Pregnant patient with doctor writing on clipboard
Substance Use Disorder Initiative
Initiative Overview
Initiative Objectives
1

Increase the number of women screened with a validated tool for SUD/OUD on the L&D Unit.

2

To identify, map, and maintain up-to-date community resources to support individuals with substance use disorder, improving care coordination, referral processes, and access to comprehensive services across the continuum of care.

3

Develop and promote evidence-based pain management protocols specifically for women with increased pain sensitivity associated with SUD/OUD in the Labor & Delivery setting.

4

Ensure patient satisfaction in appropriately managing pain before, during, and after delivery.

SUD Toolkit
Initiative Leadership
Ayesa Hilvano, MD
Ayesa Hilvano, MD
Ayesa Hilvano, MD

Dr. Ayesa Hilvano currently serves as the Obstetric Anesthesia Director at St Elizabeth Healthcare - Edgewood Hospital in Edgewood, KY and is a council member with the Women Health Institute at St Elizabeth Healthcare. Dr. Hilvano also serves as the Board Director at Seven Hills Anesthesia in St Elizabeth Division and Chairs the Compliance Committee at Seven Hills Anesthesia. Dr. Hilvano is a Diplomate in the American Board of Anesthesiology.

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John O'Brien, MD
John O'Brien, MD
John O'Brien, MD

Dr. John O’Brien specializes in Obstetrics and Gynecology Maternal-Fetal Medicine at the University of Kentucky, where he serves as Medical Director for Labor and Delivery and Professor of the Department of Obstetrics and Gynecology. Dr. O’Brien graduated from Kalamazoo College in Michigan with a B.A. in Biology and from Wayne State University in Detroit with an M.D. in 1988. He completed his residency in Obstetrics and Gynecology in 1992 and a Fellowship in Maternal Fetal Medicine in 1994 at the University of Tennessee.

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Cheryl Parker, DNP, CRNA, RNC-OB, FAANA, FAWHONN
Cheryl Parker, DNP, CRNA, RNC-OB, FAANA, FAWHONN
Cheryl Parker, DNP, CRNA, RNC-OB, FAANA, FAWHONN

Cheryl Parker is the Director of Nurse Anesthesia Program at the University of Louisville, in Kentucky. She is also an actively practicing obstetric anesthetist providing services with NorthStar Anesthesia at Norton Hospital, Labor & Delivery department in Louisville. 

She earned her BSN from Eastern Kentucky University and her MSN and DNP from Murray State University. She has been a nurse for 30 years, working primarily in the areas of women's health, specifically: Postpartum, L&D, and NICU. For the last 17 years her focus has been Obstetric Anesthesia. She is a member of AANA (American Association of Nurse Anesthesiology), KyANA (Kentucky Anesthesia Nurses Association), SOAP (Society for Obstetric Anesthesia and Perinatology), KyPQC (Kentucky Perinatal Quality Collaborative), and a long-standing member of AWHONN (Association for Women's Health, Obstetrics, and Neonatal Nursing), where she served 2 years on the Public Policy Committee. In 2020 she was instrumental in the submission and acceptance of KY-HR73; approving legislation to establish January 23rd as Women's Health Awareness Day; and making Kentucky the 5th state in the nation to inaugurate an MHA resolution. In 2023 she was inducted as a Fellow of both the AANA and AWHONN. Her primary practice is the Director of the UofL Nurse Anesthesia Program.

Dr. Parker's publications include: a case report in JOGNN (Journal of Obstetrics, Gynecology, and Neonatal Nursing), May 2015, entitled: An Innovative Nursing Approach to Caring for an Obstetric Patient with Rape Trauma Syndrome (RTS); in 2019 she served on AWHONN's Evidence Based Guidelines-Revision Science Team, which produced the evidence-based clinical practice guideline entitled: Analgesia and Anesthesia in the Intrapartum Period, and in October 2020, an AWHONN Practice Brief and Podcast entitled: Lower Extremity Nerve Injury in Childbirth.

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Sara Petruska, MD
Sara Petruska, MD
Sara Petruska, MD

Dr. Sara Petruska is a generalist obstetrician-gynecologist at the University of Louisville, where she serves as Medical Director for Labor and Delivery and Associate Dean for Admissions. She graduated from Boston College with a B.S. in 1994 and from the University of Florida with an M.D. in 2000. She completed residency training in 2004 and a fellowship in Medical Education in 2008 at the State University of New York Stony Brook. In 2008, she relocated to Louisville with her husband Jeff as they joined the faculty of UofL together. She believes we are at our best when we are a team with the patient at the center.

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Yunus Muneer Shah, MBBS, DABPM, DABIPP, DAAPM
Yunus Muneer Shah, MBBS, DABPM, DABIPP, DAAPM
Yunus Muneer Shah, MBBS, DABPM, DABIPP, DAAPM

Dr. Yunus Shah is a dedicated, Board-Certified Physician specializing in the practice of Anesthesiology with particular interests/expertise in the fields of Obstetric Anesthesia, Pain Management and Addiction Medicine. He serves as the attending Anesthesiologist for Labor and Delivery at Norton Hospital and Norton Women and Children’s Hospital in Louisville, KY. Dr. Shah specializes in ante-partum consults for high risk/complicated pregnancies, intra-partum management with whole range of analgesia and anesthesia options, general anesthesia, epidural/spinal/CSE neuraxial anesthesia, as well as IV medications for pain control.

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Leann Baker, DNP, APRN, NNP-BC
Leann Baker, DNP, APRN, NNP-BC
Leann Baker, DNP, APRN, NNP-BC

Dr. Leann Baker is an Assistant Professor at the University of Louisville, where she holds a joint faculty appointment with the Schools of Nursing and Medicine. At the School of Nursing, she is the coordinator for the Neonatal Nurse Practitioner Program; her appointment with the School of Medicine includes her continued practice as a Neonatal Nurse Practitioner with Norton Children’s Medical Group. She brings a unique perspective to the KyPQC steering committee, with over 25 years of healthcare experience as a previous labor and delivery and NICU nurse, and now as a neonatal advanced practice provider and leader.

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Hannah Fischer, MD
Hannah Fischer, MD
Hannah Fischer, MD

Hannah Fischer completed her training in neonatology at the University of Louisville and joined faculty as an assistant professor in 2015. She has completed the Intermediate Improvement Science Series and Advanced Improvement Methods courses through Cincinnati Children’s Hospital and currently serves in the role of Director of Quality Improvement and Safety for the division of neonatology. She has been involved with or lead many quality improvement projects locally and is inspired by the improvement in outcomes that can be achieved. She aspires to teach others to improve their healthcare systems and has developed the Neonatal Fellows Quality Improvement Curriculum to further this goal. Her work has been recognized by her peers and received the “Pediatrics Outstanding Performance Award” for her quality improvement work from the University of Louisville Department of Pediatrics in 2019.

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Pauline Hayes, RN, BSN, CLC, MPH
Pauline Hayes, RN, BSN, CLC, MPH
Pauline Hayes, RN, BSN, CLC, MPH

Pauline Hayes is a registered nurse with 46 years hospital experience, 43 of which were spent as a NICU nurse and the last 11 years as unit manager. During her hospital experience, Ms. Hayes took part in research, quality improvement projects, and staff education. She served as a member of the multidisciplinary task force that developed the first treatment protocol for NAS in 2009. Ms. Hayes serves as a hospital-based NRP instructor and STABLE instructor. She is certified in Neonatal Intensive Care Nursing and she finished her MPH in December of 2018. Currently, Ms. Hayes is the Perinatal Nurse Consultant/Inspector for the Division of Maternal and Child Health within Kentucky’s Department for Public Health. Besides being a member of the Neonatal workgroup for the KyPQC,  Ms. Hayes is also on the board of the Kentucky Perinatal Association.

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Tracey Jewell, MPH
Tracey Jewell, MPH
Tracey Jewell, MPH

Tracey Jewell has over 22 years of public health experience practicing Epidemiology.  She is currently the Senior Maternal and Child Health (MCH) Epidemiologist with the Kentucky Department for Public Health and serves as Manager of the Program Support branch, which houses all Epidemiologists within the MCH Division.  She has mentored several graduate students in public health and has guest lectured in several graduate level MCH and Epi courses.  She also manages the Pregnancy Risk Assessment Monitoring System program for Kentucky, the Neonatal Abstinence Syndrome Registry for Kentucky as well as managing several federal grants for the Division of MCH.  Tracey also has extensive experience in applying epidemiological principals/methods and data analysis to monitor trends, evaluate programs, establish surveillance systems, and enhance public health programs. Mrs. Jewell earned her Bachelor of Science degree from Western Kentucky University where she majored in Community Health and minored in Psychology.  She then earned her Master of Public Health degree from the University of Alabama Birmingham, School of Public Health with a concentration in Epidemiology and International Health.

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Maureen Marra, MD, FACOG
Maureen Marra, MD, FACOG
Maureen Marra, MD, FACOG

Maureen Marra, MD, FACOG, currently works as Physician Advisor for Medical Staff Quality within the Baptist Health Louisville Quality and Outcomes Management Department.  Her primary role is reviewing Women and Children’s Health cases to assure quality of care. Her interests include analyzing trends in outcomes data and utilizing evidence-based medicine for policy and procedure development. Dr. Marra previously worked in private practice in Louisville, Kentucky. She is a graduate of the University of Kentucky, College of Medicine, and completed her residency in OB/GYN at the University of Louisville.

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Participating Hospitals
St Elizabeth Hospital Logo
Norton Hospital Logo
ARH Logo
UofL Hospital Logo
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Norton Women's and Children's Logo
Baptist Health Paducah Logo
UK Healthcare Logo
Baptist Health La Grange Logo
ARH Logo
Baptist Health Louisville Logo
Baptist Health Corbin Logo
ARH Logo
MedCenter at Bowling Green