Page 7 - CASA Bulletin 2019 Vol6 No2

US academic medical centers — Harvard, Johns Hopkins, Stanford, Yale, Tufts, Ohio State, UT- Dallas, Stony Brook, Wash Univ-St . Louis, Mt Sinai-New York and others— about his plan for a global health initiative. In 2008, the first NPLD-GHI trip was launched in Dr. Hu’s home city, Hangzhou, China visiting the first hospital with 16 volunteers.
From the beginning, Dr . Hu knew that he had to change the mindset of the Chinese physicians, nursing staff, hospital administration plus the patients and their families with regards to their ideas about using neuraxial analgesia during labor and delivery . The challenge was
how could he efficiently and effectively recommend implementing a 24/7 obstetric anesthesia service in Chinese hospitals, while at the same time
assuring that labor analgesia would be used safely and
effectively? Because team-based medicine is an integral
part of the modern American labor & delivery unit, a
major obstacle to overcome by the Chinese hospital
staff was understanding and incorporating the concept
of a multidisciplinary TEAM . To ensure that both
uniformity and continuity would be achieved at each
participating hospital, Dr . Hu developed a series of
stepwise, structured, progressive, protocol driven projects
emphasizing change through EDUCATION . The NPLD-
GHI Model uses annual one-week site visits with daily
goals and debriefings; bedside education and coaching;
simulation drills; weekend conferences; problem
based learning discussions; education and modeling of
multidisciplinary team collaborations; with vigorous
follow-up site inspections . Additionally, over the years,
Dr . Hu has introduced into his program: patient education
books, social media education in professional forums by
way of WeChat and the on-line Journal of No Pain Labor
& Delivery – Global Health Initiative .
Another enhancement to NPLD-GHI was necessary after China’s two-child policy went into effect nationwide in October 2015 . The following year, there was a spike in live births to 18.46 million! [NOTE: As of 2016, China’s population was 1.38 billion people.] Because of China’s very high non-medically indicated cesarean section rate under the one child-policy, the 2018 NPLD-GHI protocols and guidelines were updated to embrace the challenge of high risk deliveries by incorporating standards for TOLAC (Trial of Labor after Cesarean) . It became clear that older parturients with or without a scarred uterus might be seeking labor analgesia for delivery of their second child .
Concurrently as part of fulfilling its commitment to the United Nation’s MDGs agreement,
the Chinese central government initiated national practice changes for hospitals . Among these
Vol.6, No.2, 2019
7