OBJECTIVE: Given the increasing rates of labor induction and cesarean delivery, and efforts to reduce early term births, we examined recent trends in methods and timing of delivery.
STUDY DESIGN: We identified delivery methods and medical indications for delivery from administrative hospital discharge data for 231 691 deliveries in 2006 and 213 710 deliveries in 2010 from 47 specialty care member hospitals of the National Perinatal Information Center/Quality Analytic Services. In a subset of 17 hospitals, we examined trends by gestational age.
RESULT: From 2006 to 2010, there was an 11% increase in labor induction and a 6% increase in cesarean delivery, largely due to repeat cesareans. There was a 4 per 100 reduction in early term births (37 to 38 weeks), mostly due to a decline in non-medically indicated interventional deliveries.
CONCLUSION: We report a shift in deliveries at 38 weeks, which we believe may be attributed to efforts to actively limit nonmedically indicated early term deliveries.
Here's an example of a PDSA Cycle:
This implementation guide was developed to support hospital leaders’ efforts to successfully implement the best obstetric hemorrhage practices and tools to create active quality improvement processes to drive successful implementation. The following information outlines the objectives of this quality improvement collaborative, the methods to support it, and the expectations of both FPQC and participants. Use this information to communicate this opportunity throughout your organization and network. Click here to view or download...
The initial group of hospitals who will be chosen to participate will be institutions who demonstrate readiness, commitment, and capacity to be a leading hospital for quality service delivery related to hemorrhage. This survey will be used to determine the first hospitals to participate in implementing the collaborative initiative.
We are seeking a cadre of hospitals in various settings across the state, representing all sizes and levels. In order to be considered for this initiative, each hospital must commit to obtaining active participation from a hospital administrator and a physician and nurse who will serve as project champions. The Collaborative will offer materials, training and technical assistance to those hospitals chosen to participate in this phase at no charge to the hospital. The hospital commitment will be for a period of 18 to 24 months with implementation of core recommendations beginning in October 2013. The hospital will set local priorities and determine which tools to adopt or adapt from a toolkit to be provided.