Health Systems

Fighting Maternal Mortality with Baylor’s Perinatal Outreach Team

Anyone who has ever had a job knows this routine. There is an unfamiliar person in the break room or lobby, often adjacent to a table with some bright signage, swag, and perhaps a tray of brownies. They are a bit too friendly, searching desperately for your eye contact. You want that treat or stress ball, but you will end up having to do something between signing up for a newsletter and starting a Roth IRA in order to get it.

If you worked in healthcare and a group from an unaffiliated hospital showed up in the break room, you might be suspicious of their motives. But for Baylor Scott and White’s perinatal outreach team, things are a bit different. They see the expertise they share with area providers as part of their mission, and say they don’t expect anything in return.

Baylor’s outreach team focuses on the care other providers and hospitals give to their patients in order to decrease morbidity and mortality for women in maternity. Texas is near the bottom of the list of states for maternal mortality, and nationwide the US ranks below most other developed countries when it comes to maternal mortality. The perinatal outreach team’s goal is to improve the rates of maternal mortality.

Marci Lasiter is Baylor University Medical Center’s Perinatal Outreach Coordinator, and she travels to facilities throughout Dallas and the region to share best practices for the time before, during, and after childbirth. “My bosses gave me free reign to share with non-Baylor facilities,” she says.

She helps develop classes and teach staff at area hospitals as far away as Ennis and Corsicana, sometimes driving up to five hours to teach a small group of clinicians. “It is so incredibly exciting, and we get to help to make people safer,” Lasiter says.

The group practices emergency situations with other hospitals that don’t have the educational and technological resources of larger teaching hospitals. They discuss when a patient would need to be transported to a more advanced hospital, and how to deal with other obstetric emergencies.

The team consists of nurses, physicians, and the transport medical director, Dr. Paul Payne, working with techs, nurses, doctors, and surgeons at area hospitals. The team is focused on education, and tries to make regular appearances at in the region’s facilities. Dr. Anthony Gregg is a maternal fetal medicine doctor and geneticist at Baylor University Medical Center says Baylor works to enhance its maternal care programs and make improvements in house before they share it with other programs.

Gregg arrived at Baylor over a year ago and has worked all over the country, but has not seen this level of cooperation in other systems. “Every hospital is really trying to advance care with the resources that they have, and for the most part, they are doing a good job. But you don’t know what you don’t know.”

There are transportation agreements between Baylor and certain regional medical centers with lower levels of care, but Gregg says that doesn’t affect who receives the outreach. “There is never a guarantee there will be a return,” he says. “The return is the health of the women in these places. We share our expertise so other hospitals can improve, and we do this out of the goodness of this institution’s heart. It’s true altruism.”

The perinatal group also works with midwife practices, developing a relationship so that if a mother and baby need more care than is available at the birthing center, they better understand best practices for transport.

Amy Tate is a midwife at Origins Birth and Wellness, a birthing center in Dallas. The facility has been on the receiving end of the outreach team’s education efforts. She says Lasiter came to her facility and offered to do training and drills with the staff. “It was very unique,” she says. “We had never been offered that opportunity.”

The teams worked on dealing with hemorrhage training and core prolapse, providing expertise that Tate says could have taken years to acquire.  They filmed practice procedures and the team provided feedback on how everything went. “It was super beneficial to us as midwives and to our patients most importantly,” Tate says.

The partnership has provided advantages for the midwives as well. Should a mother need to be transported to Baylor, the midwife is allowed to stay with her as she is transported to Labor and Delivery, which doesn’t happen at other facilities, Tate says. “We feel like they just care – we felt very heard and supported. A lot of people talk about building bridges and closing the gap. Marci has kept all of her promises.”

The program has been in place for over a year, but Gregg sees technology as a way the team could expand their reach. Virtual education could reduce the hours lost driving, and conferences allow the group to reach several facilities at once.

“This is a unique place,” Gregg says. “I have been in a many places, and there is a real effort to meet the needs and service our small hospitals in the surrounding region.”


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