Outcomes Manager in St. Luke's Women's Services Balances School and Career

The list of letters following Robin Fleschler's name is going to get even longer before too long. Fleschler, M.S.N., R.N.C., C.N.S., and perinatal nurse practitioner, who works as an outcomes manager and researcher for women's services at St. Luke's Episcopal Hospital, is a doctoral candidate at The University of Texas at Austin.

"I've always liked school," she offers modestly. "And St. Luke's has been fabulous in supporting my work toward a Ph.D."

So has the federal government. The National Institutes of Health (NIH) recently awarded a very competitive and prestigious grant to Fleschler to undertake the development of an ambitious and potentially invaluable research tool. The purpose of her dissertation, which is funded by a National Research Service Award from NIH, is to develop what she calls "a prenatal health behaviors instrument."

Such an instrument, Fleschler explains, would measure the impact of certain behaviors women engage in before and during their pregnancies. These behaviors include smoking, drinking alcohol, becoming overheated during exercise, and being exposed to certain toxins, like those found in cat litter.

After calculating scores for the women based on their behavior, Fleschler will correlate them with the women's well-being, overall physical health and level of depression (if any). Previous studies have shown when well-being and health are positive and depression level is low or non-existent for new mothers, all the members of their families have fewer developmental, physical, and emotional problems down the road.

An accurate tool for measuring health behaviors and identifying outcomes resulting from those behaviors among pregnant women simply does not exist right how, Fleschler explains. "Health promotion for pregnant women carries with it an added dimension that clearly differentiates it from health promotion in the general population," she says.

"If I'm successful, this will provide health care providers with a tool to better understand the impact of prenatal health behaviors and well-being in pregnancy and life-long health in women. Development of a reliable measurement of health behaviors would greatly advance our ability to clarify this link."

When she's not commuting to Austin to meet with her dissertation committee, Fleschler works as an outcomes manager at St. Luke's. There, working with other managers, she engages in a different kind of research.

By evaluating outcome data from patients in women's services and staying current on the latest research, Fleschler is able to look for ways to enhance the care provided at the hospital. "It's a collaborative process," she stresses, "working with doctors, nurses, pharmacists, educators, and other managers in our department, we look for ways to improve the quality of care for patients at St. Luke's while keeping costs down."

Tali Neumann, administrative director of women's services at St. Luke's, praises Fleschler's commitment to the hospital and to her continuing education.

"Robin is very skilled in conducting and applying her research projects to real people and real situations," says Neumann. "She makes a positive difference at the hospital."

Among the projects Fleschler has spearheaded at St. Luke's is an evaluation of the St. Luke's high-risk obstetrics program. The outcome measurements Fleschler developed were used to make the case to managed care organizations that St. Luke's should receive higher reimbursement for its efficacy in managing high-risk pregnancies.

"Much of her success comes from her expertise as a practicing clinician," says Neumann. "Her technical skills and clinical proficiency command the respect of physicians and other health practitioners. She also clearly sees and articulates the research implications applicability to patients and their families."

Summing up, Neumann says she would add another set of initials to the list that already trails Ms. Fleschler's name: "MVP. She's one of the most valuable people I work with here at St. Luke's."

- CHRIS FERRIS

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©2006 Texas Medical Center

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