The Exec: Good Clinical Care and Sustainable Finances Are Compatible

Addressing maternal morbidity and mortality

Thadhani is an internationally recognized clinical leader in preeclampsia, a leading cause of maternal and perinatal morbidity and mortality.

Maternal mortality should be a top concern for CMOs, according to Thadhani.

“Birthrates have gone down in the United States; however, maternal mortality rates have not gone down,” Thadhani says. “The rates of maternal mortality and morbidity in the United States are among the highest compared to other developed countries.”

Thadhani says a combination of factors are contributing to the high U.S. maternal mortality rate, including problems with access to care, limited access to prenatal care, and comorbidities such as diabetes.

“Many women across the country have difficulty gaining access to good prenatal care, particularly individuals in underserved communities and individuals with a low socioeconomic status,” Thadhani says. “The limited access to good prenatal care puts a burden on clinicians such as family medicine practitioners, primary care physicians, obstetricians, and midwives.”

CMOs and other clinical leaders need to rethink how they are providing care for pregnant women who have comorbidities, according to Thadhani.

“The way we try to provide care today for pregnant women with comorbidities, which is to try to have these women receive care more frequently, is unfortunately not working,” Thadhani says. “We do not have enough caregivers for pregnant women with comorbidities, which mirrors the shortage of prenatal care specialists.”

The best path forward for providing care for pregnant women with comorbidities is to embrace innovation, Thadhani explains.

“We need to explore ways to monitor pregnant women at home,” Thadhani says. “We are looking at innovative tests that can predict comorbidities during pregnancy. We need to have an early understanding of risk in terms of screening—we should be screening for risk factors before pregnancy such as cardiac disease, diabetes, and high blood pressure.”

Promoting patient safety

Transparency is crucial in boosting patient safety at health systems and hospitals, according to Thadhani.

“At the hospital systems where I have worked, some of them have embraced transparency about patient safety but others have been reluctant to be open about patient safety,” Thadhani says. “Once the transparency barrier is overcome, it helps create an environment where caregivers are encouraged to deliver the best safety measures when patients come to the hospital.”

“We want to get patients out of the hospital quickly, but we need to discharge patients safely,” Thadhani says. “If we discharge patients too early, they can end up being readmitted to the hospital. We need to strike a balance between the desire to discharge patients quickly and readmissions.”

As a clinical leader, Thadhani has been involved in several patient safety initiatives, including efforts to reduce falls in the hospital setting.

“People often think that infections are the most common complication experienced in the hospital setting, but falls are just as common if not more common,” Thadhani says. “When you think of falls, they happen in patient rooms, they happen when patients get transferred from one bed to another, and they happen when patients go to an imaging procedure.”

One of the fall reduction initiatives that Thadhani helped to lead involved embracing technology.

“We put monitors in patient rooms to watch patients and predict when a patient was at risk of falling from a bed,” Thadhani says. “For example, if a patient’s leg was slipping out of bed, the monitoring system would trigger an alarm that the patient could be falling.”