|
|
Post by jenperryhidalgo on Jan 22, 2019 17:48:34 GMT -5
Hello- I am interested in hearing how sites deal with patients risking out of low-risk Centering care. We are running our first group and have a patient who risks out of health department care d/t GDM. ( We transfer our GDM patients to the university practice in town.) She is very interested in continuing the education/community-building piece of Centering care. How do folks deal with this? Our university practice does not offer the Centering model of care. Do groups allow patients to continue without providing the assessment piece of care? Please let me know your thoughts. Thanks- Jennifer Perry-Hidalgo, CNM Pitt County Health Department Greenville, NC |
|
|
|
Post by Tanya Munroe on Jan 23, 2019 9:57:39 GMT -5
Hello Jennifer, I hope some others chime in as this is a common question. It is wonderful that your mom wants to stay in group and it would be great if she can indeed stay even though she may not be having the billable assessment portion of the session. I know some sites do still have the assessment portion and that mom simply has additional visits at the high-risk practice. Maybe over time your colleagues at the university practice will get interested in groups for their GDM moms : )
|
|
Shannon Busch
GA - Centering Georgia
Posts: 14 
I work at a: Healthcare Facility
My job role is: Administrator
|
Post by Shannon Busch on Jan 23, 2019 10:41:32 GMT -5
Our higher risk moms are allowed to attend Centering in our practice but we do not do the provider assessment portion of their session. They do their vitals and record them in their book. We try to schedule their traditional provider visit the same day if it is at all possible either before or after group. For us, with the small groups that we have, another happy participant only adds to our group experience.
|
|
|
|
Post by Rachel L on Jan 25, 2019 9:48:27 GMT -5
We have created a pretty good relationship with the high risk clinic at our associated hospital. We do a healthy level of co-management so that our patients can continue with centering if they want. Very high risk patients on insulin end up fully transferring, but a lot of our GDM's on oral's stay with us as long as sugars stay controlled. We do sugar log evaluations with an RN during the beginning of group while waiting for their belly check and discuss diet at that time. I believe the high risk clinic will call the patient and do a phone evaluation of the sugar logs as well.
I think it has been healthy to have a solid relationship with high risk and an OB on staff that is confident with the controlled GDM's, and it has worked for us to keep them in group with a few additional individual visits in-between group sessions.
|
|
starrrivera
GA - Centering Georgia
Posts: 23
I work at a: Healthcare Facility
My job role is: Staff
I am interested in Centering because: As a military spouse myself, I can see the HUGE benefit Centering has to our expectant moms who are often many miles from home with no friends or family nearby! I feel like the Centering model is a perfect fit for our environment!
|
Post by starrrivera on Feb 13, 2019 15:29:25 GMT -5
We are a military clinic, so billing is a little different for us..... Most of our GDMs will be able to stay in Centering for the education piece, but will sometimes still see a physician. It just depends on the Centering provider's comfort level.
|
|
pamcnm
In-House Trainers
Posts: 33
My job role is: Healthcare Provider
I am interested in Centering because: The centering model and facilitative leadership provide families with the support, education & assessments they need to become partners in their own care.
|
Post by pamcnm on Feb 14, 2019 7:39:25 GMT -5
Our GDM's don't risk out of centering care but are informed they will need to attend any GDM specific visits in addition to attending centering. We continue to do routine assessments and will help make sure any NST's, ultrasounds are scheduled in a timely manner. All of our GDM's are managed by the regional perinatal service center, and patients being seen for both centering and individual care have weekly telephone appointments to manage blood glucose levels and make sure they see one of our two docs who specialize in caring for pregnant women with diabetes, and so this helps!
|
|
Cynthia CE Wade
Active Member
Posts: 69
I work at a: Professional Organization
My job role is: Healthcare Provider
|
Post by Cynthia CE Wade on Feb 21, 2019 10:28:20 GMT -5
Our women who risk out also continue to come to Centering. Since our OBHR doctors are the residents and attending MDs of our same practice, there is no problem with them going to both visits. Depending on how high risk the problem is, the CNM is the group might co-manage the patient, but they must go to their OBHR clinic. Because the women wanted to keep coming to the group, our midwifery practice actually began caring for the GDM's as long as they didn't require medication or insulin.
If each individual midwife decided that whatever the condition was, was too high risk for them to manage, they wouldn't do the assessment, but just bill for an education only visit. For example, I had a patient that knew before she joined the group that she was having twins, but she wanted to come to Centering so she did. I did feel comfortable trying to listen for two fetal heartbeats with my not-so-great doppler, so I didn't do her assessment. She came to all the groups and all her OBRH appointments and also our PP reunion.
|
|
