High-risk obstetrical call center: a model for regions with limited access to care.
OBJECTIVE
High-risk obstetrical care can be challenging for women in rural states with limited access.


METHODS
Data were evaluated from 62,342 obstetrical calls from pregnant and postpartum patients within rural Arkansas to a nurse call center. Call center nurses provided triage using evidence-based guidelines to patients across the state. Data were extracted and analyzed using retrospective data collection and descriptive statistical methods.


RESULTS
Women had an average maternal age of 28 years old, average weeks gestation was 27.4, over half had Medicaid 32,513 (52.15%), and the greatest percentage were in their first pregnancy 14,232 (34.1%). The greatest percentage of calls resulted in a recommendation to come to the hospital to be evaluated 25,894 (41.54%) followed by advice with no prescription given 19,442 (31.19%). The most frequent guidelines used included preterm labor 5114 (8.24%) followed by abdominal pain >20 weeks 4,518 (7.28%).


CONCLUSIONS
A centralized obstetrical nurse call center model, including 24/7 availability, using triage software for obstetrical care, with experienced labor and delivery nurses to answer and respond to calls and secondary triage performed by OB/GYN physicians or Advance Practice Registered Nurses (APRN) has the potential of improving access to obstetric care in rural areas.
a Department of Obstetrics and Gynecology , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Sarah J
SJ
Rhoads
a Department of Obstetrics and Gynecology , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Hari
H
Eswaran
a Department of Obstetrics and Gynecology , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Christian E
CE
Lynch
b Department of Biostatistics , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Songthip T
ST
Ounpraseuth
a Department of Obstetrics and Gynecology , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Everett F
EF
Magann
a Department of Obstetrics and Gynecology , University of Arkansas for Medical Sciences , Little Rock , AR , USA.
Curtis L
CL
Lowery
D000328:Adult; D001131:Arkansas; D000070456:Call Centers / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data; D009773:Obstetric Nursing / Q000379:methods*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000523:psychology; D015397:Program Evaluation; D019114:Remote Consultation / Q000458:organization & administration*; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D013689:Telephone; D014481:United States; D055815:Young Adult
High-risk pregnancy; postpartum; telehealth; triage