Back to Top Skip to main content Skip to sub-navigation

Award-winning Navy team successfully improves care for women, infants

Labor and Delivery providers were the front-line adopters of the Induction of Labor care pathway at Naval Medical Center San Diego. As of July 2019, over 80 percent of the hospital’s providers were using the pathway. (U.S. Navy photo by Mass Communication Specialist Seaman Joseph A. Boomhower) Labor and Delivery providers were the front-line adopters of the Induction of Labor care pathway at Naval Medical Center San Diego. As of July 2019, over 80 percent of the hospital’s providers were using the pathway. (U.S. Navy photo by Mass Communication Specialist Seaman Joseph A. Boomhower)

Recommended Content:

Military Hospitals and Clinics | Children's Health | Women's Health | Nurses Week

A team of nurses and providers at Naval Medical Center San Diego were awarded the Rear Adm. Elizabeth S. Niemyer Award for Evidence-Based Practice this August, for their work improving outcomes for pregnant women and babies.

In 2018, childbirth made up 42 percent of all hospital admissions in the MHS. As with other national health systems, data have shown that delivering top outcomes for pregnant women and babies continues to be one of the MHS’s greatest challenges.

This is why providers and staff across the MHS have been working on ways to improve outcomes for pregnant women and babies. The award-winning team at Naval Medical Center San Diego have had some success.

They focused on the care process for inducing labor in pregnant women. In 20 percent of pregnancies, labor must be induced. This can be a long and complex process for mothers and babies. Induction of labor can lead to complications as well. So, the team developed and implemented a care pathway.

Care pathways approach care from the patient’s perspective. They guide a patient with a specific condition through each step of the care experience. Providers use the pathway to ensure all patients receive consistent, high-quality care aligned to best practices.

When the Induction of Labor care pathway was used in the hospital, the team found that patient outcomes improved.

The team saw a 2 percent decrease in unplanned NICU admissions. Time from hospital admission to delivery decreased by an average of four hours. And chorioamnionitis infections in labor went down 5 percent. Chorioamnionitis is a bacterial infection that can affect both mothers and babies.

Now that the team has seen results in San Diego, there may be opportunity to expand and improve outcomes for women and babies across the MHS.

“We are looking for the best way to roll out the pathway to other military treatment facilities,” said the project team lead, Navy Cmdr. (Dr.) Monica Lutgendorf.

This project is just one example of teams improving care for MHS patients. Lutgendorf is the chair of the MHS Women and Infant Clinical Community. The MHS Clinical Communities are networks of MHS providers who collaborate on clinical process improvement and standardization to ensure a consistent level of excellence in patient care at each facility.

“Our Clinical Communities identify, develop and pilot clinical performance improvement projects like the Induction of Labor care pathway to improve the way we deliver care,” said Dr. Paul Cordts, Chief Medical Officer for the Defense Health Agency.

Success in San Diego

The Induction of Labor care pathway was modeled after evidence-based processes used in other health systems. The MHS Women and Infant Clinical Community and the team in San Diego adapted these processes to fit the needs of their patients.

Developing the care pathway was just one step to success. After that, the team had to ensure providers used the pathway, and had to monitor progress for patients. The project team said educating staff, building support and adjusting the pathway were essential to success.

“Cmdr. Lutgendorf’s most critical role was as the provider,” said Jeffrey Budge. Budge is a registered nurse and process improvement expert on the project team. “She led the change and led other providers to adopt the care pathway. Without someone actually using the pathway when taking care of the patients, it’s all theoretical.”

By July 2019, more than 80 percent of the hospital’s providers were using the pathway.

Real-time data collection served an important role in showing the success of the pathway. This helped the team gain the support of other providers. This data will also inform the MHS approach to expanding the pathway to other facilities.

Standardization across the MHS

The MHS Clinical Communities, including the Women and Infant Clinical Community, develop and spread improvements like this pathway. The communities target areas of varying care and apply standard approaches to get the best outcomes for patients.

Current changes within the MHS support standardized and improved care. The Defense Health Agency is becoming responsible for the Army, Navy and Air Force hospitals and clinics. This authority advances the MHS’s efforts to become a reliable system that drives improvement and decreases disparity in care. This will ensure every patient receives the best possible care.

“There is definitely work involved in implementing, but it is rewarding to change the system, and even more rewarding to improve outcomes for your patients,” said Lutgendorf.

You also may be interested in...

Sesame Street supports military families with health care transitions

Article
9/15/2020
Sesame Street character comforts a military child during a doctor visit.

This article introduces the new Sesame Street for Military Families: Transitions in Health Care section and how it can support military families as they transition to new health care providers.

Recommended Content:

Children's Health

DHA encourages women leaders through Federal Women’s Program

Article
9/4/2020
Navy Rear Adm. Mary Riggs greets Army Maj. Angela Hinkson

What are the right tools for successful women leaders?

Recommended Content:

Women's Health | Nurses Week

USAF doctor strives to advance women leaders in military medicine

Article
9/1/2020
Photo of Dr. Yun

While the military has come a long way regarding females in the higher ranks, Yun sees more progress to come.

Recommended Content:

Coronavirus | Women's Health | Heroes Behind the Mask

Back-to-school vaccinations in the age of coronavirus

Article
8/12/2020
Medical technician wearing a mask, filling an immunization needle

DHA experts answer questions about back-to-school vaccines

Recommended Content:

Immunization Healthcare | Vaccine-Preventable Diseases | Public Health | Medical and Dental Preventive Care Fitness | Children's Health | Immunizations

BAMC nurses: “It’s us against COVID”

Article
8/6/2020
Group of nurses at a hospital

With safety on the line, mistakes aren’t an option when it comes to PPE.

Recommended Content:

Coronavirus | Heroes Behind the Mask | Nurses Week

Determined to Serve: Critical care nurse joins the Reserve at age 50

Article
7/22/2020
Two military healthcare workers wearing masks

The Air Force Reserve does indeed have a critical need for critical care nurses.

Recommended Content:

Coronavirus | Heroes Behind the Mask | Nurses Week

BAMC follows through with redesignation of Army’s WTBs

Article
6/16/2020
Soldier in front of flag speaking into microphone

Brooke Army Medical Center’s WTB made the formal announcement of the pending change on June 3, 2020, with a brief tree dedication ceremony.

Recommended Content:

Military Hospitals and Clinics

Air Force medical recruiting up while recruiters, applicants serve their communities

Article
6/10/2020
Four  military nurses wearing masks

The pandemic is increasing unemployment rates, driving many people to seek career paths in health sciences and military medicine.

Recommended Content:

Coronavirus | Nurses Week

From the battlefield to the homefront: MHS nurses continue to serve

Article
5/12/2020
Seven soldiers standing behind an American flag

Nurses fill many roles including research, education, leadership

Recommended Content:

Coronavirus | Nurses Week

A passion for helping and leading: Nurse leads Air Force Medical Service

Article
5/11/2020
Image of Lt. Gen. Dorothy Hogg

During her 36-year career in the Air Force, Hogg has climbed through the ranks and became the first nurse, as well as the first woman, to hold the position of Air Force surgeon general.

Recommended Content:

Coronavirus | Nurses Week

Nurses stay ready during COVID-19 pandemic

Article
5/11/2020
Image of two military nurses talking in a hospital hallway

MHS nurses go above and beyond the call of duty

Recommended Content:

Coronavirus | Nurses Week

The evolution of military nursing

Article
5/8/2020
Image of vintage military nurses

A look back on nurses who blazed the trail for nurses today

Recommended Content:

Coronavirus | Nurses Week

NMRTC Bremerton recognizes National Nurse Week/Navy Nurse Corps Birthday

Article
5/8/2020
image of nurse Amy Salzieder, with the statement "Nurses care for people, not just treat a person. In doing so, we receive the satisfaction of knowing that we have made a difference to patients and their families."

Nurses Care for People...Not Just Treat a Person.

Recommended Content:

Nurses Week

MHS Nurse Advice Line proves to be invaluable during COVID-19 pandemic

Article
5/7/2020
Image of military nurse on the phone

Learn about the NAL and other ways to get advice on COVID-19

Recommended Content:

Coronavirus | Nurses Week

Defending the Homeland: 'I Am Navy Medicine, helping stop the spread of COVID-19'

Article
5/7/2020
Image of nurse wearing a mask

NMRTC Bremerton’s Urgent Care Clinic (UCC) is a microcosm example of nurses – and teamwork - in action.

Recommended Content:

Coronavirus | Heroes Behind the Mask | Nurses Week
<< < 1 2 3 4 5  ... > >> 
Showing results 61 - 75 Page 5 of 7

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.