Healthcare News & Insights

Hospital safety initiative cuts preventable birth injuries, lawsuits

To keep mothers and their babies safe during birth, several hospitals have banded together to implement a set of best practices in the Premier Perinatal Safety Initiative.

The results? According to a report, the hospitals managed to reduce injuries, care costs and legal liability relating to births in only two years,

In participating hospitals, the annual adverse outcome rate for mothers and their babies decreased by 7.5% overall. Neonatal birth trauma was reduced by 22%, and instances of birth hypoxia and asphyxia, which can cause brain damage, went down 25%. Maternal complications decreased by 15%.

Although some injuries occurring during birth aren’t preventable, an estimated 30% of them are, and the goal of this initiative was to determine which methods improved outcomes the most.

The best results were achieved with two factors: An increased adherence to evidence-based care bundles in participating hospitals, and enhancing communication and teamwork among hospital staff.

Using evidence-based care bundles

With care bundles, practices designed to improve the outcomes of childbirth are used in tandem.  Each bundle comprises four practices, with a strict set of standards maternity staff must follow.

As an example, one care bundle has a specific goal of reducing the risks of augmenting labor. The care elements that must be used consistently with this bundle are:

  • Documenting the estimated fetal weight
  • Ensuring the fetus is at normal status
  • Performing a pelvic exam prior to administering oxytocin to accelerate the birth, and
  • Recognizing and managing tachysystole.

Better communication, teamwork

Communication breakdowns among maternity staff cause 70% of incidents involving death or serious injury to mothers and babies.

To reduce these adverse events, strengthen communication and promote teamwork, hospitals in the initiative:

  • Implemented the TeamSTEPPS system. TeamSTEPPS, created by the Agency for Healthcare Research and Quality, is a process that provides training to healthcare staff about the most effective ways to successfully work together using various tools, including Web conferences and classroom sessions.
  • Used the Situation Background Assessment Recommendation (SBAR) communication tool. Taking a page from the U.S. military, hospitals improved teamwork with SBAR. Using the strategy, staff members were able to relay relevant details about their patients’ conditions in a focused, straightforward manner. SBAR proved especially helpful during handoff conversations at shift changes, or when nurses needed to communicate key info to doctors.
  • Participated in simulation exercises. Exercises using both real-life actresses and mannequins helped hospital staff practice communication and teamwork skills before using them in real-life crisis situations. Simulations prepared staffers to handle life-threatening issues, including infant distress and maternal hemorrhage.

Reducing hospital liability

Safer births save the healthcare system money overall. But they also help hospitals financially by reducing the risk of a lawsuit.

Malpractice lawsuits involving injuries at birth can cost hospitals millions of dollars, and the payouts are some of the priciest in health care.

In fact, because of these lawsuits, over half the risk management budget of an average hospital is spent on the labor and delivery area.

Hospitals participating in the initiative fared better than their counterparts regarding liability lawsuits. Because of the safety protocols they followed, the number of claims filed per delivery decreased by 39% between 2006 and 2010, compared to a mere 10% decrease for non-participating hospitals.

Transferable outcomes

Since childbirth is one of the top reasons for hospital admissions in the U.S., making strides to keep mothers and newborns safe can have a significant positive effect on hospital safety rates, and even ease budget woes.

The positive outcomes experienced by hospitals participating in this initiative show that implementing some of these measures at your hospital could be well worth the effort.

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