Important Links/emails:

Feedback: online here (this link can also be found by following the QR code in the Team Room) or via email at feedback.madres@fammed.wisc.edu (if urgent action needed can also be given directly to Jensena Carlson (jensena.carlson@fammed.wisc.edu, 715-379-6148))

Procedure Card: https://uwmadison.co1.qualtrics.com/jfe/form/SV_beaSucVFosYnVM9 

How to Access the Meriter Mother-Baby Sharepoint drive and QR Codes for 2020 Learning Modules 

Where can I find the number of Nexplanons, Circumcisions, Deliveries, or XYZ that I did last month/year? 

The FAMILY MEDICINE Provider Activity Report we get emailed to us monthly includes these numbers. Alternatively, you can use SlicerDicer in EPIC to run reports (check out ULearn for video instructions).

For signing resident notes:

o   Use “attest in encounter” or “attest”

o   Double check the dates on the note to be sure they have been updated (there is a reminder in the resident note but this is an ongoing issue)

o   Use an attestation phrase on day of discharge that includes the time spent

Wildwood Coverage

Wildwood physicians will still deliver the majority of their own patients. 

However, if the Wildwood PCP is unavailable for the delivery, the UW DFMCH residency OB call group faculty member and resident on call will attend these deliveries in place of a Wildwood call person. The Wildwood rounder will still round on these mom/babies after delivery, so the delivery notification will still go to the Wildwood postpartum rounder.

Also, UW DFMCH residency OB call group resident (staffing with faculty member on call) will take all Wildwood patient pregnancy triage phone calls up until 36 weeks gestation. Starting at 36 weeks and zero days, the Wildwood primary OB provider will be called first. If they don’t answer, then UW DFMCH resident/faculty member should be called.

Also, all Wildwood antepartum admissions that are managed by family medicine will be cared for by the UW DFMCH group.

GHC Coverage

GHC-DFM Back-up system for routine coverage of Labor and Delivery flows as follows:

1. GHC Primary FMOB Attending - The GHC Primary FMOBs cover > 90% of their own patients through labor and delivery.

2. GHC Practice Partner - If the above is not available, often an immediate GHC practice partner covers labor and/or delivery.

3. GHC Back-up Provider - If the above is not available, the GHC Back-up provider covers labor and/or delivery. Although the GHC Back up provider is usually available for coverage, due to the small size of the GHC group, the GHC Back-up provider is not required to be available 24/7.

4. DFM Residency Attending - If the above is not available, the DFM-Residency attending on service or on-call (depending on time of day) will provide coverage for labor and/or delivery. (See details in this document)

5. DFM-Community Attending - If the DFM-Residency attending is occupied at SSM St. Mary’s Hospital, they will contact the DFM-Community Back-up provider for coverage assistance at UPH Meriter.

MCTS Attending Guide - updated 6/2023 

Not currently active but for further consideration: Tracking Residency Faculty L&D Management (From Couture email update 2/21/22) - Due to St. Mary's concerns about monitoring faculty "OB numbers" for credentialing, at the January FREACC meeting we opted to start tracking our OB faculty involvement in any L&D management. In Meriter Epic, I created a shared list titled “Residency DFMCH OB Tracking," which should automatically show up on the left side of your lists screen. Anytime you are significantly involved in the management of our patients or when cross covering for a community partner (e.g. helped place cooks balloon, watched the strip for 2 hours while at a meeting, covered for a precip delivery), please drag that patient onto this shared list, and leave a note on the blue sticky note in top left of the chart describing what your involvement was. I'll plan to check this monthly so that we can get a sense of how our labor management load compares to our delivery numbers. 

Mag Privileges:

Once your IV insulin/magnesium/anti-hypertensive privileges have been approved, you can co-manage patients with OB (OB consult is required). Due to the varied experience with insulin and magnesium amongst us, there are several ways this could look. As experience, trust, and confidence grows, you may find yourself shifting from one approach to the next. Key themes across each approach: clear communication with OB regarding experience/comfort and expectation of roles and responsibilities.

1. FM manages labor course with OB managing insulin/mag/ant-hypertensives. A good starting point to gain experience while ensuring patient continuity for you and our residents.

2. FM manages labor and insulin/mag/anti-hypertensives. In this scenario, the FM attending has prior experience with the IV medication being administered and, in discussion with the OB attending, is comfortable placing orders, conducting q4hr mag checks, and maintaining open communication with the OB consult.

3. I’m certain there will be addtl approaches we discover. This list is not exhaustive.

An FM and OB working group has drafted a Co-management Protocol. This protocol (with a May 2, 2022 roll out) is a suggested (not required) outline of resident and attending roles/responsibilities for IV Anti-hypertensives/Mag. The protocol is meant to serve as a tool to assist both FM and OB residents and faculty as we navigate new waters. We will develop a QR code/link to gather feedback about the process; we expect to evaluate the protocol in Nov/Dec 2022 and identify areas for improvement.