Women of childbearing age need accurate, objective data in order to make informed choices about birth settings and providers. The Birth Survey, a mechanism to share, systematically track, and retrieve up-to-date information about the quality of care received will equip consumers with the information necessary to make informed decisions and enable individuals to play a larger role in determining their care and to make real informed health care choices.
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.
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.
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.
In the Literature: At Intermountain, process improvement reduces inductions, cesareans, NICU admissions, and costs
As a result of process improvement efforts bolstered by robust information systems, the proportion of all inductions that lacked strong indications for clinical appropriateness fell from 28 percent to less than 2 percent. The project also resulted in decreases in both NICU admissions and cesareans, and Intermountain estimates that the elective induction protocol reduces health care costs in Utah by $50 million per year.
NH Patient Voices’s mission is education and advocacy for safe, quality, compassionate healthcare that puts patients & their families at the center of care in both policy and practice. Since 2005, we’ve worked tirelessly to bring the collective voice of patients to healthcare providers, administrators, legislators, public policy, and public health leaders.
HPC Community Doulas is a non profit 501(c) 3 maternal-infant agency dedicated to serve low income pregnant women receiving prenatal care at federally qualified health centers in Hudson County, NJ. Our grant is committed to reducing perinatal disparities in birth outcomes, so we offer free community doulas to pregnant women on Medicaid and/or enrolled in the WIC program.
In the Literature: Geisinger’s ProvenCare safely reduces cesarean rate with implementation of evidence-based guidelines
Geisinger Health Systems in Pennsylvania set out “to demonstrate that a large integrated health care delivery system, enabled by an electronic health record (EHR), could successfully reengineer a complicated clinical process, reduce unwarranted variation, and reliably deliver evidence-based care.” Geisinger has successfully demonstrated effectiveness in acute care specialties with their ProvenCare system and sought to adapt it to perinatal care, for the first time addressing a largely well population and integrating multiple outpatient clinics.
We set out to change the method that is used to measure the results of different labor management strategies. We created an indicator that uses each patient’s unique physical characteristics to adjust an obstetrical care provider’s cesarean delivery rate to reflect the physical characteristics of their patient population. This indicator is called the Birthrisk Cesarean Birth Measure.
The Louisiana Birth Outcomes Project is a state-wide effort coordinated by the Department of Health and Hospitals. This multi-stakeholder initiative drew inspiration from the Transforming Maternity Care project and charged several interdisciplinary task forces with constituencies modeled after the five TMC stakeholder workgroups to determine critical steps for progress in four major areas: quality and safety, interconception care, behavioral health, and performance measurement.