Challenge 11

Optimizing Obstetric Safety

Obstetric safety, or the safety of women who are giving birth, focuses on improving the quality of care delivered to soon-to-be mothers. The goal is to improve the early recognition, readiness, and responsiveness of healthcare professionals treating these women. The PSMF is focused on the following obstetric-related challenges: pre-eclampsia, postpartum hemorrhage (PPH), and unnecessary c-sections.

Each Actionable Patient Safety Solutions (APSS) includes an Executive Summary Checklist, Performance Gap, Leadership Plan, Practice Plan, Technology Plan and Metrics. Please click Download below to view the full document. A preview of the Executive Summary is offered below.

Sub-Challenges

Statistics

11.1% of pregnancy-related deaths in the U.S. resulted from “hypertensive disorders of pregnancy,” including preeclampsia.1
Pre-eclampsia is the cause of 15% of premature births in the U.S.2
2.

Jeyabalan, A. (2013). Epidemiology of preeclampsia: Impact of obesity. Nutrition Reviews, 71(0 1), 10.1111/nure.12055. http://doi.org/10.1111/nure.12055

Obstetric hemorrhage and pre-eclampsia account for over 70% of cases of severe maternal morbidity.3
3.

California Maternal Quality Care Collaborative. Project Overview/FAQs. Retrieved from: https://www.cmqcc.org/resource/2900/download

Over the past decade, severe maternal morbidity in the United States has increased by 75% for complications associated with delivery and, specifically, 114% for postpartum hemorrhage.4
4.

Callaghan, W.M., Creanga, A.A., Kuklina, E.V. Severe maternal morbidity among delievey and postpartum hospitalizations in the United States. Obstet Gynecol 2012;120:1029-36.

125,000 women a year are affected by postpartum hemorrhage.5
5.

The AWHONN Postpartum Hemorrhage Project. Maternal Morbidity & Mortality.

Postpartum hemorrhage is a leading cause of pregnancy-related complications, with an estimated 2.9% of the women who give birth in the U.S. will bleed too much.6
6.

The AWHONN Postpartum Hemorrhage Project. Maternal Morbidity & Mortality.

Approximately 50% of hospital risk management budgets are allocated for obstetric events, and birth-related events account for more than 75% of claims paid in amounts over $1 million.7
7.

Perinatal Safety Intervention Program (PSIP): Design and Development: AHRQ’s 2012 Annual Conference Slide Presentation. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/news/events/conference/2012/track_a/106_hendrich_kamerow/kamerow.html

Anemia is estimated to be responsible for 17-46% of cases in maternal death.8
8.

Fawzia Ahmed Habib, Intessar Sultan and Shaista Salman (2012). Morbidity and Mortality in Anemia, Anemia, Dr. Donald Silverberg (Ed.), ISBN: 978-953-51-0138-3, InTech, Available from: http://www.intechopen.com/books/anemia/morbidity-and-mortality-in-anemia

Over the past decade, severe maternal morbidity in the United States has increased by 75% for complications associated with delivery and, specifically, 114% for postpartum hemorrhage.9
9.

Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol 2012;120:1029–36.

Obstetric hemorrhage and preeclampsia account for over 70% of cases of severe maternal morbidity.10
10.

California Maternal Quality Care Collaborative. Project Overview/FAQs. Retrieved from: https://www.cmqcc.org/resource/2900/download

The United States is the one of the only countries where maternal deaths and injuries have increased.11
11.

Gaskin, I. M. (2008). Maternal Death in the United States: A Problem Solved or a Problem Ignored? The Journal of Perinatal Education, 17(2), 9–13. http://doi.org/10.1624/105812408X298336

Every 10 minutes, a woman in the United States almost dies of pregnancy-related complications.12
12.

The AWHONN Postpartum Hemorrhage Project. Maternal Morbidity & Mortality.

30-40% of “near misses” and severe maternal morbidities may be preventable through changes in patient, health care provider, and system factors.13
13.

Perinatal Safety Intervention Program (PSIP): Design and Development: AHRQ’s 2012 Annual Conference Slide Presentation. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/news/events/conference/2012/track_a/106_hendrich_kamerow/kamerow.html