'The onus lies on us': UChicago Medicine's plan to close gaps in maternal care

When it comes to maternal health disparities, Sarosh Rana, MD, believes it's time for institutions to walk the talk. 

"We just keep saying, 'oh, the metrics are so bad,' so we should do something to improve," she told Becker's in a recent interview. 

Year after year, U.S. reports show dismal maternal health metrics. From 2018 to 2021, the nation's maternal death rate doubled, reaching nearly 33 deaths per 100,000 live births. In Black women, the rate is nearly 70, according to the March of Dimes latest annual report card on maternal and infant health. 

In November, UChicago Medicine, an urban academic health system predominantly serving Black patients, named Dr. Rana as its first chief obstetrical transformation officer — a role that stands out as among the first C-level health system positions to address a distinct form of health equity. She previously served as the organization's maternal-fetal medicine chief and led a postpartum hypertension management program that eliminated a disparity in follow-up visit rates for the condition between Black and white patients and improved clinical outcomes since it began in 2019. More than 5,000 patients have been enrolled in the program that earned UChicago Medicine a health equity advancement award from The Joint Commission in October.

Now, as chief obstetrical transformation officer, Dr. Rana aims to continue making measurable improvements in eliminating maternal health disparities by expanding access to high quality obstetrical care. Establishing strong relationships with community partners and safety net hospitals are key in doing so.

"We really need to create patient-centered processes and involve our community partners," she said. "Involve your community partners. Involve your federally qualified health centers. Involve your safety net hospitals and create systems which will benefit and will create a kind of safety net for all patients." 

"If we don't do this, who will?"

And UChicago Medicine is doing just that, working closely with South Side Healthy Community Organization, a nonprofit comprised of 13 healthcare organizations including safety net hospitals, health systems and federally qualified health centers to advance care for patients in South Chicago. Through this partnership, UChicago Medicine is piloting maternal-fetal medicine care and high level ultrasound and consultation services at several FQHCs in the region. 

Additionally, strengthening relationships with safety net hospitals is a key priority to eventually bring maternal health quality programs like the postpartum hypertension management initiative to other clinics and hospitals in the area. Right now, UChicago Medicine is focused on optimizing collaboration with its Ingalls Memorial Hospital and the FQHC associated with it to develop an OB quality program and integrate MFM care. 

"One of the first things that I want to do is put some of these programs which are very successful — we've done them, we're already had them running here for several years — in the Ingalls system so that they can directly impact and reduce disparities in the care of patients," Dr. Rana said. 

Three to four years down the line, the ultimate goal is to develop a roadmap other AMCs across the nation can use to create a sustainable model of care for women to access high quality material healthcare. 

"Maternal morbidity and mortality is a very prevalent problem and I think bigger institutions need to take a major role and say, 'Let me try to figure this out,'" Dr. Rana said. "The onus lies on us. It lies on the institutions … if we don't do this, who will?"

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