Operative Experience logo

Innovative Approach Tackles Labor and Delivery Challenges in Critical Access Hospitals

Newborn baby with mother
Newborn Baby Icon

Rick Breuer had a problem. As the CEO of Community Memorial Hospital in Cloquet, Minnesota, Rick was keenly aware that the obstetrics practitioners at his smaller hospital weren’t able to attend to as many patients in his area as they would like. There were just too few high risk cases to keep skills sharp, and Rick and the rest of the team wondered if they were really as prepared as they should be for what Rick termed “rare, terrifying events” like maternal hemorrhage.

Rick’s hospital is only 30 miles from Duluth, but in the case of a hemorrhaging patient, even that could be a road too far. With many small, rural hospitals struggling in the recent past and even closing, Rick knew many rural patients could be forced to go much farther distances.

Rick also knew when an emergency did present itself, it was all hands on deck to ensure a good outcome for mothers and babies.He realized quickly he had the same problem for the nurses and staff who worked these critical incidents hand in hand with the physicians.

In the absence of actual case load, health professionals rely on training. However, in the case of a small, rural hospital, simulation-based training often isn’t available outside of academic settings, making it a challenge to get staff the kind of real world experience they need in a life-or-death situation.

As CEO, it was also Rick’s responsibility to see and manage the potential risk and financial downside to these critical incidents. A single claim could devastate a hospital. He really needed a better solution. One incident, one family, one team was one too many to leave to the existing model.

Rick had always been a small town guy. He loved his work with rural hospitals. He was active in his professional organization representing rural hospitals and especially enjoyed figuring out how to get these critical institutions the things necessary to support their population.

Doctors performing a surgery in and operating room

And so, Rick undertook a fact-finding mission to see what other training options might work for his teams, his hospital and his community. He looked at e-learning, but there wasn’t a lot of hands on for that. He knew there were manikins used for training, but the ones he’d seen in the past weren’t very realistic. And they could be expensive

A practice baby delivery using an Operative Experience labor and delivery simulator

t was during this time that Rick saw Operative Experience’s RealMom simulator. RealMom 2.0 is the latest generation of the world’s most lifelike birthing simulator. RealMom is a full-body birthing simulator and full-term baby with unsurpassed realism and lifelike appearance. It features
realistic, soft tissue, accurate internal anatomy and a soft tissue birth canal. It provides learners with human-like dilation and effacement with massageable fundus, amniotic reservoir, hemorrhaging capabilities and a fully-realistic uterus, and a baby with placenta and umbilical cord.

Operative Experience also makes the C-Celia suite which includes fetal extraction trainers, postpartum hemorrhage trainers as well as emergency c-section and hysterectomy trainers.

The RealMom training solution provides normal delivery, breech, shoulder dystocia, nuchal cord, cord prolapse and placenta previa, compound delivery, and assisted delivery with forceps or vacuum devices. It also provides for Instructor control via tablet for dilation and delivery progression, physiological presentation and control of maternal and fetal heart rate, fetal heart tones and contractions, pulses, blood pressure and SpO2. The Operative Experience RealMom is so lifelike that the entire team could train together and react to changes in condition just like a real case. Rick was impressed!

C-Celia simulator and baby

Rick was determined to offer this as a solution to his team. He wanted to figure out a way to fund the purchase and then share the model with other hospitals, either to emulate or to participate. He put his risk hat on and approached Blue Cross/Blue Shield (BCBS) with a risk benefit scenario. He was evidently persuasive, as BCBS agreed to fund the project in its entirety.

Rick also knew he wanted to offer CE and CEUs for staff to use the system. His team secured continuing education credits for physicians licensed in Minnesota. CEUs for nurses are also in the works.

Rick took delivery of his OEI RealMom 2.0 in June 2021. Operative Experience is providing a Train the Trainer experience for obstetrics department leaders. Rick estimates about two months to get set up, trained and the documentation updated for his hospital.

Doctors performing a delivery

Once he has RealMom up and running for his hospital, he has big plans for other rural hospitals that want to work with him to use this new training platform. His hospital is large enough to have training space–he just needs to work out the details. And working them out, he is!

Because he is a self avowed “home town” boy, he realizes how hard it is to take time away from your own hospital to train somewhere else. To that end, he’s working with state officials to tap into more funds to cover ongoing expenses when they open the training platform up to others, including working with local restaurants and hotels to offer food and lodging for those coming in.

Rick’s hope is that cohorts of doctors and nurses will come from other locations to train as a team so that they benefit from one another. Best practices can be documented and shared. And, if he succeeds in his fundraising efforts, his vision is that the center could be funded so that others have a very little to no cost option for very realistic training that could save lives.

Rick has also been asked to speak at conferences about his plan. He has received very supportive interactions with hospital administrators, physicians and nurses who are excited at the prospect of “sharing this wealth”.

The beauty of this plan is that Rick can see this opening up to others like EMTs, or the Minnesota Comprehensive Advanced Life Support organization. Any group who assists in births could benefit from this training.

And Rick feels the sky, honestly, could be the limit for this shared model he has envisioned. Operative Experience also develops tactical, trauma and surgical simulators. As margins tighten and budgets contract, it will be important for rural communities to band together to preserve and advance their standard of care.

To reiterate, it will be early summer before the comprehensive program springs to life. If you are interested in Rick’s solution, or his progress in helping the rural hospital community, check back often to see how Rick and Community Memorial are progressing!

In the meantime, check out https://operativeexperience.com/realmom/
and learn about RealMom 2.0. You’ll be glad you did.

Doctors with a labor and delivery simulator

Ready to train like a pro?