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Leading hospitals, healthcare experts collaborate to eliminate preventable birth injuries

Premier healthcare alliance Perinatal Safety Initiative designed to enhance communications, reliable use of evidence-based quality measures; Healthcare experts to serve as advisors, provide expertise

Washington, D.C. (May 14, 2008) – The Premier healthcare alliance today announced a 21-month national collaborative designed to achieve the consistent delivery of evidence-based care with the goal of eliminating preventable birth-related injuries and deaths.

The Premier Perinatal Safety Initiative is comprised of 16 of the country's leading hospitals, representing 12 states, in which approximately 115,000 babies will be delivered over the course of the collaborative. The initiative seeks to significantly lower the incidence of certain infrequent though serious injuries that could result in birth asphyxia or permanent neurologic disability.

“Infants in the United States experience close to three birth injuries for every 1,000 births, many of which are preventable, and the U.S. ranks near the bottom of industrialized nations in infant mortality,” said Congresswoman Shelley Moore Capito, R-W.Va., co-founder and co-chair, Congressional Caucus on Infant Health and Safety. “We are hopeful that this study will help identify best practices and help share them across all hospitals so as to reduce harm to infants and mothers.”

Leveraging knowledge gained from similar initiatives, including a Premier/Institute for Healthcare Improvement collaboration, the participating hospitals aim to improve their culture of safety, increase teamwork and improve communications among team members. The initiative will also evaluate cost savings through supply chain improvements and the reduction of adverse events. As part of the initiative, Premier has established an advisory committee to garner guidance in undertaking the program and to ensure transparency.

"I applaud this effort's goal to eliminate preventable birth injuries by implementing evidence-based guidance for providing the highest quality perinatal care," said Congresswoman Lois Capps, D-Calif., co-founder and co-chair of the Congressional Caucus on Infant Health and Safety. “Even one birth injury creates significant emotional trauma and costs everyone involved."

Evidence-based “care bundles”
Currently, there are five recurring clinical issues that are commonly cited as being responsible for the majority of perinatal harm and associated costs and obstetrical professional liability. These issues include failure to recognize an infant in distress; failure to initiate a timely cesarean birth; failure to properly resuscitate a depressed baby; inappropriate use of labor-inducing drugs; and inappropriate use of vacuum or forceps.

Through the use of “care bundles,” which are groups of evidence-based interventions that are more effective when implemented together rather than individually, participants work towards the reduction of perinatal injuries.

“Many of the processes addressed in this project can lead to significant, lifelong injury to newborns, along with immense emotional trauma to families and healthcare team members,” said Susan DeVore, chief operating officer at Premier. “Consistent, reliable delivery of the care bundles has proven to decrease the incidence of these injuries. They follow published best practices and national standards established by expert clinical organizations and are audited by participants to ensure implementation in an ‘all-or-none’ fashion, unless a medical condition suggests otherwise.”

Project participants will work together to enhance sharing of information and best practices, all the while documenting cost and quality impact consistently and reliably to assess opportunities for improvement. Initiative results and feedback will be offered in a transparent manner so outcomes can be shared nationwide to help transform healthcare.

“This collaborative provides hospitals a unique opportunity to track their success using evidence-based interventions to reduce harm to infants and mothers,” said Hal C. Lawrence, III, MD, FACOG, vice president of Practice Activities for The American College of Obstetricians and Gynecologists (ACOG). “We are hopeful that all hospitals will evaluate best practice parameters and incorporate innovative tools that help lead to better outcomes. Improvements in ob-gyn care have reduced the maternal death rate by more than 95 percent and the neonatal death rate by more than 66 percent over the last 50 years.

“ACOG has a long history of advancing the highest quality care for our patients, and this emphasis is being driven further by ACOG President Douglas H. Kirkpatrick, who has made patient safety the priority of his presidential year,” continued Lawrence. “Our organization is proud to build on our longtime commitment to patient safety by participating on the Perinatal Safety Initiative Advisory Committee and we look forward to providing guidance and input on this important issue.”

Perinatal team members at participating hospitals will conduct simulations for certain high risk protocols so that they are prepared to take appropriate action during worst case scenarios. Data from participants will be collected and results measured against benchmarks from similar hospitals. Customized harm measures were developed, and will be analyzed through the assistance of the National Perinatal Information Center. Expertise in team building, simulations and data analysis will be provided to the group by the University of Minnesota School of Public Health.

“Harris Methodist Fort Worth Hospital and Presbyterian Hospital of Dallas, part of the Texas Health Resources system, take pride in the high quality of care that each patient receives,” said Amy Hailey, RNC, MS, director of Women's Services, Texas Health Harris Methodist Fort Worth Hospital. “Both hospitals are already leaders in proving high-risk care to women in North Texas. Our participation in this initiative will only allow us to provide higher standards of care for patients in North Texas and throughout the country.”

Hospitals participating in the Perinatal Safety Initiative are:

Arizona

Illinois

Kentucky

Massachusetts

Minnesota

New Mexico

Ohio

Tennessee

Texas

Washington

West Virginia

Wisconsin

About the Perinatal Safety Initiative Advisory Committee
The Premier Perinatal Safety Initiative Advisory Committee is comprised of recognized visionaries and opinion leaders in healthcare with a specific focus on perinatal care. The purpose of the Advisory Committee is to provide a venue for open discussion and feedback regarding this initiative. Premier will look to the expertise of this committee to help determine clinical and quality best practices. Advisory Committee members include:

About the Premier healthcare alliance, Malcolm Baldrige National Quality Award recipient
Premier is a performance improvement alliance of more than 2,400 U.S. hospitals and nearly 70,000 other healthcare sites working together to achieve high quality, cost-effective care. Owned by not-for-profit hospitals, Premier maintains the nation's most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network. A world leader in helping deliver measurable improvements in care, Premier works with the Centers for Medicare & Medicaid Services and the United Kingdom's National Health Service North West to improve hospital performance. Headquartered in Charlotte, N.C., Premier also has offices in San Diego, Philadelphia and Washington. http://www.premierinc.com

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