The ADP team systemically collected data on common discharge barriers, developed expertise in addressing common discharge barriers and inefficiencies, improved identification of patients likely to discharge and assisted with completing discharge tasks. Length of stay improved from 8.1 to 7.4 days in the intervention group.

Through the Caring Wisely program, our interprofessional team seeks to develop a platform to communicate discharge barriers with other disciplines at the unit and the health system level through Informatics and APeX build support. We ultimately aim to increase the number of on-time discharges, reduce length of stay, and support UCSF’s global capacity optimization efforts.

PROJECT LEADS: Christine Blauvelt MD, Neda Ghaffari MD, Roxanna Irani MD PhD 

EXECUTIVE SPONSOR: Nerys Benfield MD MPH  

ABSTRACT:  Hypertensive disorders of pregnancy (HDP) are increasingly prevalent, posing significant risks to maternal health, including stroke and renal failure. At UCSF, one quarter of deliveries involve HDP, far exceeding the national average. Postpartum hypertension remains a leading cause of readmission, with about half of postpartum readmissions at UCSF due to hypertension-related issues. This proposal aims to implement a structured remote blood pressure (BP) monitoring program for high-risk patients, utilizing Bluetooth-enabled devices, an integrated APeX dashboard, and nurse-driven protocols for timely intervention. The program aims to improve BP self-monitoring, reduce postpartum length of stay, readmissions and emergency visits, and enhance patient confidence in managing their health. Preliminary data from our pilot program has shown promising results, with enrollees demonstrating high engagement, high patient satisfaction, and a 0% readmission rate for hypertension among postpartum participants. Our pilot has proven the feasibility and clinical importance of this work, and our Caring Wisely proposal aims to further build infrastructure and sustainability into our program so it can ultimately be expanded to all high-risk pregnant and postpartum patients at UCSF. 

PROJECT LEADS: Rebecca Carter, MD, Vidya Pai, MD, Clare Pearson, RN, CNL

EXECUTIVE SPONSORS: James Anderson, MD, Director of Neonatology, UCSF Benioff Children’s Hospital Oakland, Leslie Lusk, MD, Medical Director, ECMO Co-Medical Director, UCSF Benioff Children’s Hospital Oakland