Updates

Teams are continuing to record and use data to plan and implement changes to eliminate elective deliveries under 39 weeks gestation without documented pulmonary maturity studies...

Written and Directed by Erik Ewers, Your Story Films, Walpole, NH. Produced by Julie Coffman, NNEPQIN producer Becky Ewing, MD. Co Stars: Michele Lauria, MD, Bill Edwards MD, Andrea Damato and Bonnie Morrissette

Risk is a very human twenty minute educational DVD that helps patients and their providers experience potential outcomes of elective late preterm delivery through the stories of two moms.

Dr. Lauria and Dr. Edwards provide the medical context in language that is accurate and understandable.

More here

On August 31, 20 teams came together in Chapel Hill to celebrate the accomplishments of the 37 hospital teams that worked to achieve a 43% decrease in the rate of elective deliveries <39 weeks between October 2009 and June 2010.  Hospitals shared strategies they have implemented over the past year to reach their goals of reducing elective deliveries <39 weeks.  Teams reported that they have noticed less congestion in their L&D units as a result of fewer admissions for elective inductions. Hospitals have noted a decrease in NICU admissions and newborn complications. Several hospitals discussed the importance of having a peer review mechanism in place to address deliveries performed before 39 weeks without clear medical indication. The data collected for this initiative also showed an increase in the presence of evidence in the chart to support medical indications for non-elective early deliveries, and an approximate 12% decrease in scheduled deliveries (both inductions and c-sections) at gestational ages between 36.0 and 38.6 weeks.
 
Through our partnership with March of Dimes for this initiative, a press release was issued in conjunction with the final learning session, and the 39 Weeks Project received coverage from the Raleigh News & Observer and WUNC, the local National Public Radio affiliate.
 
In addtion to reviewing data, the learning session included a web-based presentation by Kathleen Rice Simpson, RN, PhD, FAAN on safety and best practices in labor induction.  Two panel presentations focused on the role of physician leadership in achieving quality improvement in maternity centers and the importance of transparent communication between patients and providers to ensure decisions about scheduled delivery remain focused on what is safest for mother and baby.  Two patients shared stories about physicians who built trust with them by sharing information and taking time to talk with them about making decisions about their pregnancies.  These stories highlight the best practices which already exist in North Carolina and which PQCNC can disseminate through collaborative learning sessions such as our meeting on August 31.
 
We also took time to recognize the hospital teams who worked so hard to collect data on all inductions and scheduled c-sections between 36.0 and 38.6 weeks of gestation over a nine month period and who continue to strive to deliver high quality maternity care.  On a lighter note, PQCNC bestowed various awards of recognition, including the Most Data Entered between the Hours of 1:00 and 4:00am, the Dog Ate My Homework Award (for best excuses for missing data entry deadlines), and the Healthiest Wrists Award (to the hospital that so few scheduled deliveries <39 weeks they entered almost no data).

While formal data collection for the 39 Weeks Project wrapped up on June 30, 2010, several teams expressed interest in continuing to collect data either to ensure they hold the gains made over the past year or to measure ongoing improvement as they continue to implement changes to reduce elective deliveries <39 weeks.  PQCNC has created a new data entry program to support the collection of this data through June 2011 and will continue to prepare monthly and quarterly reports for all hospitals entering "continuation data.