Health information technology

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: 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.

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Filed in Blueprint, Clinical audit, case review, or analysis of adverse events, Clinical controversies, Clinical practice guideline/policy change, Health information technology, Health information technology, In the Literature, Payment reform, Performance measurement, Performance measurement/reporting on Fri., Jul 29, 2011

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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.

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Filed in Blueprint, Care coordination, Clinical controversies, Clinical practice guideline/policy change, Health information technology, Health information technology, In the Literature, New care delivery model, Performance measurement, Performance measurement/reporting, Strategies on Thu., Jun 16, 2011

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From the Field: Birthrisk Cesarean Birth Measure

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.

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Filed in Clinical controversies, Decision making and choice, Educational materials for health professionals, Health information technology, Health information technology, Performance measurement, Performance measurement/reporting, Stories from the Field on Fri., Apr 29, 2011

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From the Field: Louisiana Birth Outcomes Project

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.

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Filed in Blueprint, Care coordination, Childbirth Connection, Clinical controversies, Clinical practice guideline/policy change, Community education/outreach, Disparities, Health information technology, Health information technology, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Scope of covered services, Staffing/care coordination change, Stories from the Field on Fri., Apr 22, 2011

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Federal Legislative Action: Partnering to Improve Maternity Care Quality Act of 2010

This act addresses many of the recommendations put forth in the direction-setting Blueprint for Action, with provisions related to many of the Blueprint’s 11 focal areas, including performance measurement and leveraging of results; payment reform aligning incentives with quality; scope of covered services for maternity care; coordination of maternity care across time, settings, and disciplines; decision-making and consumer choice; and development and use of health information technology.

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Filed in Care coordination, Childbirth Connection, Decision making and choice, Federal Legislation, Health information technology, Health information technology, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Scope of covered services on Mon., Apr 4, 2011

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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