Multifaceted quality initiative can reduce adverse obstetric outcomes

A new study published in the Journal for Healthcare Quality reveals that a multifaceted quality initiative can significantly reduce adverse obstetric outcomes, thereby improving patient safety and enhancing staff and patient experiences.

Led by Adiel Fleischer, MD, Chairman of Ob/Gyn at North Shore University Hospital and Long Island Jewish (LIJ) Medical Center, researchers designed a program to improve perinatal safety initiatives.

Specifically, they designed and implemented a two-year comprehensive training program for all staff in the obstetrics wing at North Shore University Hospital and LIJ Medical Center. Staff was required to complete the formalized training that included evidence-based protocols to reduce adverse effects.

A team of scientists in the Division of Health Services Research in the health system's Department of Population Health, and from the Biostatistics Department analyzed almost a dozen adverse outcomes measures.

Results showed that adverse events, including returning to the operative room and birth trauma, were significantly reduced by more than half; from 2 percent to 0.8 percent. Data also showed that better outcomes were maintained over the two-year study period.

Additionally, staff perceptions of safety, patient perceptions of whether staff worked together, and documentation rates of abnormal fetal heart tracings and obstetric hemorrhage were all significantly improved.

"In order to improve care and reduce adverse events in obstetrics, a multifaceted best practice based approach that introduces standardized documentation, trains entire teams, and facilitates communication from both those trained and those being cared for, is convincingly effective," Fleischer notes.