Along with our partners at the Informed Medical Decisions Foundation, we are celebrating Shared Decision Making Month, and last week the spotlight was on maternity care. Maureen Corry was interviewed as part of a series on Shared Decision Making Along the Continuum of Care. Then she moderated a webinar about maternity care shared decision making with Kim Gregory, MD, MPH and Ob-Gyn and Vice Chair of Women’s Healthcare Quality and Performance Improvement at Cedars-Sinai in Los Angeles, Kate Chenok, Director at the Pacific Business Group on Health, and Kristen Oganowski, a mother, doula, and blogger at Birthing Beautiful Ideas.
Childbirth Connection has been advocating for greater access to birth centers for much of our 95 year history. We opened the first urban birth center in 1975 and helped found the organization that would later become the American Association of Birth Centers (AABC). Our director from 1970 to 1995, Ruth Lubic, went on to win a MacArthur “Genius” Award for her pioneering work in birth center innovation. Although the number of birth centers has increased in the intervening decades, birth centers remain a very small segment of the health care system. Just 0.3% of U.S. births take place in birth centers.
But a new study out today and a congressional briefing next week are sure to heighten attention to this high-quality, high-value care option. Added to other trends and recent developments, we anticipate this new study will trigger rapid growth in birth centers, and more focused and innovative efforts to integrate birth centers into the health care system. Here are 5 reasons birth centers have met their moment.
One of most commonly cited barriers to improving maternity care is the risk of providers and hospitals being held liable for bad outcomes. Whether it is reining in overuse of tests and procedures, honoring women’s preferences, or increasing interdisciplinary collaboration, good ideas often cannot move forward once the issue of liability is raised.
If we cannot make progress toward more evidence-based, woman-centered care because of liability concerns, then the liability system is functioning poorly. But what are the aims of a high-functioning liability system? Is it just to avoid lawsuits and hold liability insurance premiums down?
In our new report, Maternity Care and Liability, we hold 25 possible liability reforms up to a framework that addresses the needs and interests of all of the system stakeholders: those who deliver care, those who pay for care, and most importantly, the women and newborns who receive care. We developed this framework based on maternity care and liability studies and with the input of clinicians, legal scholars, consumer advocates, policy makers, and others.
This year, World Breastfeeding Week coincides with a major milestone for mothers: on August 1, the women’s preventive health provisions of the Affordable Care Act (ACA) go into full effect. Every new insurance policy will now begin covering breastfeeding equipment and lactation support services without co-pays.
Back in April, Carol Sakala wrote about the new and continuing perinatal and reproductive health quality measures endorsed by the National Quality Forum. The final Technical Report on the set of NQF-endorsed measures is now available.
At Childbirth Connection, we know that performance measurement is an essential element for moving toward the maternity care system that women and families deserve — one that meets the Triple Aim of better care, better outcomes, and better value. Performance measurement is central to our 2020 Vision for a High-Quality, High-Value Maternity Care System and companion Blueprint for Action consensus reports. So, we are thrilled that the National Quality Forum (NQF) has approved for endorsement 12 continuing and 2 new maternity care performance measures.
Pending a 30-day appeal period, these will continue to be available or be newly available as nationally endorsed performance measures for both quality improvement and public reporting. I am pleased to offer this update as co-chair of the multi-stakeholder Steering Committee that evaluated measures submitted by developers within the formal NQF consensus development process with explicit criteria for endorsement.
One year ago, the Leapfrog Group released results of their annual Hospital Survey, for the first time publicly reporting rates of early elective deliveries (inductions or planned c-sections occurring before 39 weeks without a medical reason). The results were shocking, with hospitals varying from virtually zero to well over half of elective deliveries occurring before 39 completed weeks. Last week, we partnered again with the Leapfrog Group and other organizations to publicize the release of this year’s survey results, and we’re pleased that the data show rates moving in the right direction.
Our Leading Change series profiles leaders in efforts to transform maternity care. This month we bring readers an interview with Christine Morton, PhD, a medical sociologist at the California Maternal Quality Care Collaborative. Christine and I discuss the rising rate of maternal mortality, how standardizing care for obstetric hemorrhage can help, the need for better data collection and reporting, and how state quality collaboratives can lead change. Thanks Christine for taking the time to answer these questions, and thanks everyone at CMQCC for your work to transform maternity care!
I attended the Home Birth Consensus Summit, along with our Director of Programs, Carol Sakala, late last week. The meeting was the result of several years of planning by a multi-stakeholder group of maternity care leaders. It was led by facilitators from Future Search, a theory and planning strategy designed around having the “whole system in the room” to find common ground on complex or divisive issues.
From the TMC blog: Making women and families our maternity care system’s “unwavering focus and fully-engaged agents for change”
The prosperity of a nation is tied fundamentally to the health and well-being of its citizens. It follows, then, that citizens—each one a past, current, or future patient—should represent both the healthcare system’s unwavering focus, and its fully engaged agents for change.
This passage begins the new report from the Institute of Medicine’s Learning Health System Series, Patients Charting the Course: Citizen Engagement in the Learning Health System. This report builds on themes addressed in the Institute of Medicine’s landmark report, Crossing the Quality Chasm, which also formed the foundation for the Transforming Maternity Care 2020 Vision.