Impact of a comprehensive patient safety strategy on obstetric adverse events
Presented at the 28th Annual Meeting of the Society for Maternal–Fetal Medicine, Dallas, TX, Jan. 28-Feb. 2, 2008.
Received 27 September 2008; received in revised form 14 November 2008; accepted 19 January 2009. published online 02 March 2009.
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.
Correspondence: Christian M. Pettker, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar St., PO Box 208063, New Haven, CT 06520-8063
MCIC Vermont, Inc (New York, NY) provided partial financial support for this project as a quality assurance activity.
Cite this article as: Pettker CM, Thung SF, Norwitz ER, et al. Impact of a comprehensive patient safety strategy on obstetric adverse events. Am J Obstet Gynecol 2009;200:492.e1-492.e8.
ABSTRACT
Impact of a comprehensive patient safety strategy on obstetric adverse events