Impact of a comprehensive patient safety strategy on obstetric adverse events

Objective

We implemented a comprehensive strategy to track and reduce adverse events.

Study Design

We incrementally introduced multiple patient safety interventions from September 2004 through November 2006 at a university-based obstetrics service. This initiative included outside expert review, protocol standardization, the creation of a patient safety nurse position and patient safety committee, and training in team skills and fetal heart monitoring interpretation. We prospectively tracked 10 obstetrics-specific outcome. The Adverse Outcome Index, an expression of the number of deliveries with at least 1 of the 10 adverse outcomes per total deliveries, was analyzed for trend.

Results

Our interventions significantly reduced the Adverse Outcome Index (linear regression, r² = 0.50; P = .01) (overall mean, 2.50%). Concurrent with these improvements, we saw clinically significant improvements in safety climate as measured by validated safety attitude surveys.

Conclusion

A systematic strategy to decrease obstetric adverse events can have a significant impact on patient safety.

Key words: crew resource management, medical errors, obstetric adverse outcomes, patient safety