Labor Link: A Tool to Reduce Burnout for Obstetricians

Clinicians are spending more and more time on clinical documentation, which is a major driver of clinician dissatisfaction and burnout. For obstetricians, documentation is essential because a complete and accurate medical record is critical in reminding them and helping others understand the care of the laboring patient.

Making Intrapartum Documentation Easier and Faster

Across Northwestern Medicine, more than 20,000 babies are delivered every year, which means the health system provides inpatient obstetric care for about 15% of all births in Illinois each year. With each of these labors progressing at different rates, and obstetricians balancing multiple clinical needs and tasks based upon urgency, timely and accurate documentation ensures the care team is aligned on each individual plan of care. However, it is physically impossible for obstetricians to be at a bedside continuously during labor, and even if they could be, that would leave little opportunity to document the care being provided.

An important consideration during management of labor is the fetal heartrate tracing (FHT). The FHT gives obstetricians insight into how the fetus is doing throughout the labor process. However, the existing process for accessing FHTs electronically is time-consuming and cumbersome. Additionally, clinicians have to access the FHT and document it in different electronic platforms, making it burdensome for care teams to switch between the two.

To make this process easier and faster for obstetricians, teams at Northwestern Medicine have created Labor Link, a novel software application that allows obstetricians to access, assess and document on FHTs from their approved mobile devices — whether they are at home, in their office or elsewhere in the hospital.

Collaborating to Create a Solution That Works for Obstetricians

The Etemadi Research Group and a representative cohort of volunteer obstetricians collaborated to create Labor Link — an innovation designed for obstetricians, by obstetricians. The Labor Link landing page is personalized for each obstetrician, sorting their current patients to the top of the page. The application is refreshed within seconds and maintains the prior hour of data so obstetricians can easily evaluate the evolution of the FHT over time. Labor Link makes it easy to switch from one FHT to the next, a task that an obstetrician performs repeatedly during labor management and that can be very frustrating in the existing process.

Any time an obstetrician needs to write a note, they can do so in a form streamlined to collect only the most essential components via a push-button interface, while still providing space for the clinician to add their own free-text impressions, as needed. This documentation files to EPIC within one minute, so all members of the clinical team can see them quickly. This keeps nurses, residents, midwives and physicians all on the same page when it comes to patient care.

Committing to a Better Physician Experience

In a survey of current obstetrician experience with managing FHTs in labor, most obstetricians felt that when they were not on the Labor and Delivery floor, it was difficult or very difficult to access (65.1%) and document (69.8%) FHTs.

The initial goal of Labor Link was to create an easy way for obstetricians to access and document FHTs. Northwestern Medicine was creative and strategic when putting together a skilled technological team (Etemadi Research Group) and an engaged group of end-users (volunteer obstetricians) to design, build and deploy software that meets this clinical need. This approach to innovation resulted in immediate and widespread use of the application, in contrast to many external technology solutions, which are often designed without end-user engagement and result in much smaller uptake by intended users.

The next challenge for Labor Link is to explore the possibility of creating actionable alerts triggered by an artificial intelligence model.

The goal of Labor Link is to give clinicians more time to focus on patient care and to spend less time on administrative tasks such as navigating electronic interfaces or cumbersome ways of documenting. Teams across Northwestern Medicine are committed to making this happen.