Nick Obiri, Division Chief of Neonatology, Reading Hospital Tower Health

Christine Novak CCBH Pre/post Natal Care Manager

Mario DeMarco, Family Physician, University of Pennsylvania

Sharon Silks, Intensive Care Nursery, Penn Medicine

Krista Flaherty, LCSW Allegheny Health Network

Maryann Mattes, RN, Clinical Informatics Specialist OB/NICU/Peds, Main Line Health

Nick DeGregorio, Sr. Medical Director UPMC Health Plan

Good Morning, Williette Walker, RN from the NICU at The Hospital of University of Pennsylvania

Mary Beth Dastalfo, BSN, RN - Clinical Leader New Beginnings, Wayne Memorial Hospital

Carolyn Byrnes, PADOH, Senior Advisor

Brigid Kelly, MSW Administrative Assistant Pettaway Pursuit Foundation in Lansdowne, PA

Erica Bolden, RN, ICN, Penn Medicine

Heather Cecil, PhD

Jen Sullivan, Nurse Manager for OB at Evangelical Community Hospital, Lewisburg

Brittney Bogar, RN, Quality Improvement Advisor, Penn State Health M.S. Hershey Medical Center

Kara Poremba, RN Practice Manager of Women's Health, Wayne Memorial Hospital

Jenn Young, MSN, UPMC Hamot, Erie PA, Clinician OB Triage, Patient Safety

Good morning, Lakshmi Reddy, Medical Director with Gateway Health

BJJS - statistician

Good morning everyone. Kerin Kohler, Women's Health Social Worker, Reading Hospital.

Kimberly Leonard CRNP-Regional Director of Magee Women's Health Service Line of UPMC Northern Pod

Deb Knittle Geisinger Bloomsburg L&D Team Coordinator

Tracy Chandler

Daryl Stoner, MD, Ob Einstein Medical Center Montgomery

Tracy Chandler- -Main Line Health

Hello,

Rachel Cunniffe, Geisinger Wyoming Valley, Nursing Professional Development Specialist, Obstetrics

Renni Rodriguez BSN, RN Quality Management Coordinator for Guthrie Healthcare systems.

Meghan Bragers, MSW, LCSW, Women's Health Social Worker at Penn State Health in Hershey, PA

That increase is awesome! Sometimes it is hard to see the big picture, and this overview is very helpful!

Virtual packet: https://www.whamglobal.org/june-29th-2021-learning-collaborative

PA DDAP funding opportunity for pregnancy support services re: SUD (due July 13 by 12pm) https://www.ddap.pa.gov/DDAPFunding/Pages/Funding-Opportunities.aspx

Social media toolkit re: increase in WIC benefits for fruits and vegetables through September 2021 https://drive.google.com/drive/folders/1xFvdaJmTkbfF8sKr_pZXyS3EyX5oGp4J

I do not think NTSV "not for medical reasons" is a fair representation of that metric. But the data representing the disparity is still important.

NTSV = Nulliparous, Term, Singleton, Vertex

I love the idea of adding doulas to the hospital setting.

Can you elaborate more on the doula work in the hospital?

CAN YOU PLEASE SHARE YOUR INFO AGAIN

atanmcgrory@partners.org

race and ethnicity related to newborns , I guess we generally just put mother's race because we know who the mother is and not necessarily who the father is. So what ever the mother self identifies as is generally what we put. But I concede the very valid point that we should still ask the parents what race/ethnicity who should use for their child.

Aswita Tan-McGrory, MBA, MSPHDirectorThe Disparities Solutions CenterMassachusetts General Hospital atanmcgrory@partners.org

Thank you for sharing!

Thank you for the excellent presentation. A few years ago we changed the process regarding the completion of the newborn filter paper. We copied the newborn filter paper information and provided it on a letter to the parent to complete the information including race. The parents can complete the race section or not. In the past the nurse would complete the race section. The state has opportunity to be more inclusive in the current listing in the race section.

how do you determine race if their is no birth certificate in the chart and the mother does not answer what the race is, how do we submit that to CMS

Excellent question!!!!

@joseph gobern, I just looked at the report and Black women at MGH have consistently higher rates of primary Cesarean deliveries, a finding not entirely explainable by differences in other measurable characteristics such as obesity, medical co-morbidities, obstetrical risk factors or labor management practices.

How about socio-economic background? Interesting that we can't measure trust in providers as a metric, and yet we know that has an impact on people's progress in labor. Does telling patients that their demographic does not trust providers enhance trust or deepen distrust?

Dr Tan-McGrory, That is an unfortunate common finding for those of us monitoring and measuring. Thank you again for your leadership and active investigation. I share your passion for the pursuit of health equity.

IPLARC PLease

don't see rooms opening - OUD please

NAS Breakout

NAS Please

not seeing the room

OUD

OUD please

Not seeing the rooms option - OUD please

There is no room option

Maternal SUD/OUD please

Momd please

Maternal SUD/OUD pls

IPLARC Please

OUD, please

MOMD pleasee

Maternal SUD/OUD please

Kim Amon & Anita Alloway for NAS. Please

NAS breakout please

PA AIM please.

Maternal SUD/OUD please

AIM for me - don't see option to select

MOMD please

Ann Santeusanio for NAS please!

I would like to join maternal SUD but unable to enter room

It's not there for many of us Steve

NAS Please

Didn’t get a pop up and would like to join OPUD

Maternal OUD please

momd please

https://static1.squarespace.com/static/5e8f4e2a4eaf8154a7c9c939/t/5f8893c7c0207b1930f52e4b/1602786254066/opqc_nas_parent_guide_092914.pdf

https://nastoolkit.org/

https://cha.com/wp-content/uploads/2019/01/SHOUT-GUIDELINE-inpatient-buprenorphine-4-18-18.pdf

Does your organization complete a Urine UDS in addition to the 4Ps questions?

How do you bill for that test?

Thank you

Payment for toxicology screening in pregnancy is frequently denied by insurances in Pennsylvania. Including MCOs.

This is for standardized toxicology at initial OB appt.

Where are you housing moms post discharge for ESC? Are your babies admitted to the NICU once mom is discharged or do they stay in your newborn nursery? This is a barrier we have not worked through yet.

Dr Herrine - Why 3 days of observation for buprenorphine-exposed vs. 5 days for methadone-exposed neonates?

@Beth Ann Pyle - Reading Hospital partnered with the pediatric inpatient floor to support the Eat Sleep Console Program after a mother is delivered.

excellent thank you DR Herrine

At Reading Hospital, we moved to ESC in March 2020. Babies are admitted to the pediatric unit when mom is discharged unless there is a medical reason requiring NICU admission. Parents are encouraged to stay with baby throughout stay. We ask for 20 our of 24 hours/day.

At Redeemer Health, we have 2 designated PP rooms close to the NICU.

We have been practicing ESC for almost 1 yr.

At Abington, we do ESC. For patients who do not require NICU care, we transfer to peds for care

We have also been doing ESC for close to 2 years.

Parent/designated caregiver can stay on peds

This seemed to only come about when we switched to a point of care testing method that we are aware of at this time. It crosses Medicaid and commercial payers in denying coverage of the testing.

I'm just wondering (as we move closer to legalizing marijuana in this state and already have legal medical marijuana), how do you address marijuana use in pregnancy in patients with medical marijuana cards? Is there any follow up with those women after their hospital stay? What about if they don't have a medical marijuana card?

Wondering the same thing Elizabeth!

Motivational Interviewing resources https://www.whamglobal.org/resources#Motivational-Interviewing

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Additional information about SUD screens during pregnancy is available here https://www.whamglobal.org/list-documents/374-validated-sud-screens-in-pregnancy/file

We screen in Labor and Delivery with the NIDA and f/u positive screens (moderate to high risk) with a maternal urine tox screen and umbilical cord screen. Please comment on this approach - are both of these tests necessary?

I love your gender inclusive language in presentation.

Dr. Wright - I'm curious for your thoughts about responses when a person declines screening or toxicology testing.

That is very helpful!! Thanks!!

If you don't require the urine test for those at risk, how can you be sure you have a clear picture of what the fetus was exposed to?

How does the CPS time out work with state mandates to call into childline

(plans of safe care-- goes to childline)

At UPMC if mom meets testing criteria but declines we still test the infant - as we are advocating on their behalf.

My son was born at UPMC and was tested at birth. His birth mom was terrified that they were going to take him from me (just a lot of overall fear). They were great explaining it

Thank you for further clarifying Dr. Wright.

we are mandated to notify CPS when a baby is affected by both a legal or illegal substance. Many of these notifications are not taken up as CPS cases and do not have CPS involvement even though the notification is required.

Wonderful presentation, Dr. Wright!

Great talk and recommendations Dr. Wright! Thanks!!

Thank you

Thank you Dr. Wright

great presentation and content!!

Great information in your presentation

Please complete the electronic evaluations by Tuesday, July 6: https://www.surveymonkey.com/r/LXNGDDGVirtual packet of materials (including) survey: https://www.whamglobal.org/june-29th-2021-learning-collaborative

Thank you for participating today and for everything you do to care for pregnant and postpartum individuals in PA

Thank you!

Thank you!

Thank you!

Thank you!

Thank you

Thank you

Thank you 👏🏽

Great Job Robert and All. Thanks!

Thank you

thank you

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thank you!

thanks everyone, very informative and well run!