WMJ Vol 120: Barriers to Self-Disclosing Level of Maternal Care: What Are Wisconsin Hospitals Worried About?
Objective: The American College of Obstetrics and Gynecology (ACOG) has recommended every hospital disclose their level of maternal care (LOMC) to categorize the capabilities of their birthing center and regionalize perinatal care. Of the 98 birthing centers in Wisconsin, 44% have self-disclosed their LOMC. In many states, disclosing LOMC is mandated but, despite evidence and professional association recommendations, Wisconsin relies on voluntary self-reporting. We surveyed all birthing centers in Wisconsin to better understand the barriers to disclosing their LOMC.
Study Design: An anonymous survey was sent to all 98 birthing centers in Wisconsin. Survey recipients were hospital administrators, nursing supervisors, or physician directors of obstetric units. The survey sought information on perceived barriers to completing self-assessments and disclosing their hospital’s LOMC. Quantitative descriptive statistics were used for data analysis.
Results: Of 98 birth centers in Wisconsin, 40 (40.8%) responded. Fifteen of the 40 responses were from birthing centers that have not yet disclosed their LOMC. Of these, 93% were unsure how to disclose, 73% found the paperwork confusing, and 80% did not have the time or staff to complete the paperwork. Respondents did not report lack of departmental support, concerns about losing business or reputation, or future physician recruitment as barriers. Of all respondents, 77.5% were aware of ACOG’s LOMC recommendations, but only 35% thought disclosing their LOMC would be beneficial to maternal care.
Conclusions: Birthing centers in Wisconsin need further guidance on how to complete a self-assessment of their LOMC. In order to increase self-disclosure of LOMC, statewide perinatal organizations will need to continue to emphasize the benefits of releasing this information. Organizations should also provide additional support to level 1 and 2 birthing centers and improve maternal and neonatal care overall.
The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.
As a result of this journal-based activity, learners will be able to:
- Explain how the regionalization of perinatal care is aimed to improve the care of the mother-baby dyad with the healthcare team.
- Recognize the American College of Obstetricians and Gynecologists, amongst other national organizations, recommend birthing centers disclose their Level of Maternal Care to establish perinatal care regionalization.
- Identify the barriers encountered by birthing centers in Wisconsin interfering with their ability to self-disclose their Level of Maternal Care and how to support these institutions in this endeavor.
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
|Name of Individual||Individual's Role in Activity|
Name of Commercial Interest &
|Kathleen M. Antony, MD, MSCl||Author||No relevant relationships with ineligible companies to disclose||No|
|Terese Bailey, BS||Accreditation Specialist||No relevant relationships with ineligible companies to disclose||No|
|Katie Gillespie, DNP||Author||No relevant relationships with ineligible companies to disclose||No|
|Kathy Hartke, MD||Author||InControl Medical, LLC (Other securities)||No|
|Ronni L. Hayon, MD||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Medha Karmarkar, MD, MPH||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Roberta Pawlak, PhD, RN, NEA-BC||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Jenna Racine||Author||No relevant relationships with ineligible companies to disclose||No|
|Sarina Schrager, MD||Editor||No relevant relationships with ineligible companies to disclose||No|
|Cynthia Wautlet, MD, MPH||Author||No relevant relationships with ineligible companies to disclose||No|
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.
The ACCME does not consider providers of clinical services directly to patients to be commercial interests.
|In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.|
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
Iowa Board of Nursing accepts ANCC contact hours for nursing continuing education requirements.
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™
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