Posts tagged with '39 weeks'

From the TMC blog: “Choosing Wisely” in maternity care: ACOG and AAFP urge women to question elective deliveries

Last April, the ABIM Foundation, with Consumer Reports and other partners, drew national attention to overuse of ineffective and harmful practices across the health care system with their Choosing Wisely campaign. As part of the campaign, professional medical societies identified practices within their own specialties that patients should avoid or question carefully. Today, the American Congress of Obstetricians and Gynecologists (ACOG) and the American Association of Family Physicians (AAFP) have joined the campaign, drawing national attention to the overuse and misuse of induction of labor. ACOG and AAFP are telling women and their maternity care providers:

- Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age.
- Don’t schedule elective, non-medically indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable.

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Filed in Blog, New Reports and Resources on Thu., Feb 21, 2013

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From the TMC blog: Sign-up Now for October 10 Webinar on New National Goals and Strategies to Reduce Early Elective Delivery and Cesarean Section in Low-Risk Women

Over the last nine months, the Maternity Action Team, comprised of nearly 30 public and private organizations, has set aspirational goals and worked on the development and implementation of a plan to reduce elective deliveries prior to 39 weeks to 5% or less and reduce cesarean section in low-risk women to 15% or less. This effort is focused on three key strategies: 1) Increasing uptake of The Joint Commission perinatal core measure set; 
2) Implementing hard-stop policies and checklists; and 
3) Aligning consumer and provider messaging.

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Filed in Blog, Webinars on Tue., Oct 2, 2012

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From the TMC blog: Early Elective Deliveries Are Decreasing

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.

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, New Reports and Resources on Tue., Jan 31, 2012

From the TMC blog: Leading Change: An Interview with Christine Morton of CMQCC

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!

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Filed in Blog, Clinicians, Consumers, Hospitals and Health Systems, Interviews, Leading Change, New Reports and Resources, Quality Collaboratives on Thu., Dec 15, 2011

From the TMC blog: Guest Post: Lessons for Maternity Care from…Moneyball?

The movie Moneyball has been a recent box office hit, inspired by the true story of how Oakland Athletics General Manager Billy Beane went against baseball orthodoxy to create a winning baseball team. Facing baseball’s elite teams on a fraction of their budgets, Beane realized that the A’s couldn’t compete if they played the same old ballgame. When I saw the movie recently I was startled to see a considerable amount of thematic overlap with the issues currently facing maternity care.

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Filed in Blog, Costs - Charges - Value, Guest Posts on Wed., Nov 16, 2011

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From the TMC blog: Maternity Care Improvement: Will it Play in Peoria?

You’ve probably heard the phrase, “Will it play in Peoria?” It originated in the early ’20s and ’30s during the US vaudeville era, when Peoria, IL was a popular stop for vaudeville acts and performances. If a show was well received in Peoria, it was likely to work throughout the country. Peoria has since become a well-known test market to gauge the popularity of products and ideas nationwide.

So what does this have to do with maternity care? Well, in this case, what’s playing in Peoria goes way beyond products and ideas to a full-blown actionable healthcare quality improvement project called “Healthy Babies, Healthy Moms.”

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, Quality Collaboratives on Wed., Sep 14, 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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State Legislative Action: A Bill to Reduce Early Births, Costs in Minnesota

This legislation would alter the organization of and payment for maternity services by: creating a mechanism to deny Medicaid payment for elective deliveries before 39 weeks, bundling payment for the full episode of maternity care for low-risk women, enabling access to midwives and birth centers providing high-quality, high-value care, and developing standards and a certification process for “pregnancy care homes”

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Filed in Care coordination, Clinical controversies, New care delivery model, Payment reform, Payment/reimbursement change, Scope of covered services, Staffing/care coordination change, State Legislation, Workforce on Tue., Apr 26, 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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From the Field: Washington State Perinatal Collaborative Reducing Elective Delivery Before 39 Weeks Project

The collaborative is seeking to understand the reason for rising C-Section rates and possible modifiable factors leading to this rise. The collaborative believes that the variation among hospitals in cesarean, VBAC, and induction rates are affecting maternal and infant health across the state of Washington. To address these variations the collaborative is engaging agencies, hospitals, organizations, and the community to encourage birthing hospitals to collaborate and address issues such as inductions, trial of labor, appropriate admissions, and accessibility to vaginal births after cesareans. The first initiative uses the March of Dimes Toolkit and other resources to reduce early elective deliveries in the state of Washington.

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Filed in Clinical practice guideline/policy change, Payment reform, Payment/reimbursement change, Performance measurement, Performance measurement/reporting, Stories from the Field on Fri., Mar 18, 2011

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