While most deliveries seem to go smoothly, many births experience some kind of pregnancy complication. These complications can be harmful for the other and infant, and result in increased maternal and neonatal care. One area of focus within obstetrical adverse events is the elimination of early elective deliveries. Delivery before 39 weeks of pregnancy can cause a host of negative consequences for the baby. In 2010, the Leapfrog Group reported that elective early deliveries ranged from 5 to 40 percent of all elective deliveries, depending on the hospital. Coalition for Care members are working to institute hard-stop policies to prevent induction before 39 weeks. Learn more about obstetrical adverse events »
IHA’s Council on Quality and Patient Safety approved a motion to promote awareness of the Institute for Healthcare Improvement’s research regarding the perinatal care “bundles” and its white paper 
Idealized Design of Perinatal Care.
Implementing policies regarding induction prior to 39 weeks gestation is among the bundle interventions that IHI is encouraging hospitals to adopt for better patient outcomes. The paper also recommends strategies for enhancing uterine contractions, preparing for safe inductions and making culture changes to reduce the incidence of early inductions.
Early
Elective Delivery Rate Reduced in the State, Statewide Policy Developed
IHA and the Indiana
State Department of Health (ISDH) are proud to announce that the rate of early
elective deliveries before 39 weeks has been
reduced from 11 percent in 2012 to less than 3 percent. Through quality
improvement initiatives, hospitals across the state have been successful in
reducing early elective deliveries. To date, 86 out of 93 delivering hospitals
in Indiana have adopted hard-stop policies for all elective deliveries that do
not meet medical criteria or receive approval from medical staff leadership.
The Indiana Hospital Association, in conjunction with the ISDH Perinatal
Quality Improvement Collaborative, developed a recommend hard-stop policy, scheduling form and consent form addressing early
elective deliveries.
Healthcare
Communities Website Offers Obstetrical Adverse Events Resources
HealthcareCommunities.org
(HC) is a web-based knowledge management
system that provides multiple means for the healthcare quality improvement
community to share knowledge and contribute to each others’ quality improvement
work. Within this site, there is a Partnership
for Patients Community of Practice's dedicated Resource Center for sharing
public documents, presentations, webinar recordings and other helpful tools.
You will find many obstetrical adverse event tools and resources, including a comprehensive OB resources guide. This guide includes links to
perinatal safety resources, including topics of OB hemorrhage, early elective
deliveries, induction and augmentation, simulation of OB emergencies and much
more.
Other Resources
American Hospital Association’s Hospital Engagement Network shares best practices for avoiding obstetric adverse events. Find tools you can implement at your hospital, look for case studies or prepare a presentation for hospital leaders, board members or staff.
News Release: Indiana Hospital Association, Indiana State Department of Health Collaborate to Reduce Early Elective Deliveries for Expectant Mothers
