A number of health issues may have a negative impact on a woman’s well-being during pregnancy and childbirth. Three out of five maternal deaths in the U.S. are considered preventable, yet the U.S. has a higher rate compared to other high-income countries. The Center for Women & Infants (CWI) has been making strides to improve maternal morbidity and mortality at UofL Health – UofL Hospital. Here are a few of the patient safety initiatives they have been working on:
- Obstetric hemorrhage: CWI has developed a postpartum hemorrhage cart (similar to a crash cart) and an emergency medication box. This allows staff to treat postpartum hemorrhages quickly and efficiently. They started quantifying blood loss by weighing all laps, towels, chux, etc. for all deliveries so hemorrhage can quickly be identified and staff can intervene quickly.
- Severe hypertension in pregnancy: CWI created a treatment algorithm for staff to refer to when managing a patient with severely high blood pressures. They worked with pharmacy to ensure that staff can quickly obtain emergency blood pressure medications to treat severe range blood pressures. All patients receive timely treatment well below standard treatment time of one hour, with an average of 16 minutes.
- Venous thromboembolism: CWI created a risk assessment tool to help staff identify patients most at risk for developing blood clots. Staff educate every patient on their risk and on the signs of symptoms of blood clots prior to discharge.
- Racial disparities: CWI is now also beginning to focus on educating staff on the root causes of racial disparities, providing implicit bias training, using best practices for shared decision making, and providing patient education that meets the health literacy, language, and cultural needs of our patients. They are creating a disparities dashboard that tracks quality measures stratified by race and ethnicity, and this information will be used to develop further quality improvement projects.
- Parental engagement in the NICU: The NICU is working on strategies to increase parental engagement for mothers with substance use disorder by researching best practices for reducing stigma, enhancing self-efficacy, and promoting best feeding practices.
- Simulated emergencies: CWI holds regular drills with the nursing staff, resident team, anesthesia team, nursing educators, and attending MDs to simulate obstetric emergencies, and focus on education, communication, and teamwork.
To learn more about these initiatives, contact Jaki Patterson, RNC-OB, BSN, CLC, C-EFM, quality improvement coordinator in the Center for Women & Infants, at firstname.lastname@example.org.