2016 ACNM BENCHMARKING BEST PRACTICES. How do you become a best practice?
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1 2016 ACNM BENCHMARKING BEST PRACTICES How do you become a best practice? Best practices are named based on the data reported by the practice being one of the top three practices in that category. The purpose of naming best practice is to recognize practices that are performing well. Perhaps more importantly, it gives ACNM members the opportunity to know which practices to contact to discuss how to improve performance. By networking with best practices, you can learn how to modify your practice processes to achieve better outcomes on quality indicators. To provide a fair comparison, practices are compared based on practice volume by number of births per year: Low: 50, Low Moderate: , High Moderate: , High: 500 births/ year. Note: For some volume groups, it is impossible to determine best practice for certain indicators. In the low-volume group there are many practices achieving 100% breastfeeding rates and 0% cesarean birth rates. How do I know which indicator to select for improvement? When looking at the benchmarking report, the outcomes should fall within the appropriate range of colleagues in similar volume practices. For example, if your practice is above the 75 th percentile of your comparison group in episiotomy, there is a practice variance that suggests need for improvement. This indicates overuse of the procedure when compared to midwifery practices attending a similar number of births/year. Similarly, if your practice is within the lowest 25% of your cohort in spontaneous vaginal birth or breastfeeding, the data suggests an opportunity to improve performance. The ACNM Division of Standards and, Quality Section functions to support quality improvement activities of ACNM member practices. Please note- there are mixed risk status and mixed models within EVERY best practice category (e.g. high volume birth centers and low volume, high risk practices). Please avoid the initial temptation to assume my practice is different or unique. By contacting best practices, you may find that there is a similar practice achieving better outcomes.
2 Congratulations to the 2016 ACNM Best s! Labor and Birth Outcomes Spontaneous Vaginal Birth Rate Welcome Home Midwifery BK Midwifery Skagit Family Health Clinic and Mount Vernon Birth Center (WA) Skagit Family Health Clinic and Mount Vernon Birth Center (WA) Henry County Health Center Midwifery Services (IA) Welcome Home Midwifery Women's Birth & Wellness Center (NC) Midwifery Care of Monsey Denver Health Midwives (CO) Gundersen Healthcare Midwives (WI) Park Nicollet- Methodist Primary Cesarean Rate Midwifery Care of Monsey North Metro Midwives Gundersen Healthcare Midwives (WI) Parkland CNM (TX) Franciscan Women s Health Associates (WA) VBAC Success Rate Rate of Cesarean Birth among Nulliparous women with a Term, Singleton baby in a Vertex position (NTSV) Rate of Postpartum Hemorrhage The Natural Birthing Center (TX) Fairfax Home Birth (VA) Lucas County Health Center (IA) Khristeena Kingsley, Midwife, PC Labor of Love Midwifery Service (IL) Klamath Women's Clinic & Birth Center (OR) North Country Midwifery Henry County Health Center Midwifery Services (IA) New Birth Company KCK (KS) Cleveland Clinic AGMC OB- GYN (OH) Northwest Professional Obstetrics & Gynecology (IL) Virginia Complete Care for Women (VA) Midwifery Care of Monsey Certified Nurse Midwives at St. Joseph Hospital (CO) Canandaigua Medical Group OB/Gyn and Midwifery Midwifery Care of Monsey FamilyCare Health Centers (WV) Caring For Women (TX) Shenandoah Women's HealthCare (VA) UW Health Nurse-Midwifery Service (WI) CMG Women's Center (VA) Franciscan Women s Health Associates (WA) Eisner Pediatric & Family Medical Center (CA) UW Health Nurse-Midwifery Service (WI) Florida Women's Center (FL) Shenandoah Women's HealthCare (VA) Kaiser Permanente Baldwin Park Medical Center (CA) : Unable to establish a Best as all practices in the birth volume sub-category reported 0 or 100% per the variable.
3 Perineal Outcomes Rate of women with intact perineum (perineum is intact or only small laceration(s) not requiring repair) Klamath Women's Clinic & Birth Center (OR) Sweetwater Midwifery (WY) Hudson Valley Midwifery M.A.M.A.S., Inc. (MD) The Midwife's Place (NE) New Beginnings Birth Center (ID) Charleston Birth Place (VSC) Avalon-A Center for Women's Health (NJ) Carolina Women's Specialists (SC) Catawba Valley Medical Center Maternity Services (NC) Providence Woman's Clinic, Providence St Vincent (OR) University Hospitals Case Medical Center Division of Nurse-Midwifery (OH) Rate of episiotomies University Midwifery Associates Erie Family Health (IL) University Hospitals Case Medical Center Division of Nurse-Midwifery (OH) 3rd or 4th degree laceration rate Olmsted Medical Center Mercy Birthing Center (MO) Connecticut Childbirth & Women's Center (CT) Maimonides Midwifery Faculty practice Gundersen Healthcare Midwives (WI) CMG Women's Center (VA) : Unable to establish a Best as all practices in the birth volume sub-category reported 0 or 100% per the variable.
4 Preterm Birth Rate (infants from a singleton birth born at less than 37weeks gestation) Low Volume 50 births/year Infant Outcomes Mercy Birthing Center (MO) Mountain Midwifery Center (CO) Kaiser Westside Medical Center (OR) El Rio Birth and Women's Health Center (AZ) Parkland CNM (TX) Rate of Low Birth Weight (infants from a singleton birth born weighing less than 2500 grams) North Shore Birth Center (NJ) Connecticut Childbirth & Women's Center (CT) Silverton Health Midwives (OR) Oregon Health & Science University Nurse-Midwives (OR) Kaiser Westside Medical Center (OR) CMG Women's Center (VA) Rate of NICU Admissions of infants born from a singleton birth. (any admission to a level 2 or level 3 nursery for any length of time) River & Mountain Midwives Mt. Eaton Midwifery (OH) Westside Midwifery & Women's Health (MT) Women s Specialist of Houston at Texas Children's Pavilion for Women (TX) Swedish Midwifery and Women's Health Issaquah (WA) Midwives at Magee (PA) Shenandoah Women's HealthCare (VA) UMHS Nurse Midwifery Service (MI) Exclusive Breastfeeding Rate first 48 hours The Midwife's Place (NE) Lebanon Valley Midwifery and Women's Wellness (PA) A Gentle Beginning (OR) IHA Nurse Midwives (MI) Perkin Alternative Birth Center (LA) Women's Birth & Wellness Center (NC) Center for Midwifery (CO) OSU (OH) LMG Midwifery (OR) : Unable to establish a Best as all practices in the birth volume sub-category reported 0 or 100% per the variable.
5 Breastfeeding Outcomes Rate of Women who Attended their 6week Postpartum Visit. Scenic Drive Midwives, LLC (WV) Manhattan Birth Midwifery Tania Zirulnik Home Birthing Skagit Family Health Clinic and Mount Vernon Birth Center (WA) Lebanon Valley Midwifery and Women's Wellness (PA) Mat-su Midwifery and Family Health (AK) UH Westshore Midwifery Associates (OH) Canandaigua Medical Group OB/Gyn and Midwifery Minnesota Birth Center Shenandoah Women's HealthCare (VA) Oregon Health & Science University Nurse-Midwives (OR) OB-GYN and Midwifery Associates of Ithaca Rate of Women Breastfeeding at their 6week Postpartum Visit. UC San Diego Nurse-Midwifery Service (CA) Oregon Health & Science University Nurse-Midwives (OR) UNC Midwives, Dept of OB GYN, University of North Carolina (NC) : Unable to establish a Best as all practices in the birth volume sub-category reported 0 or 100% per the variable.
6 Resource Utilization Outcomes 50 births/year Rate of Inductions Nativiti Family Birth Center (TX) Mat-su Midwifery and Family Health (AK) Alaska Family Health and Birth Center (AK) Valley Women for Women (AZ) Beach Cities Midwifery & Women's Health Care (CA) Parkland CNM (TX) Midwifery Services at the GW MFA (DC) EMCM Midwives Rate of epidurals used for pain relief during labor (not including epidurals placed only for anesthesia for operative delivery) Nativiti Family Birth Center (TX) Alaska Family Health and Birth Center (AK) New Birth Company KCK (KS) Mountain Midwifery Center (CO) BirthCare & Women's Health, Ltd (VA) Midwifery Services at the GW MFA (DC) HealthEast Certified Nurse-Midwives UW Health Nurse-Midwifery Service (WI) : Unable to establish a Best as all practices in the birth volume sub-category reported 0 or 100% per the variable. Measures Low Moderate Volume High Moderate Volume Total number of practices reporting at least one water birth Total number of practices reporting births of term infants with delayed cord clamping Total number of practices reporting that they provide care using the Centering pregnancy model
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