New maternity management program aimed at improving outcomes, lowering costs

UCHealth pilots new pregnancy program to school district, Columbine Health
March 1st, 2016

A proactive approach to one’s health is never a bad idea — but it becomes even more important when one’s actions directly affect another.

“Our goal is to improve health outcomes as well as help employers lower their health care costs,” said Laura Dvorak, UCHealth’s Lifestyle Health manager in northern Colorado.

The program started Jan. 1 for employers who have contracts with UCHealth for Lifestyle Health Services, and as of late February, seven women have enrolled.
“This program does not replace what OB [obstetrics] providers do but rather augments the care they provide,” said Dr. Brad Stern, an OB and gynecologist with The Women’s Clinic of Northern Colorado and medical director of UCHealth Women and Children’s Services in northern Colorado.

Maternity Management Program participants first go through a lifestyle and health assessment to establish a baseline, as they also do in the Lifestyle Health Services program. However, the maternity management assessment is a blend of evidence-based maternity evaluations, and Dvorak focuses on questions around their current health and care from their OB/GYN. UCHealth registered dietitian Brooke Floerke talks with participants about their diet, while a fitness professional conducts a physical assessment.

The assessment is used to develop an individual program plan for each participant, including trimester-based education. Dvorak is developing a tiered approach to the program’s design. For example, a woman who has no health issues, but who may need help making health-conscious changes, may fall into tier one. A woman who has several chronic illnesses, such as diabetes, obesity and anxiety, may be placed in tier three or four.

“The program’s design allows us to step in early,” Dvorak said. “If we have someone who could have a high-risk pregnancy, we don’t replace the support she is getting from her provider but rather add additional support.”

To help women dealing with chronic issues, Dvorak has recruited UCHealth OB Nurse Navigator Kelly Bernatow. Her role is to be a participant’s care coordinator — connecting her with community resources, answering questions and helping her follow through with the care plans set up by her providers.

“Participants who may be high risk meet with me to get a more specific risk assessment done, and if there are pieces that present red flags, I can make appropriate referrals to help mitigate those issues,” Bernatow said. “Maybe that’s working more frequently with Brooke [Floerke] because they’re on the cusp of diabetes, or if they’re high risk for a preterm pregnancy, then I can help them set up a neonatologist consultation.”

Bernatow said she already connects via providers with a lot of pregnant women, but many times it’s a reactive — rather than proactive — approach to these resources.

“I think this program is going to prove to be very successful,” she said. “And hopefully the result we see is a decrease in preterm birth rates — or even see those with potential for preterm deliveries extending the length of their pregnancy — because these women are getting plugged into the resources they need quicker, and because of the additional education they’ll be getting, hopefully we’ll also see a decrease in potential C-sections.”

While Bernatow and Dvorak work together to provide lifestyle plans, Floerke focuses on providing each participant with trimester- and health-conditions-based nutritional plans.

UCHealth maternity management team
The UCHealth Maternity Management Program team. From left, UCHealth registered dietitian Brooke Floerke, Laura Dvorak, UCHealth’s Lifestyle Health manager in northern Colorado, and Fitness professional and exercise physiologist Ryan Kinney.

“We’ll be talking about the timing of eating, how to pair foods for energy, and digestion — which are all very specific and different for each person and even more so when they are pregnant,” Floerke said. “My goal is to help support a healthy childbirth, and diet plays a big role in that.”

Fitness professional and exercise physiologist Ryan Kinney, through a UCHealth partnership with Miramont Lifestyle Fitness, also plays a big part in the program, offering up maternity-specific exercises for participants.

“Our goal is to meet all the needs of the participant in the early stages of pregnancy, if possible,” Dvorak said.
These needs also include making sure participants are connected to childbirth classes at little or no cost, including hospital tours and breastfeeding support. This is done by partnering with the UCHealth’s family education program and is another advantage to enrolling in the maternity management program, she said.
The program is only in its pilot stage, but if successful, it will expand to provide care for women who are considering becoming pregnant, helping them address any health issues and illnesses before conception. To determine if the program is successful, Dvorak said they’ll be evaluating preterm birth rates, C-section rates, complications, NICU stays and lengths of stays among participants to see if the extra education and support did make a difference.

“For those eligible to participate in the program, we want to make sure it’s as easy as possible for patients to get to those resources,” Stern said. “Our goal is to promote healthy habits and encourage healthy pregnancies.”

About the author

Kati Blocker has always been driven to learn and explore the world around her. And every day, as a writer for UCHealth, Kati meets inspiring people, learns about life-saving technology, and gets to know the amazing people who are saving lives each day. Even better, she gets to share their stories with the world.

As a journalism major at the University of Wyoming, Kati wrote for her college newspaper. She also studied abroad in Swansea, Wales, while simultaneously writing for a Colorado metaphysical newspaper.

After college, Kati was a reporter for the Montrose Daily Press and the Telluride Watch, covering education and health care in rural Colorado, as well as city news and business.

When she's not writing, Kati is creating her own stories with her husband Joel and their two young children.