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August 2011
Maternity Care Moving from Vision to Action through the TMC Partnership!

In this Issue:
Survey seeks information on pregnancy internet use | Join IHI's Perinatal Improvement Community | 16 hospitals work together to improve safety | Webinar will address safety in maternity care | New standards for systematic reviews and clinical guidelines | Hospital promotes post-cesarean skin-to-skin contact | Birth centers: coming soon to Illinois

Dear Friend,

As summer winds down, momentum is building for high-quality, high-value maternity care. Earlier this month, I wrote about a prominent obstetric leader's clarion call to his profession to curb the rising cesarean rate. Stakeholders across the country are embracing the national effort to eliminate early elective deliveries. Perinatal safety is on the national agenda - reducing obstetric adverse events is a priority for the Partnership for Patients and the theme of an upcoming webinar that I'm honored to co-present. Each week we find inspiring projects to add to our Transforming Maternity Care Directory. There's still much work to be done, but we're grateful for the passionate and growing community working toward the 2020 Vision for a High-Quality, High-Value Maternity Care System. Maternity care is moving in the right direction!

Take Action: Help Transform Maternity Care

Childbearing women needed for survey on internet use and decision making
As Childbirth Connection and our partner, the Foundation for Informed Medical Decision Making, embark on our Shared Decision Making Maternity Initiative, we are seeking to learn more about how women use the internet to find pregnancy and birth information and support decision making. Our consulting partner, Mad*Pow, has developed a brief online survey. Please help us share the survey link with women who are planning pregnancy, are currently pregnant, or have given birth in the past 2 years. Participants are eligible to win a $50 Target gift card. Go to the survey.

IHI accepting teams to Perinatal Improvement Community
The Institute for Healthcare Improvement Perinatal Improvement Community provides support and resources to help hospitals implement data-driven perinatal safety programs. Participating teams start with in-depth assessment and goal-setting processes and identify initial areas of focus, such as induction of labor, augmentation of labor, or vacuum-assisted delivery. Teams adapt and apply IHI "improvement bundles" and engage in a rapid cycle of improvement and continuous measurement. IHI is currently accepting new teams to begin in September. For more information, visit IHI's Perinatal Improvement Community web site.

Good News from the Field: Partners Putting the Blueprint into Action

Collaborative of 16 hospitals works on reducing liability costs by avoiding perinatal adverse events
One group that has implemented IHI's improvement bundles has received a large federal grant to implement more changes to reduce liability costs by improving safety. Recently added to the Transforming Maternity Care Directory, the 16-hospital collaboration led by Fairview Health Services, Premier, and the University of Minnesota is working to improve compliance with 4 clinical care bundles and implement TeamSTEPPS, an evidence-based simulation training program focused on effective teamwork in high-risk scenarios. More information is available from Premier.

Consider This: Resources to Expand Your Vision for Improvement

Patient safety webinar zeros in on maternity care
The Partnership for Patients national program for improving patient safety, together with the National Priorities Partnership, will offer a free webinar on September 28 about Obstetrical Adverse Events. The webinar will address strategies to meet the national goal of eliminating 30% of preventable obstetrical adverse events and will feature Childbirth Connection's Maureen Corry and patient safety expert Kathleen Rice Simpson. Registration is now open.

Upgrading the tools to guide practice: IOM issues new standards for systematic reviews and clinical guidelines
Thousands of systematic reviews about maternal and newborn care have been published, and more and more are released every week. We clearly have guidance for many important questions related to safe effective practice, so why don't we have a high-quality, high-value maternity care system? The trustworthy evidence must be translated in practice, a tall order. Also, we cannot improve practice, without first doing a good job of interpreting the research evidence.

Two much-needed recent companion reports from the Institute of Medicine will help us interpret the evidence. The first report sets a high bar for standards used to carry out systematic reviews. The second sets a similarly high bar for the standards used to develop clinical practice guidelines. Access these reports and read about their significance for maternity care in Carol Sakala's recent post on the TMC Blog.

Cause for Optimism: Maternity Care Moving in the Right Direction

Hospital changes cesarean procedures to get moms and babies skin-to-skin in the OR
San Francisco General Hospital, a Baby-Friendly Hospital, implemented an improvement project to alter operating room procedures to enable routine, early skin-to-skin contact after cesarean birth. Lack of skin-to-skin contact in the first hour after birth is considered a major contributor to higher rates of breastfeeding difficulties and early weaning in women having cesareans.

Using the "Plan-Do-Study-Act" method of quality improvement, the team introduced and refined a flow chart and trained staff to routinely offer early skin-to-skin contact after cesarean surgery. Following implementation, the proportion of women and babies who had early skin-to-skin contact increased dramatically and breastfeeding outcomes improved. Read more about this improvement project.

Illinois set to license its first 10 birth centers
A 2007 law authorized a pilot program to issue licenses to 10 freestanding birth centers across Illinois, but it took four years to finalize the licensing rules. A final hearing ended last month, clearing the way for the birth centers to begin opening as soon as this year. According to an article in the Rockville Register Star, the rules stipulate where birth centers will operate: "There must be four in the greater Chicago area, three in other cities and three in rural areas. And within each of those areas, one must be run by a hospital and one must be run by a federally qualified health center, a type of clinic that cares for patients regardless of their ability to pay. What's more, the first three clinics approved in Illinois must be in areas that have a shortage of health professionals."

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Maureen Corry
Executive Director
Childbirth Connectio

Most recent page update: 12/12/2011

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Founded in 1918, Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Together, these two women's health powerhouses are transforming maternity care in the United States.
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