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Obstetrical#postpartum#hypertension#discharge#workflowPGY 1/2/3/4

Postpartum BP Monitoring — Care Companion Program

Discharge actor responsibilities, 3 pathways (Care Companion / Virtual / In-person), DRH vs DUH routing tables, RN triage IDs.

Source: PP BP Monitoring PDF (handbook supplement)

Discharge Provider:

  • Teaches about Care Companion.
  • Orders Care Companion.
  • Encourages patient to download MyChart app.

Discharge Nurse:

  • Provides BP cuff.
  • Teaches how to check BP.
  • Teaches about Care Companion.
  • Encourages patient to download MyChart app.

Patient:

  • Enters BP into MyChart daily for 14 days.
  • Care Companion will prompt to call provider / present to triage for severe-range BP or symptoms.

Clinic Office Nurse:

  • Notified of elevated BP or if no BP recorded for 3 days.
  • Follows up with calls, messages, or scheduling clinic BP check.

Pathways — All Postpartum BP Monitoring:

PathwayWhenTo do
Care CompanionEnglish-speaking patient with active MyChartProvide BP cuff. Teach how to check BP + warning signs. Teach about Care Companion. Encourage patient to download MyChart. Patient instructions automatically added to AVS. NO virtual visit order needed.
Virtual BP CheckNon-English-speaking OR patient declined Care Companion/MyChartProvide BP cuff. Teach how to check BP + warning signs. Provide log for BPs. Request virtual visit.
In-person BP CheckPer providerPatient comes back to clinic for BP check.

DRH Workflow — Where should my patient be directed?

Patient typeRouting
Resident patients (Health Dept, no PNC)Care Companion → Durham OB. Escalation → Durham OBGYN RN Triage [12446].
DOB (delivered/rounded by DOB)Care Companion → Durham OB. Escalation → [12446].
H+S (delivered/rounded by H+S)Care Companion → Harris & Smith. Escalation → H+S RN Triage [12481].
CHOB / DWCVirtual or in-person BP check with primary practice.
Family MedicineVirtual or in-person BP check with primary practice.

DUH Workflow — Where should my patient be directed?

Patient typeRouting
Health Dept / no PNCCare Companion → Duke Perinatal. Escalation → Durham OBGYN RN Triage [12446].
DWHACare Companion → DWHA. Escalation → Patterson Place DWHA Triage [12569].
Duke PerinatalCare Companion → Duke Perinatal. Escalation → [12446].
DOB / H+S / CHOB / DWC / Family MedicinePer patient preference and indication for delivery at DUH: Care Companion, virtual, or in-person BP check with primary practice.

RN Triage Routing IDs Reference:

  • [12446] — Durham OBGYN RN Triage (Durham OB, Duke Perinatal, Resident/Health Dept patients)
  • [12481] — Harris & Smith RN Triage
  • [12569] — Patterson Place DWHA Triage

Referenced by handoffs