Women & Children's Health: Safety & Quality

Women and Children's Health

The Women & Children's Health Departments of Obstetrics and Pediatrics work together to provide family-centered, evidence-based, and safe care. We strive to advance patient safety and continuously improve patient outcomes. We have solidified this commitment through the creation of a dedicated Perinatal Quality and Safety Committee. The Committee is comprised of physicians, nurses, and other personnel from across the organization. Its goals are to use best practices to improve patient outcomes and to minimize risk in the obstetrical environment.

Obstetrical Care

Approach

The staff training with life size mannequins.

The staff training with life size mannequins.

Communication and teamwork are essential to providing safe care for our patients. The healthcare field has looked to the aviation industry and to the military for tools that optimize team performance in high risk situations. In addition to the extensive training, education, and experience of our obstetrical team, the department has adopted the use of simulation. Simulation is a form of training where our team uses “practice drills” to train for both routine and urgent care situations.

Since 2009, nurses and physicians have worked together in a safe environment to manage clinical care in labor and delivery. We use mannequins (life size models) of a mother and baby, “Noelle” and “Baby HAL.” Our staff includes nurses, faculty physicians, and doctors in training. The drills have a twofold purpose: individual skill development and improvement of team performance. Research supports simulation as a best practice for teaching clinical skills and making care as safe as possible. It also allows staff to practice teamwork behaviors and communication skills in a safe, monitored environment. This helps to foster collegiality on our patient care units.

Another essential component of providing quality care is evidence based practice, or the use of the best and strongest scientific research on how to provide high quality care. A recent example of the use of the latest evidence to provide best care is our effort to reduce scheduled deliveries before 39 weeks gestation. A full gestation is 40 weeks.

Although there are sometimes medical reasons for delivering prior to 40 weeks, infants born prior to 39 weeks may have a higher risk of breathing problems and infections. Stamford Hospital recognized this was a best practice and implemented a protocol to ensure that electively induced or cesarean sections deliveries are not scheduled prior to 39 weeks gestation. This follows a best practice recommended by the American College of Obstetricians and Gynecologists.

Results

The Leapfrog Group, a national patient safety organization, has estimated that the national rate of unnecessary early deliveries before 39 weeks is 3.4%, and called for organizations to achieve less than 5%. As shown in Figure 1, through application of best practices, we have achieved a rate of 1%. Our success in this effort has led to recognition and presentation in regional and national venues, including the Association for Women’s Health Obstetrical and Neonatal Nurse’s 2014 national conference.

Unnecessary Early Deliveries Before 39 Weeks

Click Image to Enlarge (Fig. 1)

Our physicians and nurses work collaboratively to ensure that these and other evidence-based guidelines are followed, and will continue to strive to provide the highest quality care for our mothers and babies.

Stamford Hospital’s Maternal-Child Health Units received a Gold Level CQIA Innovation Prize from The Connecticut Quality Improvement Award Partnership, Inc. on June, 2014. We are among a small number of healthcare organizations in this region to receive this award. This award recognizes the innovative approach to bringing evidence based care to the bedside, disseminating data, and implementing best practices to improve perinatal, maternal, and neonatal outcomes.

To learn more about quality of care in Obstetrics, visit the American College of Obstetrics and Gynecology.

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