Risk Management in Great Western Hospital – High-risk Pregnancy Care

Risk Issues Confronting the Hospital Great Western Hospital

The case has several risk issues presented, the major risk issues being high-risk pregnancies. High-risk pregnancies in Great Western Hospital (GWH) account for 40% of all pregnancies handled in the GWH. The high risks pregnancies are caused by more pregnancies among women of advanced age; above 40 years, women with a preexisting medical condition such as obesity, high blood pressure, and diabetes, mental health condition, women with past complication in low-risk pregnancies such as preeclampsia, multiple gestations, women with past cesarean section scar, and women under Vitro fertilization (Porter, Stanton & Takvorian, 2013). The increase in cases of high-risk pregnancies also increases the risk of having a preterm birth, and retardation growth during gestation. Vitro fertilization increases twin pregnancies that increase the risk of pregnancy loss and growth restriction. Premature birth increase cases of morbidity and length of admission in the special care baby unit. This also increases the risk of care costs after birth for the hospital and the families involved. The other major risk is having women with more than one cause of high-risk pregnancy. All high risks pregnancy cases need specialized care from obstetricians and gynecologists, as well as specialists in a specific health condition. This can be quite costly to the hospital as specialists are more expensive to maintain.

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Options or Opportunities to Manage those Risk Issues

High-risk pregnancy risk can be managed by ensuring proper maternal care during pregnancy. Rather than dealing with midwives, high-risk pregnancy mothers should have their cases addressed by specialists from the early age of the pregnancy. Mothers identified to have high-risk pregnancies should start their prenatal care as early as possible. Constant monitoring and case management by all viable specialists would be necessary. To address preterm births and high morbidity as a result of multiple gestations, mothers should be given two steroid injections at 26-28 weeks to help fetus lungs mature earlier (Porter, Stanton & Takvorian, 2013). This will helps in increasing fetus survival and reducing the hospitalization period after birth. The hospital can also change the high-risk pregnancy care model to more evidence-based practice for specific forms of high-risk pregnancy. The hospital can create a condition-based model where each clinic unit is condition-specific. Each condition-based unit should be headed by a senior obstetrician and a midwife, and other specialists with knowledge in a specific health condition. The care should be characterized by regular scans to monitor fetus growth, a collaboration between obstetricians and other specialists in addressing health preconditions such as diabetes, and nutritionists to handle diabetes and obesity. Rather than visiting different specialists in each visit, each patient’s case will be handled by one obstetrician all through to ensure proper follow-up and care. In case a mother has more than one high-risk pregnancy cause, then the patient should be assigned to the unit of the major cause of the high-risk pregnancy. This will improve care among high-risk pregnancies, reducing the risk or consequences of these risks to the unborn baby. It will also reduce the cost associated with premature birth child care. The available opportunities include expanding the new evidence-based practice and model to other surrounding hospitals in the UK (Porter, Stanton & Takvorian, 2013). This is anticipated to improve patients’ outcomes in high-risk pregnancies, reduce patient management costs, increase chances of child survival after birth, and shorten hospital stay. Embracing the opportunity is also likely to improve the general hospital performance in maternity care. 

The Options that are the Best Response

Among the provided options, the best response would be the adoption of evidence-based practice characterized by a new condition-based model. This is the best option because it ensures that the hospital and the patients get the best results possible. The evidence-based practice ensures that the approach used is the only one that can give the most satisfactory results (Porter, Stanton & Takvorian, 2013). It ensures early identification of high-risk pregnancies, assignment of each patient to the right unit of care, and ensure that each patient is accessible to the right specialist based on their specific condition. This guarantees the best care that ends up improving the general pregnancy outcome of a high-risk pregnancy patient. It reduces the rate of preterm birth, mortality, and hospitalization after birth. This generally results in reduced care costs in the hospital and among patients’ families.  Therefore, this is the best possible option.

Options or Actions Most Likely to be Followed

In most cases, evidence-based practice is complex and needs a lot of specialization. In this case, the most likely option to be followed would be visiting a general practitioner and getting referred to any specialist if one is found to have a high-risk pregnancy. Other than seeing a specialist in the specific cause of high-risk pregnancy, the patient will be sent to an obstetrician or gynecologist available (Porter, Stanton & Takvorian, 2013). This means one is likely to see several different obstetricians by the end of the pregnancy rather than having a single specialist in her condition. This model is likely to integrate midwives who will play a major role in patient management rather than specialists. Patients will only be referred to specialists if the case gets complicated. The model is easier and manageable, however, the outcome is not as pleasing as the evidence-based practice model.

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