UC Health's Innovative Approach
A. Multi-site Teamwork
In 2024, with the help of its Performance Improvement coalition, UC Health celebrated the ability to offer a hypertension-focused program to its patients at both of its labor & delivery locations—UC Medical Center and West Chester Hospital.
The Alliance for Innovation in Maternal Health [AIM] Hypertension Program focuses on improved recognition and treatment of hypertension in pregnancy. The national and state-level program and collaboration ensure comprehensive care "bundling" that addresses high blood pressure from multiple angles with the goals of “improving the quality of care and outcomes for patients,” according to Dr. Hamel.
The AIM Hypertension Interdisciplinary Care Bundle at UC Health includes:
- Readiness with a standard protocol
- Recognition and Prevention
- Response during and after delivery
- Reviewing our outcomes and experiences (to improve continually)
- Respectful and Inclusive Patient Communications
B. Comprehensive Interdisciplinary Care Plan
Megan received the new AIM Hypertension program’s services. Following her check-up appointment at UC Health’s West Chester Hospital, her physician and nursing care team knew she needed more acute care due to her preeclampsia.
“As soon as they got that high-pressure reading in the doctor's office,” Megan said.
They immediately said that I needed to go to labor and delivery triage to be monitored for at least four hours with blood pressure cycling every 15 minutes to make sure.”
Megan said she felt seen and heard by her delivery team, which included by Dr. Hamel.
“What we track at this time is making sure that patients were treated appropriately with the appropriate medication, appropriate time frame that education was done, that blood pressure cuffs are given, that the postpartum follow up visits in a short interval time frame are being done,” Dr. Hamel explained of the general treatment process based on a patient’s diagnosis.
“So, just knowing that at every single step in the process of me feeling concerned, there was not one time where I felt like they did not take me seriously,” Megan said.
Her daughter, Aubrey Heitz, was born safely on October 15, 2024.
“It truly blows my mind. Like the entire time that I was in labor, I kept saying to all my nurses like, ‘I can't believe this is really happening,’” Megan recalls. “She's really coming. And she was coming so quickly to compare to my son that I was just like, ‘This is a miracle.’”
“I was there with her during her delivery,” Dr. Hamel recalls of Megan’s delivery. “I think it's so important to just listen. Listen to your patient. They can share so much with you can usually tell you exactly what's going on, and understanding them is so important. We really want to make childbirth and prenatal care as dignified of an experience as it can be.”
In addition to excellent physician care, the cornerstone of UC Health’s initiative hypertension program is a detailed interdisciplinary care plan that includes ongoing assessments and well-defined treatment protocols for managing hypertension effectively. This is tailored to before-delivery and postpartum hypertension management. If needed, Dr. Hamel says possible treatments include blood pressure medications or magnesium, depending on the patient’s diagnosis.
West Chester Hospital Labor and Delivery Nurse LaShonda Franklin, RN, says she values the new bundled program to better help patients where they are during their pregnancy. Starting with education, she says she and her fellow nurses are equipped to communicate the signs and symptoms associated with hypertension and the medications, next steps, and tools like a blood pressure cuff needed to respond in and outside the hospital.
“We provide them with mom before they go home,” LaShonda said of the blood pressure cuff. “So not only do we show them how to use that cuff, but we also show them the numbers to look for it on the cup to say, ‘Hey, this is too high, I need to call my doctor, or I need to take my medication.’”
C. Proactive Monitoring and Follow-up
The new AIM Hypertension identifies women with high-risk hypertension needs. Following delivery, the protocol specifies whether patients will need a 3-day or 10-day follow-up visit, based on the severity of the hypertension, to be closely monitored for any complications.
“We actually make sure that they have the appointment set up before they leave our presence at the hospital,” LaShonda said. “We're really trying to implement these changes to make sure that the patient is holistically cared for so they can take care of their newborn and themselves and be set up to get healed as they go home,” LaShonda said.
This structured approach allows healthcare providers to closely monitor and address before-delivery and postpartum gestational hypertension, preeclampsia, preeclampsia with severe features, and chronic hypertension.
“When we began this initiative, only about 30% of women received blood pressure cuffs. Today, we’ve increased that to over 95% for the identified high-risk hypertensive patients,” said Julie Bell, RN, Clinical Manager of Perinatal Services at the University of Cincinnati Medical Center. Julie works out of UC Medical Center, which says it gives out close to a dozen blood pressure cuffs every week to hypertensive pregnant patients.
“So that way, if there are any issues at all, we're not waiting until there is mortality or morbidity that in real-time,” Julie explained. “She's able to make sure that she's contacting the provider if she has any concerns at all.”
UC Medical Center also offers a comprehensive combined follow-up program for mothers and newborns called “Baby Steps.”
“The reason why this is so valuable to the community is because we have both moms and babies that can come back post-discharge. So for the babies, they can get their weight checked, they can get their bilirubin levels checked. And we can also have a lactation consultant work with them in real-time. And then for our moms, they can come back for their blood pressure check. And the reason why this is important is because there are a lot of ladies after they deliver who have hypertension. So they will receive blood pressure cuffs after delivery and are able to come back here and have their blood pressure checked taken by one of our nurses,” Julie explained. “And what's so great about it is that there's continuity of care.”
UC Health is dedicated to helping women in their motherhood journeys overcome barriers and access the care they need for themselves and their newborns.
