Access to accurate prenatal information is imperative to safely care for both Mom and baby.  As professional providers, we all offer the heart of caring.  Without the science (via the prenatal record) all the caring and heart in the world may not secure safe, comprehensive care delivery.  Nationally, institutions struggle with the quandry of acquiring this pertinent information.  Three competing hospitals in one midwest state came together to address this issue.  Represented are two Level-III perinatal facilities and one Level III NICU Children's Hospital.  The Maternal Fetal Medicine Quality Utilization and Improvement Project (now affectionately known as simply 'MFM QUIP') was born.  This project included a task force made up of providers from many disciplines throughout the three institutions.  Such representatives included nurses, informatics, advanced practice nurses, neonatologists, perinatologists, managers, support staff and even a patient representative. 

The global aim statement was set:  "We aim to improve communication and acquisition of prenatal data prior to delivery."  2 specific questions were addressed: 1) What is the quantity of the data (%) and can we improve it? and 2) What is the quality of the data and does it meet our needs in order to be prepared?

Each institution set about determining the flow of the prenatal record: How does it arrive, is it standardized and can we improve?  Mapping of the process of the prenatal record flow was done.  Once solidified, these were shared with regional providers.  Simply because a process is in place does not guarantee it's effectiveness.  Troubleshooting occured with specific institutions such as private practice providers and health departments to standardize their flow to meet the safety needs of our mutual patients. 

At the delivering institutions, the flow of information was audited at multiple points such as 1) is the information available in L&D when the patient arrives? 2) If the prenatal record is mailed in, is it filed appropriately and timely? 3) If a patient is discharged undelivered, is the prenatal record appropriately returned to L&D to await her next admission? and 4) Is the information available and accessible at the time of delivery? These audits are ongoing and currently one delivering institution is boasting a 98-100% compliance rate. 

The second question 'What is the quality of the data and does it meet our needs in order to be prepared and safely care for the patient?  This question is much more involved and daunting.  Yes, a prenatal record may be on the maternal chart, but did it's author complete the lab portion?  The multidisciplinary team made up 'wish lists' from both obstetric and neonatal providers.  Then an audit tool was developed and is being used to audit the quality indicators both disciplines saw as critical.

This successful multidisciplinary-multiinstitution project certainly underscores the definition of innovative.  Much  heart and caring went in to the project over the past year to assure the science of caring is available. With the participation in this project, improvement has been made in assuring the flow of the prenatal information and relationships across disciplines and specialties are strengthened.  All of this, to ultimately ensure the safety and wellbeing of our patients.