Improved liability system

In the Literature: Physiologic, evidence-based oxytocin protocol reduces tachysystole

As part of a larger program to achieve zero preventable birth injuries, this project’s goal was to avoid tachysystole or appropriately intervene when tachysystole occurred. Tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a 30-minute window, and is often associated with induced or augmented labor.

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Filed in Blueprint, Clinical audit, case review, or analysis of adverse events, Clinical practice guideline/policy change, Educational materials for health professionals, Health professions education, Improved liability system, Performance measurement, Progress, Team building on Tue., Oct 18, 2011

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From the Field: The Safe Motherhood Quilt Project

The Safe Motherhood Quilt Project, originated by midwife Ina May Gaskin, is a national effort developed to draw public attention to the current maternal death rates, as well as to the gross underreporting of maternal deaths in the United States. The Quilt honors American mothers who have died of pregnancy or childbirth related causes since 1982, the last year there was a reduction in maternal mortality.

The goal of the Safe Motherhood Quilt Project is to demand an equivalent system of counting, analyzing, and learning from mistakes made in our maternity care system here, regardless of where babies are born or what caregiver is the birth attendant. Until we do that, doctors, midwives, and nurses in the US will continue to work without a good system of feedback about what is and is not dangerous in maternity care, and preventable maternal deaths will continue to take place.

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Filed in Clinical audit, case review, or analysis of adverse events, Clinical controversies, Community education/outreach, Consumer advocacy or political action, Disparities, Educational materials for health professionals, Health information technology, Improved liability system, Performance measurement, Performance measurement/reporting, Stories from the Field, Team building on Mon., Sep 12, 2011

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In the Literature: Surgical checklist improves teamwork and compliance with best practice

For all scheduled cesarean deliveries, the hospital introduced a preoperative checklist to verify patient identity, indication for caesarean section, allergies, and presence of neonatology staff and a postoperative check to verify analgesia, oxytocic prescription, antibiotics, thromboprophylaxis and skin contact between mother and baby. Researchers examined staff attitudes before and after introduction of the checklists, checklist compliance, and whether patients experienced anxiety or were reassured by the process.

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Filed in Blueprint, Care coordination, Clinical practice guideline/policy change, Improved liability system, Team building on Wed., Aug 10, 2011

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From the Field: Eliminating Preventable Perinatal Injuries and Reducing Malpractice Claims and Costs: Creating High Reliability Obstetrics Units

We intend to reduce perinatal harm and decrease malpractice events by eliciting improved compliance in 4 clinical care bundles and implementation of an evidence-based simulation training methodology focused on improving clinical staff’s ability to work in teams. We are measuring our impact through a culture of safety survey and a high reliability survey, various outcomes measures.

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Filed in Blueprint, Care coordination, Clinical audit, case review, or analysis of adverse events, Clinical controversies, Clinical practice guideline/policy change, Decision making and choice, Health professions education, Improved liability system, Performance measurement, Performance measurement/reporting, Risk management/liability reform, Shared decision making, Skills training or drills for health professionals, Strategies, Team building on Mon., Aug 1, 2011

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In the Literature: A comprehensive perinatal patient safety program to reduce preventable adverse outcomes and costs of liability claims

After implementation of this comprehensive patient safety program, birth trauma rates decreased, the number of obstetrical occurrences (specified birth-related event or injury that may lead to a claim) decreased by 65%, and the average costs per obstetrical claim decreased. The number of new claims reported decreased by 48%.

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Filed in Clinical audit, case review, or analysis of adverse events, Clinical practice guideline/policy change, Educational materials for health professionals, Improved liability system, In the Literature, Performance measurement, Performance measurement/reporting, Risk management/liability reform, Staffing/care coordination change, Team building on Sun., Apr 3, 2011

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In the Literature: HCA reduces liability claims, cesarean sections with comprehensive patient safety approach

The general approach described in this article is the standardization of practices and protocols for several clinical situations associated with high risk of injury or harm, specifically use of oxytocin, misoprostol, or magnesium sulfate; operative vaginal delivery; and the management of shoulder dystocia and abnormal fetal heart rate tracings. In the period since the implementation of the comprehensive patient safety program, HCA saw a dramatic decrease in malpractice claims and loss rates. In addition, the primary cesarean section rate fell despite a generally liberal approach to operative delivery.

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Filed in Care coordination, Clinical audit, case review, or analysis of adverse events, Clinical practice guideline/policy change, Educational materials for health professionals, Health professions education, Improved liability system, In the Literature, Performance measurement/reporting, Risk management/liability reform, Team building on Tue., Mar 15, 2011

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In the Literature: Comprehensive patient safety program results in dramatic decrease in adverse events, 99% reduction in malpractice payments

New York Presbyterian Hospital-Weill Cornell Medical Center, a tertiary academic referral center in New York City, reports that following a multi-year, comprehensive patient safety program, sentinel events (maternal deaths and serious newborn injuries) decreased from 5 in 2000 to none in 2008 and 2009 while yearly compensation payments decreased from more than $27 million between 2003 and 2006 to $2.5 million between 2007-2009, a 99% reduction that far offset the cost of implementing the safety program.

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Filed in Blueprint, Clinical audit, case review, or analysis of adverse events, Clinical practice guideline/policy change, Educational materials for health professionals, Health information technology, Health information technology, Health professions education, Improved liability system, In the Literature, Progress, Risk management/liability reform, Skills training or drills for health professionals, Staffing/care coordination change, Team building, Workforce on Sun., Mar 6, 2011

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