The Center for Peripartum Optimization

NCT ID: NCT03522909

Last Updated: 2021-09-13

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 250 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2017-01-31
• Study Completion Date: 2020-12-31

Brief Summary

In January 2017 investigators started a Center for Peripartum Optimization (CPO) with the aim of optimizing a patient's clinical status in an outpatient setting to minimize unnecessary laboratory tests and studies, costly inpatient consultations, the likelihood of post-surgical adverse events, escalations in level of care, inpatient admissions and readmissions. This research project seeks to evaluate the impact of this innovative concept on patient outcomes during the last 12 months. Investigators will accomplish this by collecting retrospective data from patients' electronic medical records in the intervention group and comparing it to data gathered from a controlled group of patients with similar comorbidities but who were not evaluated at the CPO clinic.

Conditions

High Risk Pregnancy; Multidisciplinary Communication; Communication; Obstetric Complication

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

Study

We will be reviewing records of parturients seen at Johns Hopkins Hospital in the Center for Peripartum Optimization (CPO) clinic between January 2017 to January 2018

Seen in clinic

Intervention Type: OTHER

We will be doing a retrospective chart review of patients seen in the Center for Peripartum Optimization to look for:

1. Primary outcome variable.

• Hospital length of stay

2. Secondary outcome variables.

• Number of admissions from outside hospitals
• Adverse outcomes
• Intensive Care Unit admissions
• Opioid use
• NICU admissions
• Patient satisfaction
• Cost of inpatient admission
• Cost of outpatient care
• Hospital readmissions rate

Control

A matched controlled group patients not seen at the CPO clinic

No interventions assigned to this group

Interventions

Seen in clinic

We will be doing a retrospective chart review of patients seen in the Center for Peripartum Optimization to look for:

1. Primary outcome variable.

• Hospital length of stay

2. Secondary outcome variables.

• Number of admissions from outside hospitals
• Adverse outcomes
• Intensive Care Unit admissions
• Opioid use
• NICU admissions
• Patient satisfaction
• Cost of inpatient admission
• Cost of outpatient care
• Hospital readmissions rate

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Records of all female, obstetric patients of child-bearing age who were evaluated in the Center for Peripartum Optimization during the period between January 2017 and January 2018.
• Controlled group will include parturients with match high risk comorbidities or history of nonobstetric surgery during pregnancy who delivered at Johns Hopkins Hospital (JHH) during July 1, 2016 - Dec 31, 2016
• Patients with any one or more of these high risk comorbidities:
• Complex spine pathologies (Scoliosis, vertebral fusion, disc disease, spinal canal defects, neuropathies, and nerve disease, etc.)
• Neurological pathology (Cerebral ischemia, tumor, increased intracranial pressure, cerebral vascular disease, etc.)
• Cardiac disease (Congenital, valvular, pulmonary hypertension, cardiomyopathy, ischemic disease, arrhythmia, etc.)
• Pulmonary disease (History of pulmonary embolism, interstitial lung disease, severe asthma, cancer, etc.)
• Morbid Obesity (Obstructive Sleep Apnea, equipment considerations)
• Hematologic Disorders (Thrombophilias, coagulopathies, patients on anticoagulation)
• Cancer
• Abnormal placentation (Previa, accreta / increta / percreta)
• Anesthetic concerns (Airway abnormalities, history of adverse anesthetic reactions or experiences (i.e. recall, anaphylaxis))
• Fetal therapy patients requiring specialized management (Ex utero intrapartum treatment (EXIT), Fetoscopic endotracheal occlusion (FETO), Twin-to-twin transfusion syndrome (TTTS), Percutaneous Umbilical Blood Sampling (PUBS), etc.)
• Chronic Pain

• Records of patients seen in CPO clinic that did not deliver at our institution

Exclusion Criteria

• Records of CPO participating parturients outside the specified timeframe.

• Maximum Eligible Age: 60 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Johns Hopkins University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jamie D Murphy, MD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins University

Locations

Johns Hopkins Hospital

Baltimore, Maryland, United States

Countries

United States

Other Identifiers

IRB00163559

Identifier Type: -

Identifier Source: org_study_id