Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety

In a health care delivery system with an annual delivery rate of approximately 220,000, a comprehensive redesign of patient safety process was undertaken based on the following principles: (1) uniform processes and procedure result in an improved quality; (2) every member of the obstetric team shoul...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2008-08, Vol.199 (2), p.105.e1-105.e7
Main Authors: Clark, Steven L., MD, Belfort, Michael A., MD, PhD, Byrum, Spencer L., LCDR (ret.) USCG, Meyers, Janet A., RN, Perlin, Jonathan B., MD, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cesarean Section - statistics & numerical data
Clinical Protocols - standards
Evidence-Based Medicine
Female
Gynecology. Andrology. Obstetrics
Humans
litigation
Malpractice - statistics & numerical data
Medical sciences
Misoprostol - administration & dosage
Obstetric Labor Complications - prevention & control
Obstetrics - methods
Obstetrics - organization & administration
Obstetrics - standards
Obstetrics and Gynecology
Outcome and Process Assessment (Health Care)
Oxytocics - administration & dosage
patient outcomes
patient safety
Peer Review
Pregnancy
Pregnancy Outcome
quality medical practice
Quality of Health Care
United States
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Description
Summary:In a health care delivery system with an annual delivery rate of approximately 220,000, a comprehensive redesign of patient safety process was undertaken based on the following principles: (1) uniform processes and procedure result in an improved quality; (2) every member of the obstetric team should be required to halt any process that is deemed to be dangerous; (3) cesarean delivery is best viewed as a process alternative, not an outcome or quality endpoint; (4) malpractice loss is best avoided by reduction in adverse outcomes and the development of unambiguous practice guidelines; and (5) effective peer review is essential to quality medical practice yet may be impossible to achieve at a local level in some departments. Since the inception of this program, we have seen improvements in patient outcomes, a dramatic decline in litigation claims, and a reduction in the primary cesarean delivery rate.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.02.031