Conrad Chao, MD
Accurate fetal monitoring is an essential tool in clinical decision making for both maternal and fetal health during labor. Dr. Chao improved upon current practices by implementing an advanced computerized fetal heart rate monitoring system, the Neoventa STAN S31 monitor, at UCSF Fresno and its hospital affiliate Community Regional Medical Center. This system is more sensitive and specific in the prediction of fetal metabolic acidosis, thereby reducing the rate of hypoxic ischemic encephalopathy at birth compared to conventional monitors. In order to implement the technology, Dr. Chao first gave an educational presentation to hospital administration. The process was particularly challenging because although the system had been widely used throughout Europe for seven years, this would be the first clinical utilization of these monitors in the United States.
An essential and related goal was to analyze outcomes in both STAN monitored and non-STAN monitored labors in a study funded by the vendor. However several rounds of negotiations with lawyers and administration were necessary to clarify business relationships before IRB and contract approval were secured for the project. The first step of project implementation was training hospital staff in the STAN monitor system. More than 100 labor and delivery nurses and more than 30 physicians received a four hour training session and certification test over the course of a week.
After nearly a year of work and initial staff training, the STAN monitor was implemented on October 22, 2007. The staff continues to become certified in the use of this new system. STAN monitors have been used on more than 100 cases at UCSF Fresno and n initial evaluation of outcomes at UCSF Fresno has begun. Computer software has been installed in the labor room for informal review of cases for quality and education purposes. A formal system of ongoing review of outcomes and education is in place to continually improve staff skills with the new technology. In addition UCSF Fresno and CRMC are the first institution to participate in a multicenter study of the outcomes of this instrumentation in clinical use in the United States. Data from this center and others that begin to use the system will allow statistically valid analysis of improvement.
View Conrad's CMQCC profile.
