A Framework for Coordination between Obstetric and Pediatric Providers in Public Health Emergencies: Lessons Learned from the Zika Outbreak in the United States, 2015 to 2017

Abstract

Emergency response to emerging threats with the potential for vertical transmission, such as the 2015 to 2017 response to Zika virus, presents unique clinical challenges that underscore the need for better communication and care coordination between obstetric and pediatric providers to promote optimal health for women and infants. Published guidelines for routine maternal-infant care during the perinatal period, and models for transitions of care in various health care settings are available, but no broad framework has addressed coordinated multidisciplinary care of the maternal-infant dyad during emergency response. We present a novel framework and strategies to improve care coordination and communication during an emergency response. The proposed framework includes (1) identification and collection of critical information to inform care, (2) key health care touchpoints for the maternal-infant dyad, and (3) primary pathways of communication and modes of transfer across touchpoints, as well as practical strategies. This framework and associated strategies can be modified to address the care coordination needs of pregnant women and their infants with possible exposure to other emerging infectious and noninfectious congenital threats that may require long-term, multidisciplinary management. Key Points

Drivers and collaborative governance of public health emergency response in the context of digital city

“…Leeb et al ( 13 ) proposed a new coordination framework and strategy to improve nursing coordination and communication in PHE. This framework involved the collection and transmission of key information, communication paths and transfer methods across touch points.…”

“…The research results indicated that this framework could effectively address the nursing coordination. Long term and multidisciplinary management could be achieved ( 13 ). Baines et al ( 14 ) selected COVID-19 in 2020 as a research case to study the ethical adjustment problems that occurred during and after PHE.…”

Disaster Series: Disaster Planning for Perinatal/Neonatal Medicine: Rethinking the Process and Caring for Mothers. Infants and Technology Dependent Infants - The Time is NOW

“…Leeb and coworkers report a framework for coordination between obstetric and pediatric provides in their combined response to the Zika outbreak in the U.S from 2015 to 2017 (23). They provide a framework to help coordinate the care of pregnant women and their infants exposed to congenital threats.…”

“…Leeb et al also address creating information transfer pathways, standardized protocols and procedures, and clear handoffs that include verbal and written components that capture the quantity and detail of shared information (23). Triage and transfer lists are helpful for caregivers, unit managers, and administrators in sending and receiving facilities.…”