With COVID-19, POWER Workshop Goes Virtual to Keep Improving Maternal Health

By Ben Boulden

“We said, ‘The show is going to go on.’ We are part of UAMS Institute for Digital Health & Innovation so we’re proficient with telehealth and telemedicine,” said Tina Pennington, M.N.Sc., a clinical services manager and neonatal outreach coordinator with the institute. “There was one meeting component we had to put aside that wouldn’t translate well online, but we were able to keep our speakers, and even our breakout sessions were able to switch over to interactive video.”

The Perinatal Outcomes Workgroup through Education & Research (POWER) is an initiative of the UAMS Institute for Digital Health & Innovation and the 40 labor and delivery facilities across Arkansas. One focus of POWER is promoting the use of safety bundles to improve health outcomes for mothers giving birth. Safety bundles are a set of evidence-based guidelines to be adapted to local circumstances to better manage a medical condition and improve health outcomes.

In years past, the workgroup’s annual gathering at Petit Jean Mountain has attracted between 90-100 attendees. With the tools and the expertise available to them at the institute, Pennington and the other organizers were confident they could accommodate at least many online attendees through live, real-time video connections. They did and 93 people participated.

They polled the audience in advance and found them receptive to doing two half-day sessions instead of the usual two full days in person. With the overall topic of obstetric emergencies, they pulled together a full agenda to cover a wide range of OB emergencies. Attendees met online to hear and watch presentations.

Keynote speakers were Julie Whittington, M.D., and Kevin Sexton, M.D. Sexton is an assistant professor in the UAMS College of Medicine Department of Surgery and UAMS associate chief clinical informatics officer for Innovation, Research, & Entrepreneurship. Whittington is a maternal-fetal medicine fellow in the UAMS College of Medicine Department of Obstetrics and Gynecology.

Whittington presented the results of a study of eclampsia and how it is treated in eight different hospitals in eastern Arkansas. Ecalmpsia is a condition of high blood pressure in pregnant women that can result in seizures, coma and even death. Female participants in the study presented themselves as patients in four delivering and four non-delivering hospitals. The woman in each hospital would say she had a baby four days before and was experiencing a very bad headache, a symptom of eclampsia.

Pennington said, “We were testing to see if the nurses and physicians recognized it as eclampsia. It’s a misconception the danger is over when the mother has finished delivering her baby.”

After the surprise test, nurses and physicians in the hospitals were educated as to how to recognize the symptoms of eclampsia and how to treat it. Later, they were paid a second surprise visit from a new “patient” to see how they would respond. Pennington said the results were mixed.

“Some places got it and some didn’t,” she said, “We need to figure out a better way to get this education out in the rural areas. There were real emergencies while we were there that made the test difficult. Many of the hospitals are understaffed.”

Sexton, a trauma surgeon specialist, spoke of common formulas and tools used in the Emergency Department that could be employed to combat OB-related hemorrhage.

Curtis Lowery, M.D., director of the UAMS Institute for Digital Health & Innovation, spoke to the virtual attendees about the future of digital health and how COVID-19 has greatly accelerated the speed at which physicians and hospitals are adopting it as part of their regular practice and health care delivery.

In addition to Lowery, Sexton, Whittington and Pennington, other speakers were: William Greenfield, M.D., associate professor in the UAMS Department of Obstetrics and Gynecology; Dawn Brown, B.S.N., R.N., POWER clinical director; Kelly Urban, Ph.D., R.N.,  UAMS Trauma Program specialty nurse; Faiza Khan M.D., associate professor in the UAMS College of Medicine Department of Anesthesiology; and Stanley Ellis, Ed.D., assistant professor and director of education in the UAMS Institute for Digital Health & Innovation.

Pennington said the POWER workgroup for several years has conducted a smaller, mid-year live meeting online. Despite that, the success of the April virtual meeting and the positive feedback organizers have received from attendees, they hope to be able to resume doing it in-person next year.

“There was definitely a need to get this information out to people. Once we saw what the content would be we were determined to get it out there. We still want to do a live conference again,” Pennington said. “It always was like a retreat. There were meet-and-greets and a chance to network professionally. There’s great value in that, too.