A second webinar was held with the focus on induction scheduling practices. A physician and the nurse manager from WakeMed talked about what is in place at that hospital that has led to a relatively low c-section rate (26% overall, 14% primary c-section rate), which led to another good discussion among hospital teams about what approaches are most effective and what challenges they are facing. Several hospitals are reporting challenges with "physician buy-in" or engaging physicians around the validity and importance of improving the vaginal birth rate as a quality improvement focus. Frieda Norris gave an overview of Lamaze International's six healthy birth practices in relation to the role of labor support and other evidence-based practices to increase the rate of vaginal birth. These practices reflect a patient-centered approach to the intrapartum proceses.
Teams are actively working on the action items they identified on their action plans for this initiative. Several are in the process of developing new policies for scheduling inductions, many are working to increase the use of cervical ripening and to test changes to the cervical ripening methods they are using, and some hospitals have eliminated or plan to eliminate elective inductions generally. The Novant hospitals have formed a Women's Council to work jointly across facilities on quality improvement in the maternity setting (there are 4 Novant facilities in Support for Birth: Forsyth, Presbyterian, Presbyterian Huntersville, and Presbyterian Matthews).
