Sep 04, 2020
NYC Health + Hospitals today announced the expansion of its obstetrics (OB) simulation labs throughout the health system to help reduce maternal deaths and life-threatening complications during child birth. Six NYC Health + Hospitals acute care facilities are being outfitted with their own OB simulations lab to help replicate life-threatening health conditions during child labor, such as OB embolisms, massive hemorrhages, and eclampsia. Utilizing specially-designed, high-tech, full-body mannequins-of-color, OB physicians, anesthesiologists, nurse practitioners, midwives, and physician assistants from each of the 11 hospitals that make up the public health system will participate in simulations that will further help in identifying a potentially life-threatening condition during labor and childbirth. The goal will be to have more than 85 percent of the system’s labor and delivery personnel to complete a range of OB emergency simulations on an ongoing, rolling basis in the new labs. The program will also include staff from the blood bank and code teams. Funding for the OB simulations was included as part of the City’s previous $12.8M allocation for a comprehensive plan to support the Department of Health and Mental Hygiene and NYC Health + Hospitals programming aimed at reducing maternal deaths and life-threatening complications from childbirth among women of color.
“The expansion of our OB simulation labs across our system is just one-way NYC Health + Hospitals is making sure provider teams hone and perfect life-saving skills that will continue to reduce maternal mortality rate,” said Chief Medical Officer of NYC Health + Hospitals Machelle Allen, MD. “Our public hospital system will continue its steadfast pursuit to expand access to care, and eliminate disparities and attendant tragedies.”
“As a health system, it is critical that we provide the opportunity for all clinical personnel to remain up-to-date on training and skills that may help to save the life of a pregnant or postpartum patient,” said Chairperson of the Department of Obstetrics, Gynecology and Women’s Health at NYC Health + Hospitals/Kings County Wendy Wilcox, MD. “Many of these life-threatening complications are rare, but it is our responsibility to ensure OB teams recognize the problem early and manage the condition swiftly and effectively to avoid tragic outcomes.
NYC Health + Hospitals/Bellevue, Elmhurst, Harlem, Kings County, Jacobi, and Lincoln were each outfitted with a simulation lab within its OB departments. Each of the simulation labs consist of at least two rooms: a control room where simulation leads provide instructions in real-time and manipulate the scenarios, and another to carry out the simulations with OB healthcare teams and the mannequins. After the simulations, teams participate in a debrief to review the scenarios, responses, and outcomes. OB teams outside of these six hospitals will have the opportunity to visit and participate in simulations in addition to their own hospital’s simulation program.
“These new simulation labs will be a valuable tool in reducing healthcare disparities, improving maternal health outcomes and saving lives,” said Assembly Health Committee Chair Richard Gottfried. “I commend NYC Health + Hospitals for its leadership in the fight to improve New York’s far too high maternal mortality rates.”
“The implementation of the simulation centers is crucial in improving life expectancy rates for both mother and child. Infant mortality rates are particularly high in low-income communities of color such as the district I represent and any measures taken to give families a fighting chance from birth is imperative. I commend NYC Health + Hospitals for taking proactive steps to give children the best possible start at life,” said Assemblywoman Catalina Cruz.
“It is absolutely devastating and unacceptable that the Bronx holds the most severe maternal mortality rate in New York City, which disproportionately impacts women of color. The installation of an OB simulation lab at NYC Health + Hospitals/Jacobi is an important step in reversing this trend, by providing the resources that labor and delivery teams need to perfect life-saving skills in the event of birthing complications. New York’s staggering mortality rates are a threat to the safety of New York families, and must be treated like the public health crisis that it is,” said State Senator Alessandra Biaggi.
“I’m proud that NYC Health + Hospitals/Bellevue in my district is working to correct disparities in our public healthcare system. It is unacceptable that black women have three times the risk of maternal mortality as their white counterparts. Every New Yorker deserves the highest quality healthcare without cost, class, race, or any other factor as a barrier,” said State Senator Brad Hoylman.
“New York is among the bottom third of states for the number of pregnancy-related deaths, with women of color dying at a rate three and one-half times more than other women. The communities I represent in Brooklyn have some of the highest death rates for pregnant women in the State. I am pleased that providers at NYC Health + Hospitals/Kings County will have access to these simulation tools, and look forward to passage of the Chisholm Chance Act in Albany, which will direct further state resources toward understanding and addressing pregnancy-related deaths in our communities,” said State Senator Zellnor Myrie.
In January 2020, the NYC Health + Hospitals announced that more than 1,000 of the system’s OB physicians, anesthesiologists, nurses, midwives, and physician assistants from all 11 public hospitals had successfully completed the simulations training focused on OB life support, which included protocols and procedures to help resuscitate a patient who is having a heart attack during labor – from identifying deterioration, calling codes and performing CPR before the code team arrives.
Significant racial and ethnic disparities in pregnancy-related mortality exist. According to the CDC, black patients have a pregnancy-related mortality ratio approximately three times as high as that of their white counterparts.
The simulation trainings are just the latest contribution of the public health system to addressing disparities in maternal health. NYC Health + Hospitals. In 2018, NYC Health + Hospitals maternal mortality rates were lower than New York State’s rate of 20.9/100,000 live births.