1. Group Prenatal Care 2.0: Guest speakers, Milestones, Funding and More
in true CenteringPregnancy® spirit,
add your questions to the “board”
i.e., your gadget
[ there will be time for questions throughout! ]

2. Group Prenatal Care 2.0: Guest speakers, Milestones, Funding and More
Presented by
Elizabeth Joy Beckman, MD & Rita Girard, MD
Contributing group members:
Montiel Rosenthal, MD; Hillary Mount, MD; Barbara Hoffrogge, RN; Judy Piron, BSN; Saundra Regan, PhD

3. disclosures “self assessment” i you will :)
image credit:

4. objectives furthering the impact of a group model of care.
Avoid pitfalls with implementation of a group model of care within residency training programs.
Incorporate and share new ideas for
furthering the impact of a group model of care.
Include a novel approach to milestone assessment of residents in the group care model or maternity care rotation.

5. provider satisfaction
CenteringPregnancy®
health assessment
education
support
This is our spiel for pitching it to women (lower wait times, less repetition of counseling throughout the day by providers – say it once to all these women), etc.
preterm
low birth weight
breastfeeding
pregnancy spacing
engagement
self-confidence
provider satisfaction
source: centeringhealthcare.org

6. opener: state of prenatal group care at my institution
turn to a person next to you
share your name
share your practice location
share if group prenatal care is provided

7. implementation: family medicine (& psychiatry) residency

8. implementation: cincinnati, ohio
photo credit:

9. implementation: hamilton county
photo credit:

10. implementation: infant mortality importance
low birth weight 3.4% (6.4%)
preterm delivery - us 6.5% (8.1% institution)

11. implementation: patient population
hispanic
white
african american
11% uninsured
89% medicaid insurance

12. implementation: foundation

13. implementation: financing
2013
CenteringPregnancy®
co-facilitator training
2010
2014
social work
yoga instruction
2016
any other sources of successful funding
snacks
clinical sites
child care during sessions
nursing time for steering committee meetings
CenteringPregnancy® certification fees 2011-present
photo source:

14. implementation: certification & training

15. implementation: patient recruitment

16. agree - disagree: opt out patient recruitment
source:

18. implementation: facilitation
group members
maternity faculty
nurses
resident(s)

19. agree or disagree: resident facilitation
source:

20. implementation: problem-based charting

21. implementation: poc decision-tool

22. furthering the impact: expert additions
session 4,8,10 mental health screening
session 7 infant CPR
wk 33-35
“now I know how to save my baby” - older son arrested as an infant, could only call 911, permanent brain damage - talk about empowering.
yoga mats (safe)
statistician…
session 3 yoga instructor
wk 22-26
session 2 lactation consultant
wk 18-22
session 1 registered dietician
wk 12-16

23. furthering the impact: collaboration

24. furthering the impact: your institutions
source:

25. resident evaluation: a unique opportunity
“It has given me a positive perspective not only on Group Prenatal Care but Group Visits in general as being something I could participate in and/or start. Very empowering. “
- tchucfm graduate

26. resident evaluation: milestone assessment
Group prenatal care allows much more observation of the residents’ ability to counsel patients on things such as contraception, nutrition, etc.
We have 10 areas that are very specific, observable behaviors that can be assessed when working with a resident.
They are linked to subcompetencies (see parentheses at the end of the description) and these are tracked in all rotations and compiled at the time of semi-annual review.
One attending per week fills out the form and marks the resident’s level of independence for those that were observed (usually 3-4 observed of the 10 per week).
We have tons of data tracked from other rotations and maternity care to see how our residents are doing in the different subcompetencies, mainly because this allows much more direct observation of their interactions with patients.

27. resident evaluation: feedback
There is also an area for free texting feedback on our form.
A copy is automatically sent to all maternity care faculty, the resident and their advisor.

28. resident evaluation: faculty response
“we give feedback throughout the course of the rotation instead of just the end so the resident can
incorporate feedback in real time when it's not too late to try new things in the safe environment of training” “a
huge asset”
deep connections and bonds created among patients and the care team
“ We get to observe our residents counseling patients
more than any other setting in residency due to the group model of care. “

29. resident evaluation: resident response
“OB feedback improved greatly over my 3 years”
“a nonthreatening environment
for attendings, residents and patients
to learn from one another”
“Appreciated
the times
faculty had time to discuss /
run-through
cases after
group”
Of moderate educational benefit. The actual patient care time always seems quite rushed. It felt that both patients and residents were "punished" by having to stay after if patients had concerns that could not be addressed in 3 minutes.
1.6 point increase
since implementation (1-10 scale)

30. source: https://bitmoji.com
resident evaluation: your institutions
source:

31. thank you
Lisbeth Lazaron, MD
TCHUCFM residents
TCHUCFM graduates

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