WHAT DO I NEED TO DO FOR THE WEEK OF JUNE 29 2020:
(send all feedback to [email protected])
DATA
We have a crucial discussion set for next week regarding measures and data collection for the maternal side of this initiative. Our challenge is in not only tracking improvements on the inpatient side for mothers but marking advances in screening and care of mothers on the outpatient side.
You all as Experts have made clear the challenges of accessing outpatient maternal data, especially regarding verbal screening for substance use, in some systems. How best do we then support efforts on the outpatient side to ensure 100% screening? Is it by focusing on some pilot healthcare systems that are willing to bridge the continuum of prenatal and inpatient and postpartum care? If so, over one year, we can identify best practices, do we then expand our experience and learning to a larger number of systems willing to prioritize this effort?
We know what we all ideally would like but we need to consider what is potentially possible in the first year of this effort, knowing that this is a project that will require at least 1-2 more years.
clOUDi Expert Team Webinar #9 - DATA - Wednesday, July 1 @ 12:00 PM - register here - Vitally important in depth discussion of data / data collection, please join us and make your voice heard!
CHARTER
We have received some critical input from Expert Team members that were unable to regularly participate in Calls. We have done our best to incorporate these suggestions into this draft of the Charter. The suggested edits were critical in making this charter a document that clearly demonstrates our intention to partner with mothers with OUD in a manner which is supportive, transparent and non-stigmatizing. Please take a last review of the charter as we would like this document to join the others in being finalized next week.
Finally - Two things to do:
- If your facility is interested in participating in the initiative please complete the intent form so PQCNC can start sending you the info you'll need - click here
- Register for the webinars listed below -
- clOUDi Expert Team Webinar #9 - DATA - Wednesday, July 1 @ 12:00 PM - register here - Vitally important in depth discussion of data / data collection, please join us and make your voice heard!
- clOUDi Expert Team Webinar #10 - Topic TBA / if needed - Wednesday, July 15th @12:00 PM - register here
- Register for the face to face expert team meeting in September - register here
EAT SLEEP CONSOLE
Thank you to those able to join the Eat Sleep and Console (ESC) Call this past week. We had presentations from Kevin Coppage at Caromont and Chris Westeveer at Atrium on the development and implementation of a new approach to the care of the infant at risk for Neonatal Abstinence Syndrome. Most of us have spent considerable time and effort using Finnegan scoring to guide the care of infants with opiate withdrawal and determine when to initiate pharmacologic treatment. Dr. Coppage and RN Westeveer introduced us to ESC. ESC focuses on the ability of babies to do what babies should do…eat, sleep and console….with medications as a second line prn treatment.
At its core, ESC ultimately uses the mother as the medical treatment for the baby’s withdrawal. There are logistic issues to be confronted in executing ESC in different environments, but if it is best for mom and baby, and reduces dramatically the length of stay, do we need to consider optimizing the environment and systems of care for these babies? This offers a chance to empower moms, and perhaps improve maternal outcomes as well.
I think our presenters made many of us pause and consider what we are doing using a scoring system with very variable inter-rator reliability to determine whether babies should be started on prolonged courses of medications (morphine or methadone or clonidine or phenobarbital) possibly requiring transfer to an NICU. Is there a better way?
We will be convening a webinar over the next month to talk further about whether clOUDi should assume hospitals might use Finnegan or ESC, or whether clOUDi should recommend that hospitals use ESC. Please register and join the conversation - your voices needed.
In considering this question you all have homework. Please watch Matt Grossman’s excellent presentation on neonatal opioid withdrawal, its treatment and ESC. Dr. Coppage, who had great doubts about abandoning Finnegan for ESC cites this video as a critical part of his conversion and the amazing success Caromont has had in caring for babies and moms dealing with drug withdrawal and reducing length of stay for these infants. I ask you all to watch this Video.
Watch Matt Grossman's video here
We will also be adding resources that detail implementing of ESC in hospitals. There is much to consider here regarding the details, but at the core, in order to make ESC successful, there needs to be a realization from core team members that ESC offers multiple benefits not realized in our current Finnegan centric systems of care.
Look forward to the conversation next month!
NO CALLS? HOW WILL THE EXPERT TEAM WORK PROCEED?
(send all feedback to [email protected])
Given the work at each of your facilities in preparing for and dealing with COVID 19 we have cancelled the remaining webinar but we still want/need/value your participation. We recognize that the work will need to proceed around your schedule rather than adhering to our webinar schedule. The new outline of the work flow look like this:
- We will send out a link to a document / issue for discussion or a draft for feedback
- You'll have 10 days can respond back via email with your comments/suggestions/edits
- We'll do our best to incorporate the changes
- In the next email we'll send the next iteration for discussion or possibly approval of the final version
- Repeat until we've finished all the components needed for a successful initiative
- Remember, we need your email feedback, especially as we won't be having any further calls for the foreseeable future - the more feedback you provide, the stronger the initiative!
With each initiative complicated issues arise that might need more discussion than is allowed for in the hour long meetings - these will be added to the agenda and addressed at the in person, day-long meeting in September - register here
