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Clinical patient safety interventions reduce errors in obstetrical care

Published on February 5, 2008 at 10:46 AM · No Comments

Researchers at Yale School of Medicine have implemented patient safety enhancements to dramatically reduce errors and improve the staff's own perception of the safety climate in obstetrical care.

Edmund F. Funai, M.D., associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale, will present preliminary results from this research at the Society for Maternal Fetal Medicine Annual Meeting on February 2 in Dallas, Texas.

An estimated 44,000 to 98,000 Americans die in hospitals each year as a result of errors. About half of medical errors are linked to communication errors and system failures. Obstetrics has lagged behind other specialties in attempts to improve safety because perinatal adverse events are both relatively uncommon and usually unexpected, occurring in previously healthy patients who are anticipating good outcomes.

“There is a crisis of confidence in American healthcare right now,” said Funai. “Reports in the media about patient injury in the hospital setting were causing concern, and we sought to apply some basic principles to obstetric care to make it a great deal safer than it is right now.”

Funai and his team designed and implemented clinical patient safety interventions at Yale-New Haven Hospital. These included communication training, standardizing interpretation of fetal monitoring, and creating a novel staff role—the patient safety nurse. In tracking and analyzing 14 markers for adverse outcomes, the team found that the rate of adverse events decreased by about 60 percent over 2.5 years, while the staff's own perception of the overall safety climate increased by 30 percent, according to a survey given by a third party.

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