delivery due to travel time
Reduce access to care for patients due to missed clinic appointments
Introduce communication issues due to a lack of integration between physician groups

Navigating to Next: The Solution

Both health systems were dedicated to finding a solution to best support the community with OB care, including addressing specific needs like travel time. Avoiding added travel time is essential since rural communities often struggle with adequate transportation. But how could MHS overcome its challenges and provide access to local OB care? MHS partnered with Chartis to complete a robust assessment and collaborate with key stakeholders from both health systems to define criteria and refine model alternatives. We then identified the most sustainable solution to best support community needs: Bringing MHS family physicians and SRHC OB-GYNs together in a collaborative care model.

This model would encourage patient-oriented mother and child safety and extend patient access to advanced OB care. The SRHC OB-GYNs would seamlessly integrate into the patient journey through a shared medical record, predefined care, and virtual visits until the family physicians transferred care to the OB-GYNs for delivery. The new program would create a more highly reliable program with decreased variation, mitigating any vulnerabilities. The model would also be more sustainable since it would balance resources, garner physician support, and provide long-term financial stability.

Client Impact

MHS and SRHC leadership were confident the new collaborative OB program would support the community’s needs and preserve local access to quality maternity care for the long-term. The shared care model brings clinicians together from the 2 health systems and establishes a foundation to advance safety and quality outcomes in OB and other service lines. The program also positions the organizations to improve high reliability more broadly across their service lines and sites as it can serve as a model and accelerate efforts toward a systemic approach to high reliability care.