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Safety Initiative Reduces Adverse Obstetric Outcomes

Last Updated: November 18, 2011.

The introduction of a comprehensive, multicomponent perinatal safety initiative can reduce adverse obstetric outcomes, improving patient safety and enhancing staff and patient experiences, according to a study published in the Journal for Healthcare Quality.

FRIDAY, Nov. 18 (HealthDay News) -- The introduction of a comprehensive, multicomponent perinatal safety initiative (PSI) can reduce adverse obstetric outcomes, improving patient safety and enhancing staff and patient experiences, according to a study published in the Journal for Healthcare Quality.

Brian Wagner, M.D., from the North Shore-Long Island Jewish Health System in Great Neck, N.Y., and colleagues examined whether implementation of a multistep, multicomponent PSI, introduced from 2007 to 2009, decreased adverse outcomes. The initiatives included evidence-based protocols; formalized team training stressing communication; standardizing electronic fetal monitoring with requisite documentation of competence; a program simulating high-risk obstetrical emergencies; and distribution of an integrated educational program among all health care providers. The Adverse Outcome Index was modified (MAOI) to follow 11 adverse outcome measures and in addition, individual components were assessed.

The investigators found that the MAOI decreased significantly from 2.0 to 0.8 percent within the first year, and this was sustained throughout the two-year period. Rates of return to the operating room and birth trauma were also significantly reduced over time. Staff perceptions of safety, patient perceptions of staff cooperation, the management and documentation of abnormal fetal heart rate tracings, and the documentation of obstetric hemorrhage improved significantly.

"This study demonstrates that a comprehensive PSI can significantly reduce adverse obstetric outcomes, thereby improving patient safety and enhancing staff and patient experiences," the authors write.

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