TY - JOUR
T1 - Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care
AU - Kahwati, Leila C.
AU - Sorensen, Asta V.
AU - Teixeira-Poit, Stephanie
AU - Jacobs, Sara
AU - Sommerness, Samantha A.
AU - Miller, Kristi K.
AU - Pleasants, Elizabeth
AU - Clare, Hanna Margaret
AU - Hirt, Charles L.
AU - Davis, Stanley E.
AU - Ivester, Thomas
AU - Caldwell, Donna
AU - Muri, Janet H.
AU - Mistry, Kamila B.
N1 - Funding Information:
The implementation and evaluation of the program described in this manuscript was supported by RTI International under contract to the Agency for Healthcare Research and Quality (No. HHSA2902010000241 , Task Order 3).
Publisher Copyright:
© 2018 The Joint Commission
PY - 2019/4
Y1 - 2019/4
N2 - Background: The Safety Program for Perinatal Care (SPPC)seeks to improve safety on labor and delivery (L&D)units through three mutually reinforcing components: (1)fostering a culture of teamwork and communication, (2)applying safety science principles to care processes; and (3)in situ simulation. The objective of this study was to describe the SPPC implementation experience and evaluate the short-term impact on unit patient safety culture, processes, and adverse events. Methods: We supported SPPC implementation by L&D units with a program toolkit, trainings, and technical assistance. We evaluated the program using a pre-post, mixed-methods design. Implementing units reported uptake of program components, submitted hospital discharge data on maternal and neonatal adverse events, and participated in semi-structured interviews. We measured changes in safety and quality using the Modified Adverse Outcome Index (MAOI)and other perinatal care indicators. Results: Forty-three L&D units submitted data representing 97,740 deliveries over 10 months of follow-up. Twenty-six units implemented all three program components. L&D staff reported improvements in teamwork, communication, and unit safety culture that facilitated applying safety science principles to clinical care. The MAOI decreased from 5.03% to 4.65% (absolute change -0.38% [95% CI, -0.88% to 0.12%]). Statistically significant decreases in indicators for obstetric trauma without instruments and primary cesarean delivery were observed. A statistically significant increase in neonatal birth trauma was observed, but the overall rate of unexpected newborn complications was unchanged. Conclusions: The SPPC had a favorable impact on unit patient safety culture and processes, but short-term impact on maternal and neonatal adverse events was mixed.
AB - Background: The Safety Program for Perinatal Care (SPPC)seeks to improve safety on labor and delivery (L&D)units through three mutually reinforcing components: (1)fostering a culture of teamwork and communication, (2)applying safety science principles to care processes; and (3)in situ simulation. The objective of this study was to describe the SPPC implementation experience and evaluate the short-term impact on unit patient safety culture, processes, and adverse events. Methods: We supported SPPC implementation by L&D units with a program toolkit, trainings, and technical assistance. We evaluated the program using a pre-post, mixed-methods design. Implementing units reported uptake of program components, submitted hospital discharge data on maternal and neonatal adverse events, and participated in semi-structured interviews. We measured changes in safety and quality using the Modified Adverse Outcome Index (MAOI)and other perinatal care indicators. Results: Forty-three L&D units submitted data representing 97,740 deliveries over 10 months of follow-up. Twenty-six units implemented all three program components. L&D staff reported improvements in teamwork, communication, and unit safety culture that facilitated applying safety science principles to clinical care. The MAOI decreased from 5.03% to 4.65% (absolute change -0.38% [95% CI, -0.88% to 0.12%]). Statistically significant decreases in indicators for obstetric trauma without instruments and primary cesarean delivery were observed. A statistically significant increase in neonatal birth trauma was observed, but the overall rate of unexpected newborn complications was unchanged. Conclusions: The SPPC had a favorable impact on unit patient safety culture and processes, but short-term impact on maternal and neonatal adverse events was mixed.
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U2 - 10.1016/j.jcjq.2018.11.002
DO - 10.1016/j.jcjq.2018.11.002
M3 - Article
C2 - 30638973
AN - SCOPUS:85059777489
SN - 1553-7250
VL - 45
SP - 231
EP - 240
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 4
ER -
