Improved obstetric safety through programmatic collaboration

Dena Goffman, Michael Brodman, Arnold J. Friedman, Howard Minkoff, Irwin R. Merkatz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p < 0.001). The Weighted Adverse Outcome Score (WAOS) also decreased during the same time period (3.9 vs 2.3, p = 0.001.) Given the improved outcomes noted, our unique program and the process by which it was developed are described in the hopes that others will recognize collaborative partnering with or without insurers as an opportunity to improve obstetric patient safety.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalJournal of healthcare risk management : the journal of the American Society for Healthcare Risk Management
Volume33
Issue number3
DOIs
StatePublished - 2014

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Insurance Carriers
Obstetrics
Safety
Patient Safety
Documentation
Voluntary Hospitals
Cardiotocography
Financial Support
Legal Liability
Quality of Health Care
Urban Hospitals
Risk Management
Quality Improvement
Insurance
Gynecology
Practice Guidelines
Health Personnel
Physicians
Education

ASJC Scopus subject areas

  • Medicine(all)

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Improved obstetric safety through programmatic collaboration. / Goffman, Dena; Brodman, Michael; Friedman, Arnold J.; Minkoff, Howard; Merkatz, Irwin R.

In: Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management, Vol. 33, No. 3, 2014, p. 14-22.

Research output: Contribution to journalArticle

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