Today’s Fetal Monitoring: Responding To “multiple” Needs

Today’s Fetal Monitoring: Responding To “multiple” Needs

The increasing number of high - risk pregnancies is placing greater demands on hospitals and obstetrical clinicians worldwide – and is resulting in a need for a higher level of fetal - maternal monitoring during both the antepartum and intrapartum delivery of care during pregnancy. So it is of excitement and importance to those who deliver obstetrical care to know how the latest technologies are particle to label these new challenges and demands.
Pregnancies with multiples number 2 of all live births in the United States an most developed countries, with the current frequency of high - order multiple births at 400 - 800 since 1980 and the ratio of triplets has another more than 400 of singleton gestations, over 80 % of multiple pregnancies develop complications antenatally. [5]
Fetal monitoring is the standard of care in most modern labor and delivery care settings, but with increasing multiple births, monitoring of twins and triplets is now a required functionality. Even the leading community hospital today can expect to see its fair share of multiple births. Today’s new generation of fetal monitors can indulge non - invasive triplet monitoring in one device and offer solutions for patients’ desire for ambulation as well as caregivers’ needs to be away from the bedside during labor.
Various societal factors have impacted pregnancy risk factors. Due to major changes in the lifestyle of women during the second half of the 20th century, the age at which childbirth is becoming has late in most developed countries. [1] In addition, heavier risk during pregnancy is attributed to younger age as well as original age, [3] and according to a December 2007 report from the Centers for Disease Control and Prevention, the birth rate among teenagers 15 to 19 in the United States cerise 3 percent in 2006. [4] Add to this the truth that health concerns selfsame as diabetes and obesity are on the rise in women of child - bearing age, which can jeopardize a pregnancy, and the truth that more women are conceiving with in - vitro fertilization ( IVF ), which can backwash in multiple births. [1] Together these factors contribute to a growing frequency of high - risk pregnancies and deliveries with lurking adverse complications that insert preeclampsia, gestational hypertension, and placental abruption. [5]
Lawrence Devoe, M. D., professor and former chair of the Department of Obstetrics and Gynecology with the Medical College of Georgia, explains the greater demands created by ART. “IVF is providing a child to families whose inability to conceive naturally would individual permit them childless. But the appreciate side of that is an amassed proportion of multi - fetal development, which in turn creates a post of elevated risk not inaugurate in a single pregnancy. And even with a single pregnancy, with IVF we are often dealing with a population that can be of an older age and with an elevated risk of medical problems alike as hypertension and diabetes. ”
Minimizing risk is of paramount importance with the IVF population, Dr. Devoe points out. “You can’t predict the future but you can maintain an right level of vigilance. The argument for the widespread use of fetal monitors is that without them, the unpredictability of labor can lead to supererogatory jeopardy for the mother and baby. Two common complications of labor are placental fault and placental dysfunction, which are not always possible to predict. The family that has undergone IVF has made a huge investment of time, energy, warmth and chief in having a child. You want to stay as far away from stress as possible. They are perhaps the most risk - hypersensitive population one could find. ”
The changes in obstetrical care and obstetrical patients as outlined higher has resulted in a whole new set of requirements to label these previously unmet needs needing to be addressed in state of the art fetal maternal monitoring solutions.
This is why high - level fetal - maternal monitoring solutions make a departure. When considering an investment in fetal - maternal monitoring technology for multiple births and other high - risk situations, it is prudent to consider certain features that are available on the market today:
• A larger external display that can be mounted across the room to confess clinicians to interact with the fetal - maternal observer even when they are not at the patient’s bedside.
• Electronic units linked to an obstetrical information management system give staff the ability to see the entire landscape of laboring patients, including the fetal maternal monitoring information, obstetrical log, progress of labor, at a central nursing station, in spare patient’s room, in the obstetrician’s office or even at their home via a secure internet access.
• Long - term data storage of fetal heart percentage traces and obstetrical records and backups, is an important legal mainspring so that data from the delivery can be generated even decades successive if obligatory.
• Non - invasive twins or triplets monitoring in one contrivance, with flat comparison of maternal heart scale with the fetal heart ratio ( s ) ensures each heart rate is being monitored separately and clearly.
• Monitoring of non invasive maternal blood handicap, maternal Sp02, and maternal ECG / maternal heart degree.
• Cordless transducers that own the mother to be moving while baby doll and the fetus or fetuses are being continuously monitored.
• Waterproof cordless transducers that grant the use of a Jacuzzi or bathtub or falls for leisure activity and also pain relief during labor or for the option of a water birth.
Because women usually make the majority of a family’s healthcare decisions, an obstetrics department can be considered an important marketing arm of a hospital. A reassuring and satisfying birth experience can allowance a significant impression and can offshoot in the utilization of subsequent services and referrals to others. Higher consideration is that today’s patients are educated and savvy. The availability of health information on the Internet and via note publications has resulted in patients who are aware of their options and who are requesting the highest level of clinical care and technology that is available.
It is the restraint of companies developing fetal - maternal monitoring solutions to work toward trim innovation of technology to help the clinicians deliver better care and help improve outcomes. This must be balanced with providing the best returns on investment for each tight healthcare dollar and meet various worldwide needs with affordable products that ration attractive long term cost of hold.
Dr. Devoe has attended over 10, 000 deliveries in his 39 years of practice and published one of the earliest studies involving the monitoring of multiples in the 1980s. “Fetal monitors are the first line of defense, especially when a nurse or physician can’t be at a bedside all the time, ” he concludes. “I can’t even actualize to tell you have many babies I’ve personally intervened with whose outcome would have been a great deal different if not for fetal monitoring. ”
[1] Blickstein I, The worldwide impact of iatrogenic pregnancy. Int J Gynaecol Obstet. 2003; 82: 307 - 17.
[2] Burry K. Reproductive medicine: where we have been, where we are, where are we alacrity? An ethical perspective. Am J
Obstet Gynecol. 2007; 196 ( 6 ): 578 - 80.
[3] Centers for Disease Control and Prevention. Births: Final Data for 2005. Atlanta, Ga: National Prerequisite Statistics Report; December 5, 2007. Apartment 56, Number 6.
[4] Centers for Disease Control and Prevention. Teen Birth Degree Rises for First Time in 15 Years. Atlanta, Ga: National Center for Health Statistics; December 5, 2007. Available at: http: / / www. cdc. gov / nchs / pressroom / 07newsreleases / teenbirth. htm. Accessed Step 3, 2008.
( 5 ) Centers for Disease Control and Prevention. http: / / www. cdc. gov / nchs / data / nvsr / nvsr56 / nvsr56_06. pdf Births Final Data 2005

Adaptive Case Management 101: What It Is, And Why Your Business Needs It

Adaptive Case Management 101: What It Is, And Why Your Business Needs It

There are innumerable ways to manage the daily, human - mean business processes upon which most businesses rely. These tasks – which often have prescribed best practices but materialize in different ways depending upon the players involved – make up an estimated 60 to 80 percent of the work done in any given company. If godforsaken to their own devices, employees are likely to manage these processes via e - mail or Microsoft Office applications, on paper or through said updates, none of which enable managers to passage the steps of business critical actions and arrange positive outcomes.
Ad - hoc tasks, by their mood, defy the confines of structured solutions equal business process management. However, that doesn’t mean that businesses need to accept the operational risk inherent in unmanaged or mismanaged processes.
These are the types of adaptive case management solutions that are specifically designed for the unstructured processes. They consist of crowd information, collaborating with others, managing individual workloads and making decisions that are dependent on the knowledge, judgment and experience of the participants. This technology can be a standalone solution, or can be embedded in recognized MS Office environments, making it intuitive for users and simple to incorporate into day - to - day use.
So what might those day - to - day uses encircle?
Operational risk management issues created by unstructured human processes appear in every industry, and run the reach from skilful process risk through politic process risk. The recapitulation process itself is a classic example of an unstructured human process. Recapitulation processes consist of a number of sub - tasks – e. g., defining an file plan, assembly information and defining findings, creating the recommendations based on those findings and in future, the follow - up and tracking of recommendation implementation. Each sub - process is a negotiation and collaboration between the involved parties ( in many cases done via e - mail and documents ). For illustration purposes, let’s focus on the recommendation - tracking and follow - up sub - process.
Let’s make known an scan finds a safety belief in a plant that needs corrective enterprise. An auditor e - mails a plant gaffer, alerting him to the safety question and making recommendations for addressing it. The plant manager then delegates the task ( also via e - mail ) to an employee, and explains the corrective actions. They will most likely engage in e - mail conversation about the specifics of the safety point: What is the squeeze? What needs review? What are the next steps? In discussing the answers to these questions, the parties will likely go back and radiate a few times. Depending upon the specifics, they may involve more team members to correct the belief. These exchanges are not memorable in the auditing process, but thanks to they are ad - hoc and unstructured, the auditor ( and management ) has no real visibility into the scrape - solving activities, let alone an ability to manage and alley the overall process lifecycle.
An survey is just one way human processes are used for regulatory compliance. In today’s potent regulatory environment, new regulations and greater regulatory supervision are the gauge for many industries. In most cases, the process for profit these regulations are human - centric and unstructured until the organization familiarizes itself with the regulation and it consequences. Over time, the organization may decide to run the point of compliance through a structured process supported by IT, but until then, most companies will handle it through a human process, prosaic executed via e - mail and documents.
For example, the new “breach notification” provisions of the Health Information Technology for Economic and Clinical Health ( HITECH ) Act is a healthcare regulation that has just been enacted. The regulations require HIPAA - covered entities to forthwith acquaint affected individuals, the health and human services secretary and the media of any breach affecting more than 500 individuals. Since this is a new regulation, one possible way to handle compliance is to designate someone as the breach - process owner. Her first act will most likely incorporate sending out recipe on how to handle the breach. The first step in applicability a breach might be sending an e - mail to the breach - process owner when a holy mess is discovered. At that point, the company would need to mold a response to the breach, making undeniable to meet the regulatory requirements and any relevant internal processes. That means ensuring affected individuals are notified, and, if needed, that the government and media are notified. The company may also launch an internal investigation of the breach. Without adaptive case management, all of these steps will trite be done via documents and e - mail – making it preposterous to manage, passageway and scrutiny compliance with the regulations.
Enabling the monitoring and tracking of unstructured processes through e - mail and documents also provides a complete system - of - log for settlement, an exquisite mitzvah if problems chance and an file compose is needed. For example, let’s surmise you have a customer overseas, and you need to rebut that a mammoth order can be shipped to that discriminative country. The sales executive in charge may have conscious an e - mail from the rudder notifying him of this desideratum ( i. e., checking with export controls ), but disposed the mood of e - mail, there is no way for the conductor to know that the gaffer actually took the fit process; it may have fallen through the cracks, or gotten lacking in the flood of e - mails certified by the sales gaffer.
Until your business has visibility into these unstructured activities, you are not managing the bulk of the work in your organization. If these processes should be tracked for compliance reasons, then this absence of visibility poses significant risk. Consider your regulatory and compliance processes – people - impassioned tasks that cause as a backwash of an apparent regulation. Presume of how many e - mails and documents are generated by these processes. Does your business really know how compliance procedures are executed? Or where each of the currently running compliance processes stand? These changes happen on a case - by - case basis, and people doctor to rely on documents and e - mail to deal with them. However, since these actions interject some type of redress if not concluded on time, IT must fit the ability to manage, course and detector these ad - hoc actions. Inured the way most people work and the current infrastructure in most companies, the best way to do this is by enhancing e - mail and documents with adaptive case management.
It makes sense that IT first tackled the less complicated disagreement of serviceability plan actions that eventuate in the equivalent practice over and over besides. Business process management and like products have ably automated oversight of those predictable tasks. Now, technology has dissimilar enough to handle the significantly more tangled matter of action tracking peculiar work. Adaptive case management makes it possible to overseer ad - hoc processes from start to finish in a procedure that eliminates risk and increases visibility. Inclined the importance of these tasks to organizations in virtually every industry, the cost of not managing them is too great to consider.