Improving Implementation of Cardio - Obstetric Intrapartum Recommendations Through Provider - Centered Workflow Redesign

Background

The University of Michigan Cardio-Obstetrics team is a multidisciplinary group that includes specialists in Cardiology, Maternal-Fetal-Medicine, Anesthesia, and Nursing caringfor pregnant patients with cardiovascular disease. They provide coordinated, evidence-based care across the preconception, pregnancy, and postpartum periods, with a focus on optimizing maternal and fetal outcomes through individualized management plans.Intrapartum and postpartum care plans are developed prenatally, documented in the electronic health record (EHR), and implemented by inpatient teams including generalist obstetric attending physicians and certified nurse-midwife laborists. A recent retrospective chart review demonstrated that over 30%of patients experienced deviations from Cardio-Obstetrics’documented care plans, potentially increasing maternal and neonatal morbidity.