Centering Research Assistant Greenville Health System Spring Internship 2016Taylor Jackson

Introduction

I completed my internship at the OB/GYN Center in

Greenville, SC with the Greenville Health System.

I held the position of Centering Research Assistant. I was given the opportunity to work in the OB/GYN clinic as

well as the Greenville Hospital and enjoyed it immensely.

Site

Above is the OB/GYN center sign where I spent my time working with CenteringPregnancy program and the prenatal patients.

The clinic served not only as a facility for CenteringPregnancy, but also for many other services a prenatal patient may need. Centering was giving their own entrance, shown above, so that patients could skip the hassle of a waiting room.

Cradle Study SiteAlthough my internship as a Centering Research Assistant was based at the OB/GYN Center my responsibilities and projects allowed me to travel and do work at the Medical Office building and engage with providers and patients.

The MMOB building pictured to the left is

where I recruited many of the patients to be enrolled in the Cradle study. I worked and

consented patients on the fourth floor during

their first trimester screenings, booking appointments, and anatomy scans.

DescriptionMission Statement “To improve the health of people in our communities in a

cost effective manor.”

The OB/GYN center has dedicated their facility to bettering care for women in the community in need of gynecologic and obstetric patient care. The center provides CenteringPregnancy which is a form of prenatal care that incorporates three main components: medical care, education, and social support. Along with the quality prenatal care to women with low risk pregnancies, the center has a sector for South Carolina Medicaid, WIC program, a clinical nutrition specialist, and social workers that are on site at all time.

GoalsBy the end of my rotation, I want to be knowledgeable about the CRADLE study and be able to keep up to date with the progress of the participants.

During my time working on the CRADLE, I want to help as best I can to make the study organized and efficient as possible.

I want to successfully help the patient and participants of the CRADLE complete their forms so that they are eligible for the study and their incentive.

During my time, I want to join a centering group and help them with any questions about their pregnancy and make them feel comfortable and cared for.

During my rotation, I have a goal of revamping the entranceway. Sarah has expressed her discontentment with the entrance way and her want to change it and make it better, but due to her lack of time and craft skills has never done it.

During this rotation, I personally hope to make new contacts and learn more about myself professionally, and where I would like to be.

Intern ResponsibilitiesBelow are listed day to day roles and duties required of me throughout the semester. • Attend CenteringPregnancy sessions.• Add dialogue to the CenteringPregnancy session and help keep women focused.• Put out snack before the session. • Help women with any biometric data collection at beginning of prenatal visit.• Shadowed healthcare providers and understand the flow of the OB/GYN center. • Attend meetings regarding to adjust Cradle consent. • Help enroll patients for the Cradle study.• Help reach the Cradle soft start goal of enrolling 40 patients.• Identifying all patients before research nurse come in contact with them.• Charting and organizing the patients once they have been consented into the

study.

CenteringPregnancyThe OB/GYN center provides a large variety of prenatal services to their patients. However, I worked directly under the CenteringPregnancy Coordinator, Sarah Covington-Kolb.Together we coordinated care of patients involved in CenteringPregnancy groups as well as participating in the Centering secession. The clinic can see up to 300 patients a day. Needless to say, Sarah holds a very crucial role in the clinic.

My preceptor, Sarah Covington-Kolb

CenteringPregnancyI served my patients by helping with the CenteringPregnancy groups. I was able to build strong patient relationships and uphold a level of care to insure that their prenatal care was of great quality. On this particular day we discussed the advantages of breastfeeding and importance of managing stress.

Centering Group 249, such a fun group of women!

Travel with CenteringPregnancy

Traveling to different hospitals in the state to review their progress in their CenteringPregnancy groups to discuss any problems they may arise with their patients.Centering is a fairly new form of healthcare that is being implement into different areas around the state. Sites in Lexington, Anderson, and Florence were new facilities which required a check in for monitory purposes. I traveled to the manning location along with Sarah to talk to the facility about implementing Centering Care in their practice.

Coordinating CareInterning with Greenville Health System has taught me the value of coordinating care. Not all healthcare can be delivered by hand in a clinical setting. A lot of work goes into managing and organizing prenatal care before make contact with the patients. This picture demonstrates preparing for a centering group. I would benefit and feel more comfortable in front of patients if I went over the discussion topics before hand. This particular session we were discussing all the various options of birth control that the women can access.

What is the CRADLE Study?

• CRADLE Stands for Centering and Racial Disparities (CraDle). • NIH (National Institutes of Health) has given Greenville Health

System a grant to fund the Cradle study to discover the effects of CenteringPregnancy.

• The purpose of this study is to see if CenteringPregnancy has any effect on reducing preterm birth less than 37 weeks.

• It is a randomized control trial of 3,000 patients expected to be completed in three years.

• The women that enroll in the study will be randomized into individual, one-on-one care, or to CenteringPregnancy

• There will be surveys conducted to gather data from the mother before and after delivery as well as data on the babies once they are born.

Cradle Designs

I designed this Cradle photos for the study’s soft start. This will allow

patients and providers to recognize the study and gain publicity because

it is a very new project for GHS.

Connecting Patients

I created this Facebook page so that women participating in the study can stay up to date on the progress. This will be a easy way to connect with the patients to remind them to attend their

prenatal appointments and collect their gift cards

CenteringPregnancy ProjectCenteringPregnancy delivers high quality prenatal care, while also offering a social

aspect. The advantages of meeting with a group and building relationships helps lower stress and allows the women to feel more comfortable.

Sarah had expressed her concern with the atmosphere of he clinic and her hopes of making it a more relaxed and inviting place. Pictures and decorations helped make the

facility more inviting.

A board of previous CenteringPregnancy babies.

During the third trimester women can “get on the board” meaning they have almost reached the

finish line! Patients often struggle with being very pregnant and this helps lift the moral.

Community TreeI painted a tree to make the office space more inviting and encourage patient involvement. This family tree servers as a painting a family tree so that mothers can put their thumbprint on the tree along side the other mothers and now friends in the group. When the women come in for their postpartum visit, they will add the baby’s thumbprint to the tree.

Cradle Project• The Cradle Study is a large and extensive study. One way that I found

I could help and add value to the study was by screening patients. • I would go through the patient’s demographics a health care records

to discover if the individual would be applicable to the study. • If, yes I would identify them to the study. If Not, I would disqualify

them from the study. • Based on the data I collected through the patient’s history I created a

spread sheet for every day of the week so that the upcoming patients and all their information would be available at easy access.

• This project freed up a lot of time for the research nurses. It allowed the soft start to be more organized and soft start to run more smoothly.

• Since my start with the Cradle project we screen 73 patients in a month and half time frame.

ReflectionIn conclusion, I have learn so much about prenatal care. I was allowed to dive in and get involved with the research and collecting of data. I feel very honored to have helped with the large and impressive study. Looking back I can see how the results of the Cradle Study could change the way that prenatal care is administered in South Carolina. This makes me very excited and more interested in a career in research. The work I completed during my internship was challenging and rewarding. I value the patient and professional relationships I developed during my time with Greenville Health System as a Centering Research Assistant.