LAKEPORT, Calif. – On March 21 Dr. Scott Witt spent time getting ready for an important date.

Dr. Witt, who normally works at Sutter Santa Rosa Regional Hospital, packed up his car, as he does every six months, and drove to Lakeport to spend two hours with obstetricians and nurses who care for patients at the Sutter Lakeside Hospital Family Birth Center.

Dr. Witt is a perinatologist – a special kind of obstetrician who has additional training in managing women with high-risk pregnancies or complications during pregnancy.

Also driving in for this meeting was Dr. Regina Arvon, a neonatologist from California Pacific Medical Center in San Francisco. A neonatologist is a special kind of pediatrician who has had additional training in the care of sick or premature newborns.

After everyone arrived and exchanged handshakes and hugs the group began the case conference.

Sutter Lakeside Hospital’s Family Birth Center team presented complex and unusual patient cases for the group to review, offering a chance for the entire care team – from floor nurses to specialists who usually communicate via telemedicine – to glean learning opportunities.

“Building relationships between our team and specialists within the system – and sharing knowledge between these groups – is at the heart of our philosophy,” said Jackie Rad, RN, MSN, Family Birth Center manager.

The biannual, retrospective review of cases began in 1997 and has grown to include three main modes of knowledge sharing and consultation.

Case conferences

Case conferences bring together a team of nurses and doctors – which might include anesthesiologists, pediatricians and primary care physicians in addition to the specialties listed above – to discuss best practices, review treatment plans, and develop recommendations.

“Supporting all of these specialists onsite full time would be impossible for a Critical Access Hospital,” said Rad. “By holding case conferences, we build the relationships necessary to constantly improve, collaborate, learn and break down siloes of care, improving patient outcomes. Putting faces to the names of interdisciplinary team members at different affiliates gives our nurses and doctors the confidence that when they need a second opinion, the physician on the other line is familiar with our team’s skills and limitations.”

Education

“Medical knowledge can sometimes get trapped among specialists,” said Dr. Derrick Barnes, an obstetrician (or OB/GYN) who practices full-time at Sutter Lakeside. “This is a shame because OB/GYNs are perfectly capable of caring for pregnant women with gestational diabetes, those who are HIV positive, or have other complications as long as we receive the corresponding additional education on these topics.”

This type of education won’t turn an obstetrician into a perinatologist or neonatologist, but that’s not the goal.

“The goal is to help moms and babies get and stay healthy, here in their home county if at all possible” said Barnes. “To do that everyone needs to work at the top of their license and stretch their skills within their scope of practice.”

Telemedicine

Technology has been used for the past decade to connect rural health care professionals with specialists at academic medical centers.

“In telemedicine, doctors treat patients via video conference, just as they would in a clinic setting,” says Rad. When case conferences or education aren’t enough, moms and babies receive one-on-one consultations from perinatologists and neonatologists through the Sutter Health network – thanks to years of investment in telemedicine.

Bringing it all together

“The approach Sutter is taking allows me to provide specialist-backed care – in a trusted local setting,” said Dr. Bryan Murphy, an OB/GYN who practices full time at Sutter Lakeside.

This approach not only benefits the individual patients that have greater access to perinatologists and neonatologists without leaving Lake County; other providers who participate benefit too.

“Everyone is a teacher and a learner. Obstetricians can spot things that perinatologists and neonatologists may miss and vice versa,” said Rad. “The results, such as telemedicine advancement, hands-on learning and maintaining best practices ultimately result in the best care possible for our patients.”