573 Effect of increasing body mass index on infectious morbidity at the extremes of obesity

Abstract

hypertensive disorders of pregnancy in our lower socio-economic population. Our primary aim was documentation of BP in 75% of telehealth visits within 10 weeks for WC patients with estimated gestational age (EGA) > 28 weeks or earlier if diagnosis of hypertension, history of hypertensive disorder of pregnancy, obesity, or renal disease. Our secondary aim was to prevent worsening of disparities for patients with Medicaid insurance and those who speak English as a second language. STUDY DESIGN: A needs assessment was completed during the first week of instituting telehealth visits. The process map was created, and a driver diagram identified primary and secondary drivers and nine change concepts (Fig 1). All nine interventions were applied over ten weeks by a multidisciplinary team of APRNs, RNs, midwives, and MDs. This study involved weekly chart review of WC telehealth visits. RESULTS: Documentation of BP in telehealth visits of included patients was 5% in the first week. As interventions were implemented, documentation increased to over 50% by week 5, and up to 89% by week 10, at which time our providers completed an average of 10 telehealth visits for included patients per day (Fig 2). The average number of telehealth visits with home BP documented over weeks 10-17 was 70.3%. Additional analysis revealed no significant difference in percentage of visits with documented BP of patients who identified English as a primary versus other primary language. Noted barriers to documentation were analyzed. CONCLUSION: This project demonstrates that, when utilized by a multidisciplinary team, quality improvement science can lead to effective and rapid adjustments in healthcare delivery without compromise to at risk populations. This process can be replicated as we consider adaption in a second COVID-19 wave.