A Toolbox for Perinatal Quality Improvement

Abstract

Session presented on: Tuesday, November 19, 2013: The Perinatal Community is a group of member hospitals working together to improve perinatal quality within their institutions under the auspices of the Institute for Health Improvement. This quality improvement program lasts for 36 months and provides mentoring, a toolkit for quality improvement and access to experts from the quality improvement field. The aims of the Perinatal Community are to promote the following evidence-based practices: Oxytocin Checklists, a Postpartum Hemorrhage Protocol and Algorithm, Safety Rounds and Shift Huddles. To achieve these aims a group of staff nurses, members of the leadership team and administrators came together to meet the aims and goals of the Perinatal Community. The member institutions, working together, share information to achieve their quality improvement goals. One of the milestones was to implement an Oxytocin Protocol including the Pre-Use and In-Use Checklists. The Oxytocin Deep Dive was an in-depth chart review to obtain information on the current use of oxytocin in the institution. Using this information the institution implemented the new Protocol and Checklists. Hemorrhage Protocols and Algorithms have been well-researched and clearly show benefit in: time to hemorrhage recognition and rescue. Implementation improved maternal and neonatal outcomes. Safety Rounds provides the opportunity for nurses, physicians and case managers to gather together and review patient data. Outcomes have been remarkable, improving communication between specialties, developing care plans for complex patients and improving relationships between specialties. The Shift Huddle provides an opportunity for staff to hear report on each patient, improving care by imparting patient information to nursing staff. Staff members can ask questions about patients and offer suggestions to their colleagues related to patient care. Communication was enhanced through all of these implementations. Kaizen, LEAN and PDSA methodology was used to foster stakeholder participation and ultimately to implement changes in practice.