Emily White VanGompel

Family physician. Faculty at the University of Illinois Chicago. Tweets my own.

[Emily White VanGompel @EmilyVangompel]

Congratulations to Dr. Tanu Nair, @UChicagoFM resident for headlining the @AnnFamMed February issue https://t.co/cJ0hPNucSz!

[Emily White VanGompel @EmilyVangompel]

@RJEpiOBWarrior @audreylyndon The PREM-OB Scale(TM) suite just got a shout-out at a panel on measuring structural racism by @RachelHardeman at #ARM22! Your work is here and making an impact @RJEpiOBWarrior

[Emily White VanGompel @EmilyVangompel]

@jjfrey3MD @AnnFamMed @UChiPritzker @cmqcc @NorthShoreWeb @MedscapeObGyn @AmyKaleka @kdakis @mikejohansenmd @DianeMHarperRG @ThomasOKim Also notable - the birth center was transferring to a hospital staffed by FMs with gen surg back-up for cesareans. Would like to know more about the relationship/practice around transfer. Better coordination of care in transfers = better outcomes.

[Emily White VanGompel @EmilyVangompel]

This article on birth center outcomes supports the complementary findings in hospitals (Lundsberg et al) that those who prioritize and value low-intervention practices have lower cesarean rates. https://t.co/r5hgNHZS5Q

[John Frey @jjfrey3MD]

@AnnFamMed @EmilyVangompel @UChiPritzker @cmqcc @NorthShoreWeb @MedscapeObGyn @AmyKaleka @kdakis @mikejohansenmd @DianeMHarperRG @ThomasOKim Hope you include this article in your discussion Low primary cesarean rate and high VBAC rate with good outcomes in an Amish birthing center https://t.co/IF2xTEot7F

[Emily White VanGompel @EmilyVangompel]

Would love to know more about how you are doing this! @AmyKaleka #AnnalsChat

[Emily White VanGompel @EmilyVangompel]

Thanks #AnnalsChat for giving us this opportunity!

[Annals of Family Medicine @AnnFamMed]

Follow the authors @EmilyVangompel @ElliottMain @DrSusPhD and @cmqcc to stay updated on their work #FMOB Thanks #AnnalsChat!

[Emily White VanGompel @EmilyVangompel]

@DrSusPhD @AnnFamMed @ElliottMain We actually did develop additional questions to help hospitals evaluate their patient safety culture around VB based on the qualitative work. Working with @Ob_Initiative in Michigan on this next step.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @DrSusPhD @ElliottMain @cmqcc Now that we are measuring culture, we need to develop tools to change it. Very little exists to help hospitals in the actual intentional process of culture change.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain @DrSusPhD Opportunities: true depth and understanding from qual and ability to make some generalizable conclusions from quant. Challenges: it's really hard to fit this work into usual journal requirements. Very excited that @AnnFamMed is embracing mixed methods work! #AnnalsChat

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed This does bring up how we counsel patients - and who is best able to do that objectively - when they are making the hard decisions around a trial of labor. We found fear was a key factor in quant and qual analyses.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain https://t.co/vgVlaHX2hl

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain 2/2: Attanasio and colleagues found that Black birthing people who reported less shared decision-making during birth had higher cesarean rates. Ignoring the importance of patient empowerment could exacerbate the existing disparity.#AnnalsChat

[Emily White VanGompel @EmilyVangompel]

Agreed - difference between actively supporting vaginal birth versus waiting for it to happen or not happen.

[Elliott Main MD @ElliottMain]

@AnnFamMed @cmqcc @DrSusPhD @EmilyVangompel A key step is develop a common belief that vaginal birth should be supported and to empower the nursing staff to take over labor support.

[Elliott Main MD @ElliottMain]

@AnnFamMed @cmqcc @DrSusPhD @EmilyVangompel A key step is develop a common belief that vaginal birth should be supported and to empower the nursing staff to take over labor support.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @cmqcc @ElliottMain @DrSusPhD Interprofessional/interdisciplinary education and dialogue needs to be a regular part of quality improvement work. So hospitals need to have a way to do that. And collaborative practice needs incentivizing by leadership.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @aafp @STFM_FM @FamPhysCan @FamilyPracNews As family docs are disappearing on L&D, though, I think we do have ask critically - what is unique about family medicine that contributes positively to pt outcomes? And emphasize that in our training of new FMs to do intrapartum care.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain FMs and MWs can contribute to the culture on the unit, changing norms, but they need to have a meaningful and respected presence on the unit. 0 FMs and 1 MW responded from unsuccessful hospitals compared to 18 FMs and 16 MWs from successful hospitals.

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain Our prior work found that both FMs and MWs have attitudes associated with lower provider-level cesarean rates. Based on what we have now seen at successful hospitals, physician attitudes are a huge part of hospitals’ ability to change.#AnnalsChat

[Emily White VanGompel @EmilyVangompel]

@AnnFamMed @ElliottMain Things that we have come to accept as “routine” like amniotomy and continuous electronic fetal monitoring, and early admission to L&D are so hard to de-implement without patients being able to question the care they are receiving, choosing their providers based on these practices