Welcome! Wave 2 - Group Webinar #3. Decreasing births < 39 weeks gestation without medical indication and improving birth registry accuracy project
|
|
- Dorcas Hubbard
- 5 years ago
- Views:
Transcription
1 Welcome! Wave 2 - Group Webinar #3 Decreasing births < 39 weeks gestation without medical indication and improving birth registry accuracy project Ohio Perinatal Quality Collaborative Ohio Department of Health, Office of Vital Statistics Ohio Hospital Association July 22, 2013
2 Please don t put us on HOLD! If you need to step away: Use the MUTE button on your phone or You can use *6 to place the call on MUTE and *6 to come off of MUTE
3 Roll Call: Please sign in with your name and hospital affiliation
4 Agenda Time Topic Presenter Noon Welcome, roll call, and review of Agenda Susan Ford 12:10 pm Data Review Updated Quarter 2 Aggregate Chart Mike Marcotte, MD 12:15 pm Month 2 in review Lessons Learned from Process Flow Maps Lessons Learned from IPHIS-Patient Chart Reviews Sharon Bryson, Clinical Manager OB, ProMedica St. Luke s 12:20 pm Birth Registry Accuracy: IPHIS skills 12:30 pm Less than 39 week inductions: Hard stop vs. Soft Stop; Policies regarding elective inductions prior to 39 weeks w/o a medical indication Scheduling inductions and C/S at your site 12:45 pm Using quality improvement strategies to make changes: Model for Improvement: Question 3 Judy Nagy Mike Marcotte, MD Susan Ford 12:55 pm Next steps Susan Ford
5 <39 Week Scheduled Delivery and Birth Registry Accuracy Wave 2 Hospitals Community Hospital & Wellness Center Mercer County Van Wert County Hospital Highland District Hospital Mercy St Charles Promedica Flower Hospital Promedica St. Luke s Wilson Memorial Hospital Community Upper Valley Medical Madison County Hospital Memorial Health Care System Bellevue Hospital Marion General Hospital Southwest St. John General Medical Center MedCentral Health System - Mansfield Marietta Memorial Hospital Pomerene Hospital O Bleness Memorial Hospital East Ohio Regional Medical Center Trumbull Memorial Northside Medical
6 Wave 2 teams Bellevue Hospital Community Hospitals and Wellness Centers East Ohio Regional Medical Center Highland District Hospital Madison County Hospital Marietta Memorial Hospital Marion General Hospital MedCentral Health System Mansfield Memorial Health Care System Mercer County Joint Township Community Hospital Mercy St. Charles Hospital Northside Medical Center O Bleness Memorial Hospital ProMedica Flower Hospital ProMedica St. Luke's Hospital Pomerene Hospital Southwest General Medical Center St. John s Medical Center Trumbull Memorial Hospital Upper Valley Medical Center Van Wert County Hospital Wilson Memorial Hospital
7 2006-Q1 (n=1033) 2006-Q2 (n=1089) 2006-Q3 (n=1091) 2006-Q4 (n=0923) 2007-Q1 (n=1033) 2007-Q2 (n=1026) 2007-Q3 (n=1162) 2007-Q4 (n=1000) 2008-Q1 (n=1014) 2008-Q2 (n=1023) 2008-Q3 (n=1020) 2008-Q4 (n=0918) 2009-Q1 (n=0840) 2009-Q2 (n=0918) 2009-Q3 (n=0970) 2009-Q4 (n=0770) 2010-Q1 (n=0779) 2010-Q2 (n=0769) 2010-Q3 (n=0850) 2010-Q4 (n=0898) 2011-Q1 (n=0826) 2011-Q2 (n=0859) 2011-Q3 (n=0938) 2011-Q4 (n=0837) 2012-Q1 (n=0864) 2012-Q2 (n=0871) 2012-Q3 (n=0912) 2012-Q4 (n=0875) 2013-Q1 (n=0830) 2013-Q2 (n=0707) Percent with no medical indication Births induced at weeks with no apparent medical indication for early delivery, by quarter, Aggregate of Wave 2 sites Sep. 2008: 39-Week project begins Source: Ohio Department of Health, Vital Statistics Goal Quarterly Percent Baseline Average Percent Control Limits
8
9 Month 2 in Review
10 ProMedica St. Luke s Hospital Process Flow Map Mom admitted to Labor & Delivery; given Maternal Worksheet. Admitting RN obtains Facility Worksheet. Begins to fill out first 12 questions from patient H&P, and prenatal information (which is either available on EMR or has been faxed to the unit, dependent on the practitioner.) Facility Worksheet is place on the front of the patient chart until mom delivers. RN taking care of mom at delivery fills out Facility Worksheet with the exception of the last 3questions (infant living transferred and breast feeding at discharge?) No Mom and baby discharged. Discharging RN completes last 3 questions on Facility Worksheet and checks that it is complete. Paternity affidavit competed and clerk notarizes. Yes Is mom unmarried? Mom has 24 hrs. after delivery to complete and turn in the Maternal Worksheet. Yes Both Worksheets submitted to the Nurse Manager of L&D. Nurse Manager Reviews for completeness. Complete? No Completes - missing info by looking up in patient chart. Both Facility and Maternal Worksheets are sent to Medical Records. County registrar picks up completed birth certificates once a week at the hospital. Physician signs document and returns via courier to SLH. MR prints the document and mails it to the physician via USPS mail for signature. MR enters data into IPHIS and submits as complete. MR looks thru Worksheets to be certain that all questions are answered. Follows up with mom if info is incomplete or illegible. r
11
12 OPQC: Decreasing births < 39 weeks gestation without medical indication and improving birth registry accuracy project Aim In 9 months, improve birth registry accuracy so that focused variables** will be transmitted accurately in 95% of records (** Pre-pregnancy and Gestational Diabetes; Prepregnancy and Gestational hypertension; Induction of Labor; ANCS; OB estimate of GA) Revised: Key Drivers Strong communication between clinical team and birth data staff Trained clinical and birth data teams Audit Process for data verification Appreciation of the Importance of the Birth Registry information IPHIS (BR) fields include essential and specific information/definitions Identification and spread of best practices for data entry and verification Interventions Identify a key clinical contact for birth data team Identify all sources of birth data Identify process for flow of data into the birth registry (IPHIS) system Ensure birth data team has access to necessary clinical data Utilize ODH and OPQC online education modules for training of birth data and nursing staff Ensure clear understanding of birth registry variables Ensure clear understanding by birth data team of medical terminology related to birth registry variables Coaching/reinforcement by OPQC and state quality coordinators Use medical record to IPHIS quality review feedback to identify gaps Continuous monitoring of Birth Registry data reports Clarify IPHIS definitions and instructions Group and individual webinars and 1:1 support by state quality coordinators to identify key changes
13 IPHIS: Integrated Perinatal Health Information System Ohio s birth registry software IPHIS Overview Judy Nagy
14 The Support Site When in doubt, check it out
15 IPHIS Half the Fun is Knowing Where to Get an Answer Forms, Guides, Tip Sheets and Updates Getting Help From a Real Person! Correcting Information Edits
16 The Vital Support Site
17 Hover Function
18 The Unknown Variable STOP using Unknown in IPHIS UNKNOWN None is still a choice Verify: Does mom or baby have any of the listed conditions? If yes, check the correct ones If no, check None.
19 Unknown vs. None UNKNOWN is not an option that a hospital needs to correctly identify problems or conditions / anomalies at birth. Check boxes are available for items that are confirmed by the patient medical record. Anything that cannot be confirmed should be marked as NONE. For data items that ask for a date or number (i.e., number of prenatal visits, number of cigarettes smoked, date of last menstrual period, etc.), 99 is still a valid option.
20 Get Help BEFORE Completing a Record Call the Help Desk at , Option #3 Please do not call specific staff at Vital Statistics Representatives can answer questions regarding corrections, unlocks, and notes. Surrogacy, foundling, and paternity issues should be directed to Suzie Grayson in the Registration Unit, at
21 Understanding Edits IPHIS has built in edits that will display when an answer does not fall within a specific range. It s important to verify what the system is telling you. Make a note! Notes are important to explain yourself. Why the system thinks a response is incorrect when it isn t.
22
23 The focus of healthcare for women and infants over the next century depends on the quality of the data collected by those who fill out the birth certificates. Bill Callaghan, MD MPH Centers for Disease Control and Prevention December 1, 2011
24 OPQC: Decreasing births < 39 weeks gestation without medical indication and improving birth registry accuracy project Goal: Assure that all initiation of labor or caesarean sections on women who are not in labor occur only when obstetrically or medically indicated Interventions Inform consumers of risk/benefits of deliveries < 39 weeks Communicate to patient/clinic/hospital ultrasound results Promote need for early dating to practitioners and consumers Public awareness campaign Aim In 9 months, reduce to 5% or less, the number of women in Ohio of 37.0 to 38.6 weeks gestation for whom delivery is scheduled in the absence of appropriate medical indication Revised: Key Drivers Awareness of risks & expected benefit of scheduled delivery prior to 39.0 weeks by patients and other consumers Dating criteria: optimal estimation of gestational age Hospital and physician practice policies that facilitate ACOG criteria Awareness of risks & expected benefit of near-term delivery by clinician Culture of safety and improvement Promote need for early dating to practitioners and consumers Promote sonography < 20 weeks to establish dates Document criteria used to establish EDC Appropriate use of fetal maturity testing Empower nurses /schedulers to require dating criteria Identify a specific contact for authorization dispute re: dating Provide patient with hard copy results of ultrasound Empower nurses /schedulers to require dating criteria Document rationale and risk/benefit for scheduled deliveries at 37.0 to 38.6 weeks gestation Document discussion with patient about the above Both patient and MD sign consent statement for scheduled delivery between 37.0 and 38.6 weeks Physician awareness campaign: what are the reason(s) for scheduled delivery? Maximize access to Delivery and OR for optimal scheduling Facilitate scheduling policies that respect ACOG criteria Prenatal caregivers receive feedback from postnatal caregivers about neonatal outcomes of scheduled deliveries Ensure complete and accurate handoffs OB/OB and OB/Peds Document discussion with patient about risk/benefits of near-term delivery Promote need for early dating to practitioners and consumers Continuous monitoring of data & discussion of this effort in staff/division meetings. Project outcomes posted on units and websites. Develop ways to include staff and physician input about communications and handoffs Connect with organizational initiatives on safety and use existing approaches as possible Empower nurses/schedulers to require data criteria
25 ACOG Committee Opinion 561 April 2013 Implementation of a policy to decrease the rate of non-medically indicated deliveries before 39 weeks of gestation has been found to both decrease the number of these deliveries and improve neonatal outcomes; however, more research is necessary to further characterize pregnancies at risk for in utero morbidity and mortality
26 Poll With regards to scheduling a delivery prior to 39 weeks without a medical indication our hospital has a: Hard stop Soft stop No stop Uncertain
27 Reduction in elective delivery at <39 weeks of gestation: comparative effectiveness of 3 approaches to change and the impact on neonatal intensive care admission and stillbirth Clark, et al. February 2010 AJOG HCA (27 hospitals) largest system in US 3 month period 2007 baseline 17,000+ Intervention Hard stop Soft stop Education only 3 month period 2009 measure 17,000+
28 Hard Stop Adopt policy that prohibited purely elective inductions and CS < 39 weeks Policy enforced by hospital personnel empowered to refuse to schedule any such deliveries Questionable indication handled in standard chain of command
29 Adopt similar policy Soft Stop Elective deliveries < 39 weeks allowed if ordered by attending physician All such cases referred to peer reviewed committee for evaluation and potential action
30 Education Only Provide education to attending physicians No formal policy developed
31 Reduction in elective birth <39 weeks: 3 approaches to change Clark SL, Frye DR, Meyers JA et al Am J Obstet Gynecol 2010 HARD STOP SOFT STOP EDUCATION ONLY
32 Other Outcomes NICU admission rate > 37 weeks Baseline % After intervention % (p = < 0.001) Stillbirth rate (balancing measure) Baseline 0.69% After intervention 0.71% (p = 0.38)
33 Percent NICU Admissions By Weeks Gestation Deliveries Without Complications, (n=84,538) 10% 8% 6% 4% 2% NICU Admissions Click 6.66% to edit Master title style 3.36% 3.44% 2.47% 2.65% Click to edit Master subtitle style 4.26% 0% 37th 38th 39th 40th 41st 42nd Oshiro et al. Obstet Gynecol 2009;113: Gestational Weeks 33
34 Respiratory Distress Syndrome (RDS) By Weeks Gestation Deliveries Without Complications, (n=84,538) Percent 2.5% 2.0% Click to 1.92% edit Master title style 1.5% 1.0% 0.68% 0.42% 0.41% 0.67% 0.78% Click to edit Master subtitle style 0.5% RDS 0.0% 37th 38th 39th 40th 41st 42nd Gestational Weeks Oshiro et al. Obstet Gynecol 2009;113:
35 Percent Ventilator Usage By Weeks Gestation Deliveries Without Complications, (n=84,538) 2.0% Click to edit Ventilator Master Use title style 1.8% 1.6% 1.4% 1.2% 1.0% 0.8% 0.6% 0.4% 0.2% 0.0% 1.19% 0.47% 0.47% Click to edit Master 0.25% subtitle 0.30% style 37th 38th 39th 40th 41st 42nd 0.39% Gestational Weeks Oshiro et al. Obstet Gynecol 2009;113:
36 What about 38 weeks + 4 to 6 days? Tita (NEJM 2009;360:111) (MFM Network) Examined 2,463 scheduled CS babies in this age range Respiratory outcomes worse than 39 weeks (RR= % CI , p=0.01), similar to 38 weeks as a whole Click to edit Master title style Wilminik (AJOG 2010;202:250.e1-8) (Netherlands) Examined 5,046 scheduled CS babies in this age range Respiratory outcomes worse than 39 weeks (RR=1.4 95% CI , p=0.01), Click similar to edit to 38 weeks Master a whole subtitle style 36
37 Scheduling Inductions at your Hospital
38
39 NOTE: Important to note that a culture change has occurred at Bethesda North. Obstetricians are aware of the expectation and policy that inductions should be 39 weeks or greater if there is not a medical indication to induce.
40
41 Poll Do you have a scheduling form for deliveries that needs to be completed by requesting OB/offices and sent to L&D? Yes No Uncertain
42 Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in improvement? Aim Measures Changes Act Study Plan Do P D S A Sequential small tests of change Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance
43 Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in improvement? What is a PDSA or sequential small test of change? Putting a small change into effect on a temporary basis and learning about its impact.
44 What is Not a Test? Data collection Implementing a solution Rolling out an educational program Getting a form, policy, procedure approved by the official committees
45 The PDSA Cycle Act What changes are to be made? Next cycle? Adopt, Adapt, or Abandon Study Complete the analysis of the data Compare data to predictions Summarize what was learned Plan Hypothesis or Idea Questions and predictions Plan to carry out the cycle (who, what, where, when) Do Carry out the plan Document problems and unexpected observations
46 Identify Possible Changes Think Creatively Brainstorm with your QI team Collect ideas from staff who contribute to the birth registry Adapt known good ideas Read the professional literature Network with other hospitals and the ODH Vital Statistics Look at the Key Driver Diagram Look at your process flow map again Identify opportunities within the gaps Office of
47 Plan the test What is the objective of the test? population? What tasks are necessary in order to conduct the test? Develop the action plan of tasks who, when, what How will you measure the impact of the test? What do you predict will happen? Do--test the change Plan...Do...Study...Act Study the results of the test What were the results from the test? Were there any unexpected observations? Was your prediction correct? What do you need to do next? Act on your results Adapt do you need to make revisions & re-test? Adopt do you need to scale up a successful test? Abandon did your test fail but you were able to learn from it?
48 Key Points for PDSAs 1. Do initial PDSAs on smallest scale possible A cycle of one usually best: one patient, one doctor, one day Failed cycles are good learning opportunities, particularly when small 2. As move to implementation, test under as many conditions as possible Think about factors that could lead to breakdowns, supports needed, naysayers
49 Key Points for PDSAs (cont d) 3. Always identify the prediction or hypothesis before testing the change Allows improved learning from failures and refinement of your theory 4. Use a study measure specific to the PDSA Usually not one of the project measures Is a measure specific to the small test of change Qualitative results are very valuable in early PDSAs
50 Smaller Scale Tests: The Power of one Conduct the test with one clinic day one physician one patient
51
52
53 Storyboard Information Creating Your Team Storyboard Instructions and Tips for Success Throughout this project, your assignments will build on one another to create a storyboard that you may use to track and present your progress as a team. A suggested PowerPoint template can be found on the OPQC website: These slides should be customized to reflect your team s efforts. Complete as much of the storyboard as possible, and continue to work on it with your team each month. You will have the opportunity to share your storyboard with other team hospitals at our August 26 th Learning Session.
54 Next Steps/Homework Meet as a team and choose a small test of change. Implement one PDSA Continue to add to/work on Storyboards Register for August s Learning Session Complete Monthly Progress Report (including 10 chart reviews) Link will be sent from Shirley Bogart at ODH-VS 7/24
55 Learning Session Monday, August 26 th Registration link to be sent from OPQC Crowne Plaza Columbus - Dublin Put faces with voices! Learn more great things about Quality Improvement! Get good ideas from other teams!
56 Resources OPQC web site: OPQC Susan Ford, RN BEACON Quality Improvement Coordinator Judy Nagy, State Registrar Stephanie Wilson, Project Specialist
Please don t put us on HOLD
Please don t put us on HOLD If you need to step away Use the MUTE button on your phone or You can use *6 to place the call on MUTE and *6 to come off of MUTE Welcome OPQC NEO ACTION PERIOD CALL May 20,
More informationBCI Webinar A Photo Finish Celebrating Your Success! March 29 th, 2018
BCI Webinar A Photo Finish Celebrating Your Success! March 29 th, 2018 Welcome Please enter your Audio PIN on your phone or we will be unable to un-mute you for discussion If you have a question, please
More informationAgenda 2/10/2012. Project AIM. Improving Perinatal Health Outcomes: New York State Obstetric and Neonatal Quality Collaborative
Improving Perinatal Health Outcomes: New York State Obstetric and Neonatal Quality Collaborative Marilyn A. Kacica, MD, MPH Chair Medical Director Division of Family Health NYSDOH Pat Heinrich, RN, MSN
More informationBirth Certificate Accuracy Initiative Collaborative Learning Session Webinar 1. March 23, :30 2:30 pm
Birth Certificate Accuracy Initiative Collaborative Learning Session Webinar 1 March 23, 2015 12:30 2:30 pm 1 Agenda ILPQC Overview Birth Certificate Accuracy Initiative Overview Why is Birth Certificate
More information< 39 Week Early Elective Delivery. Kim Biery Wright State University College of Nursing and Health The University of Toledo College of Nursing
< 39 Week Early Elective Delivery Kim Biery Wright State University College of Nursing and Health The University of Toledo College of Nursing State Programs Ohio Hospital Association Ohio Perinatal Quality
More informationWelcome! Neonatal Abstinence Syndrome Project Action Period Call
Welcome! Neonatal Abstinence Syndrome Project Action Period Call Ohio Perinatal Quality Collaborative April 15, 2014 Please don t put us on HOLD! If you need to step away: Use the MUTE button on your phone
More informationNAS PROJECT AGENDA. Time Session Presenter(s) Objectives Location 7:30-9:00 am Registration and storyboard setup
NAS PROJECT AGENDA Mission: Through collaborative use of improvement science methods, reduce preterm births and improve perinatal and preterm newborn outcomes in Ohio as quickly as possible Learning Session
More informationTechnology s Role in Support of Optimal Perinatal Staffing. Objectives 4/16/2013
Technology s Role in Support of Optimal Perinatal Cathy Ivory, PhD, RNC-OB April, 2013 4/16/2013 2012 Association of Women s Health, Obstetric and Neonatal s 1 Objectives Discuss challenges related to
More informationOB Hospital Teams Call. January 26, :30 1:30 PM
OB Hospital Teams Call January 26, 2015 12:30 1:30 PM Agenda EED Wrap-up HTN update Birth Certificate Accuracy Next Steps Team Talks Centegra Health System ILPQC Structure EED Wrap-Up Data entry 46 hospitals
More informationHypertension in Pregnancy (HIP) Initiative. June 2017 Learning Session: Celebration & Sustainability
Hypertension in Pregnancy (HIP) Initiative June 2017 Learning Session: Celebration & Sustainability Welcome! Please join by telephone to enter your Audio PIN on your phone or we will be unable to un-mute
More informationNICU Graduates: Using the Model for Improvement and Learning from Data
NICU Graduates: Using the Model for Improvement and Learning from Data Kristin Voos, MD and Dan Benscoter, DO Learning Session May 10, 2016 Through collaborative use of improvement science methods, reduce
More informationOB Advisory Workgroup. January 12, :30 1:30 PM
OB Advisory Workgroup January 12, 2014 12:30 1:30 PM Overview HTN Initiative Subcommittee Update to OB Advisory group from subcommittee EED Initiative BC Initiative Process and Timeline Next Steps HTN
More informationSUTTER MEDICAL CENTER, SACRAMENTO RULES AND REGULATIONS DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
I. MEMBERSHIP SUTTER MEDICAL CENTER, SACRAMENTO RULES AND REGULATIONS DEPARTMENT OF OBSTETRICS AND GYNECOLOGY SCHEDULED REVIEW: 10/2015 The Department of Obstetrics and Gynecology will consist of those
More informationOrchestrated Testing Aggregate Data
Orchestrated Testing Aggregate Data Michele Walsh, MD, MSE Through collaborative use of improvement science methods, reduce preterm births & improve perinatal and preterm newborn outcomes in Ohio as quickly
More informationReducing Non-Medically Indicated Deliveries <39 Weeks Gestation: Florida Initiatives
Reducing Non-Medically Indicated Deliveries
More informationOB Hospital Teams Call. November 24, :30 1:30 PM
OB Hospital Teams Call November 24, 2014 12:30 1:30 PM 1 Agenda ILPQC Updates Communications Birth Certificate Accuracy Initiative Team Talks PDSA Cycle Hospital Presentations Next Steps 2 Email Opt-In
More informationEvidence-Based Hospital Breastfeeding Support (EBBS) Learning Collaborative. Step #3 Webinar- Prenatal Education June 18, 2013
Evidence-Based Hospital Breastfeeding Support (EBBS) Learning Collaborative Step #3 Webinar- Prenatal Education June 18, 2013 * The speakers have no financial relationships to disclose * Amy Baisden, DNP,
More informationAll MCP Average Buckeye CareSource Molina Paramount United Total Initial Admits in Study. Pct of All Medicaid Admits. Actual to Expected
Terms: "Initial Admissions" is the number of admissions for patients in the dataset for the calendar year that began a readmission chain. Note that the following types of patients are not counted as Initial
More informationImproving neonatal outcomes in regional hospitals in Ghana using an integrated approach to systems change
Improving neonatal outcomes in regional hospitals in Ghana using an integrated approach to systems change Medge Owen, MD Professor of Obstetric Anesthesiology Wake Forest School of Medicine Executive Director,
More informationIndicator. unit. raw # rank. HP2010 Goal
Kentucky Perinatal Systems Perinatal Regionalization Meeting October 28, 2009 KY Indicators of Perinatal Health Infant mortality in Kentucky has been decreasing and is currently equal to the national average
More informationDriving Obstetrical Excellence Through a Council Structure
Driving Obstetrical Excellence Through a Council Structure Elizabeth Deckers, MD Director of Labor and Delivery, Hartford Hospital Deborah Feldman, M.D. Division director, Maternal Fetal Medicine, Hartford
More informationCROSSING THE CHASM: ENGAGING NURSES IN QUALITY IMPROVEMENT AND EVIDENCE BASED PRACTICE
CROSSING THE CHASM: ENGAGING NURSES IN QUALITY IMPROVEMENT AND EVIDENCE BASED PRACTICE Joy Goebel RN MN PhD Associate Professor of Nursing California State University Long Beach Objectives Discuss similarities
More informationEvidence-Based Hospital Breastfeeding Support (EBBS) Learning Collaborative. Webinar #3 March 19, 2013
Evidence-Based Hospital Breastfeeding Support (EBBS) Learning Collaborative Webinar #3 March 19, 2013 Presenters: * The presenters have no financial relationships or conflicts of interest to disclose.
More informationApril 28, 2015 Overview to Perinatal Care Certification Webinar Question and Answer Session
Webinar Question Are there different requirements/expectations depending on an institution/organizations ACOG/AAP Level of care status, i.e. 1,2,3,4? What is the approximate cost to the facility and is
More informationMapping maternity services in Australia: location, classification and services
Accessory publication Mapping maternity services in Australia: location, classification and services Caroline S. E. Homer 1,4 RM, MMedSci(ClinEpi), PhD, Professor of Midwifery Janice Biggs 2 BA(Hons),
More informationWednesday, April 22, :00 a.m. Eastern
Wednesday, April 22, 2015 11:00 a.m. Eastern Dial In: 888.863.0985 Conference ID: 5358648 Slide 1 Speakers Karen Harris, MD, MPH, FACOG President, North Florida Women's Physicians Medical Director of Patient
More informationEast Gippsland Primary Care Partnership. Assessment of Chronic Illness Care (ACIC) Resource Kit 2014
East Gippsland Primary Care Partnership Assessment of Chronic Illness Care (ACIC) Resource Kit 2014 1 Contents. 1. Introduction 2. The Assessment of Chronic Illness Care 2.1 What is the ACIC? 2.2 What's
More informationStrategies to Improve Postpartum Hemorrhage Outcomes. Presenter: Pamela O Keefe MS, RN, C-EFM
Strategies to Improve Postpartum Hemorrhage Outcomes Presenter: Pamela O Keefe MS, RN, C-EFM 1 Objectives Describe the Association of Women s Health, Obstetric and Neonatal Nurses (AWHONN) Postpartum Hemorrhage
More informationWhat Makes MFM Associates Unique? Privademics - A New Method of Delivering Expert Care
We appreciate the confidence you have entrusted in us by choosing to become one of our patients. While we continue to keep pace with the latest advancements in health care, we never forget that each patient
More informationOpioid Use in Pregnancy: Innovative Models to Improve Outcomes
December 1, 2017 ML12 Opioid Use in Pregnancy: Innovative Models to Improve Outcomes Daisy Goodman, CNM, DNP, MPH Instructor, Dartmouth Medical School Tina Foster, MD, MPH Director of Education, Dartmouth
More informationNew York State Perinatal Quality Collaborative (NYSPQC): Improving Perinatal Health through Partnerships and Collaboration
New York State Perinatal Quality Collaborative (NYSPQC): Improving Perinatal Health through Partnerships and Collaboration Marilyn Kacica, MD, MPH Kristen Farina, MS New York State Department of Health
More informationTier 1 Requirements. First Arm - Year One: Successful completion of
Thank you for participating in the BETA Healthcare Group Quest for Zero: OB Risk Management Initiative. We will make every effort to assure that the assessment goes as efficiently and expeditiously as
More informationAchieving Perinatal Care Certification and Lessons learned from 2016
Achieving Perinatal Care Certification and Lessons learned from 2016 Caroline Isbey RN, MSN, CDE Associate Director Heather Martin RN, MSN, MBA Associate Project Director, Specialist March 29, 2017 The
More informationProspectus Summary Brief: NICU Communication Improvement
The University of San Francisco USF Scholarship: a digital repository @ Gleeson Library Geschke Center Master's Projects and Capstones Theses, Dissertations, Capstones and Projects Spring 5-22-2015 Prospectus
More informationIndiana Perinatal Hospital Standards
Indiana Perinatal Hospital Standards 2013 Indiana Perinatal Hospital Summit Indiana Perinatal Quality Improvement Collaborative Mission To improve maternal and perinatal outcomes in Indiana through a collaborative
More informationAgenda Information Item Memo
Agenda Information Item Memo April 20, 2018 TO: FROM: Board of Trustees Ishwari Venkataraman/ VP Strategy and Business Planning Donna Carey/ Interim Chair, Department of Pediatrics SUBJECT: Agenda Item:
More informationRecommendations to the IHS from the Rural Maternal Safety Meeting
THE AMERICAN COLLEGE OF OBSTETRICIANS & GYNECOLOGISTS Committee on American Indian/Alaska Native Women s Health Recommendations to the IHS from the Rural Maternal Safety Meeting The multidisciplinary Rural
More informationThe deadline for submitting an application is September 6, 2018.
July 2, 2018 Dear Florida Hospital Leaders, It s with great enthusiasm we invite you to participate in the Florida Perinatal Quality Collaborative (FPQC) initiative for Neonatal Abstinence Syndrome (NAS)
More informationQI Project Application/Report for Part IV MOC Eligibility
QI Project Application/Report for Part IV MOC Eligibility Instructions Complete the project application/report to apply for UMHS approval for participating physicians to be eligible to receive Part IV
More information2013 Mommy Steps. Program Description. Our mission is to improve the health and quality of life of our members
2013 Mommy Steps Program Description Our mission is to improve the health and quality of life of our members I. Purpose Passport Health Plan (PHP) has developed approaches to the management of members
More information2016 Mommy Steps Program Descriptions
2016 Mommy Steps Program Descriptions Our mission is to improve the health and quality of life of our members Mommy Steps Program Descriptions I. Purpose Passport Health Plan (Passport) has developed approaches
More informationACCESS LARC INCREASING ACCESS TO IMMEDIATE POSTPARTUM LONG-ACTING REVERSIBLE CONTRACEPTION
ACCESS LARC INCREASING ACCESS TO IMMEDIATE POSTPARTUM LONG-ACTING REVERSIBLE CONTRACEPTION Chapter One: Building a Successful Initiative General Quality Improvement Tips It takes a multidisciplinary team
More informationMS3 Loyola NBN Orientation Brooke Kulp, D.O.
MS3 Loyola NBN Orientation 2018 Brooke Kulp, D.O. A Day in the Newborn Nursery- What to Expect Arrival: 6am Attire: Surgical scrubs (found in NBN locker rooms) with long white coat over. Where: Mother
More informationChange is Good: You Go First
Change is Good: You Go First Judith Schaefer Better Self Management of Diabetes Missouri Foundation for Health St. Louis, Missouri December 2 nd, 2009 Foundation s goals Support organizations that: Strengthen
More informationQuality/Performance Improvement Fundamentals
Quality/Performance Improvement Fundamentals What to do and how to do it Skill Building Session May 29, 2013 Pat Teske, RN,MHA pteske@cynosurehealth.org (661)755-5317 Today Agenda for Today Review ways
More informationM: Maternal/ Newborn Care
M: Maternal/ Newborn Care Saskatchewan Association of Licensed Practical Nurses, Competency Profile for LPNs, 3rd Ed. 113 Competency: M-1 Maternal/Newborn Nursing M-1-1 M-1-2 M-1-3 Demonstrate knowledge
More informationPlace of Birth Handbook 1
Place of Birth Handbook 1 October 2000 Revised October 2005 Revised February 25, 2008 Revised March 2009 Revised September 2010 Revised August 2013 Revised March 2015 The College of Midwives of BC (CMBC)
More informationNational Programme to Prevent Central-Line Associated Bacteraemia. Project Charter October 2011 to April 2013
National Programme to Prevent Central-Line Associated Bacteraemia Project Charter October 2011 to April 2013 1. Overview Central-Line Associated Bacteraemia (CLAB) prevention is one of the most important
More informationOB/GYN Office Staff: Proposing PowerPlans (Order Sets)
Labor & Delivery Power Plans Affiliate Providers OB/GYN Office Staff: Proposing PowerPlans (Order Sets) Overview of Process: 1. Instruct your OB patient at 30-32 weeks to call Intermountain Patient Account
More informationPPS Performance and Outcome Measures: Additional Resources
PPS Performance and Outcome Measures: PPS Performance and Outcome Measures: This document includes supplemental resources to the content on PPS Performance and Outcome Measures presented at the December
More informationCentricity Perinatal C C C A D
Centricity Perinatal C C A D A B CA B C Information at the center of care B D C A D Today s caregivers are bombarded with information from multiple systems and sources. Transforming that data into actionable
More informationOBSTETRICAL ANESTHESIA
DEPARTMENT OF ANESTHESIA RESIDENCY TRAINING PROGRAM UNIVERSITY OF MANITOBA OBSTETRICAL ANESTHESIA INTRODUCTION Residents will have the opportunity to gain experience in Obstetrical anesthesia in the course
More information10th Annual Ohio Healthcare Information Technology Day April 5, Dan Paoletti
10th Annual Ohio Healthcare Information Technology Day April 5, 2017 Dan Paoletti It is about building trust and a data governance that all stakeholders are comfortable with to accomplish what is best
More informationInformed Consent: when autonomy & beneficence collide
Informed Consent: when autonomy & beneficence collide MAWS Conference Seattle WA, May 10 th, 2013 Andrew Kotaska MD, FRCSC Yellowknife, NT, Canada Objectives Autonomy & beneficence Culture of risk Offer,
More informationCreating a Culture of Quality and Safety Gordon C. Hunt, MD, MBA Sr. Vice President & Chief Medical Officer, Sutter Health
Creating a Culture of Quality and Safety Gordon C. Hunt, MD, MBA Sr. Vice President & Chief Medical Officer, Sutter Health M2 This presenter has nothing to disclose December 2012 Blue Ribbon I & II In
More informationFetal Infant Mortality Review Implementation in Washoe County
Fetal Infant Mortality Review Implementation in Washoe County 1 National Fetal and Infant Mortality Review (NFIMR) NFIMR is a collaborative effort between the: American College of Obstetricians and Gynecologists
More informationApril 23, 2014 Ohio Department of Health Regulations and Noncompliance Findings
April 23, 2014 Ohio Department of Health Regulations and Noncompliance Findings Shannon Richey, R.N. Assistant Bureau Chief Bureau of Community Health Care Facilities and Services Ohio Department of Health
More informationNYSPFP-ACOG District II Joint Webinar on Maternal Emergencies
NYSPFP-ACOG District II Joint Webinar on Maternal Emergencies February 9, 2015 A partnership of the Healthcare Association of New York State and the Greater New York Hospital Association Agenda NYSPFP
More informationOrientation to the Family Medicine Resident - Obstetrics Rotation CREIGHTON UNIVERSITY
Orientation to the Family Medicine Resident - Obstetrics Rotation CREIGHTON UNIVERSITY Orientation Welcome to the obstetrics rotation We have developed this to help with the transition and expectations
More informationReducing First Birth (NTSV) Cesareans in California April 6, 2016
Reducing First Birth (NTSV) Cesareans in California ---------------- April 6, 2016 Regional PSF Contacts Jenna Fischer, CPPS Vice President of Quality & Patient Safety Hospital Council of Northern & Central
More informationThe Bronson BirthPlace
The Bronson BirthPlace A baby?! Is anything more exciting, inspiring or perplexing than a new life? Whether you re expecting or just pondering the possibility, the prospect of having a baby inspires great
More informationEvery Mother Counts Reducing Severe Maternal Morbidity and Maternal Mortality in Oklahoma
Every Mother Counts Reducing Severe Maternal Morbidity and Maternal Mortality in Oklahoma Oklahoma s pregnancy-related death rate for 2009-2013 was 20.4 deaths per 100,000 live births* Maternal mortality
More informationTimeline for Applications to Reducing Primary Cesareans Collaborative 2019
Reducing Primary Cesareans Application Checklist Below is a list of the items needed to complete the application for the American College of Nurse-Midwives, Healthy Birth Initiative: Reducing Primary Cesareans
More informationCochrane Review of Alternative versus Conventional Institutional Settings for Birth. E Hodnett, S Downe, D Walsh, 2012
Cochrane Review of Alternative versus Conventional Institutional Settings for Birth E Hodnett, S Downe, D Walsh, 2012 Why Study Types of Clinical Birth Settings? Concerns about the technological focus
More informationCERTIFICATE OF NEED Department Staff Project Summary, Analysis & Recommendations Maternal and Child Health Services
CERTIFICATE OF NEED Department Staff Project Summary, Analysis & Recommendations Maternal and Child Health Services Name of Facility: Our Lady of Lourdes Medical CN# FR 140701-04-01 Center Name of Applicant:
More informationEvidence-based Practice, Research, and Quality Improvement What s the Difference?
Evidence-based Practice, Research, and Quality Improvement What s the Difference? Susan B Stillwell, DNP, RN, CNE, ANEF, FAAN Associate Professor School of Nursing University of Portland Portland, OR Quality
More informationDisclosures. Case Presentation. Overview. Periviable Pregnancies: Decision Making Under Uncertainty
Periviable Pregnancies: Decision Making Under Uncertainty Aaron B. Caughey, MD, PhD Disclosures No financial disclosures related to this talk Medical Advisor to Celmatix, Mindchild Bob s Red Mill Father
More informationJourney Towards Automated. Core Measures at NYP. Scott W. Possley, PA-C, MPAS
Journey Towards Automated Click Data to Abstraction edit Master title of CMS style Core Measures at NYP Scott W. Possley, PA-C, MPAS Objectives Describe our hospital Discuss rationale behind automation
More informationSHARED DECISION MAKING
SHARED DECISION MAKING THE PINNACLE OF PATIENT- CENTERED CARE Bree Collaborative Meeting Benjamin Moulton JD, MPH Senior Legal Advisor Lecturer in Health Law HSPH Boston University Law School Foundation
More informationRuth Patterson, RNC, BSN, MHSA, Integrated Quality Services
Improving Your Joint Commission Perinatal Care Core Measure of Exclusive Breast Milk Feeding Through Baby Friendly Implementation of Evidence Based Maternity Practices Ruth Patterson, RNC, BSN, MHSA, Integrated
More informationUnderstanding OB Adverse Event Measures
Understanding OB Adverse Event Measures Partnership for Patients Pacing Event Tuesday, May 13, 2014 3:00 4:15 pm (ET) Welcome Jackie Moreland Tennessee Hospital Association Co-Lead Maternal Affinity Group
More informationImplementation Guide Version 4.0 Tools
Implementation Guide Version 4.0 Tools Program Overview Purpose of the Guide This Guide is intended primarily for INTERACT champions and trained educators who are responsible for implementing and sustaining
More informationHypertension in Pregnancy (HIP) Initiative. Sustaining HIP Standardization of Practice: Lessons & Success Stories
Hypertension in Pregnancy (HIP) Initiative Sustaining HIP Standardization of Practice: Lessons & Success Stories Welcome! Please join by telephone to enter your Audio PIN on your phone or we will be unable
More informationReducing Early Elective Deliveries. Susana Gonzalez, RN, MSN/MHA, CNML Barbara C. Schuch, RN, BSN, MSN, RNC-OB, C-EFM MacNeal Hospital
Reducing Early Elective Deliveries Susana Gonzalez, RN, MSN/MHA, CNML Barbara C. Schuch, RN, BSN, MSN, RNC-OB, C-EFM MacNeal Hospital Problem Preterm birth, birth before 37 weeks of pregnancy, is a serious
More informationProject Implementation
Project Implementation Annette Phelps MSN, ARNP, FPQC Nurse Consultant Jason James MD, Chief, Dept. of Ob/Gyn Baptist Hospital of Miami Jessica Brumley CNM, PhD, Director Division of Midwifery, USF Morsani
More informationFamily Integrated Care in the NICU
Family Integrated Care in the NICU Shoo Lee, MBBS, FRCPC, PhD Scientific Director, Institute of Human Development, Child & Youth Health, Canadian Institutes of Health Research Professor of Paediatrics,
More informationOn the Path towards Baby-Friendly Hospitals: First Steps Breastfeeding Promotion Webinar June 19, 2013 Objectives: Explain how to start planning for
On the Path towards Baby-Friendly Hospitals: First Steps Breastfeeding Promotion Webinar June 19, 2013 Objectives: Explain how to start planning for Baby-Friendly Hospital Outreach Describe the first steps
More informationImplementing PEWS. With Peter Lachman, Nikki Davey and The NHS
Implementing PEWS Sebastian Yuen Sebastian.yuen@gmail.com Consultant Paediatrician, George Eliot Hospital, Nuneaton Fellow, NHS Institute for Innovation and Improvement (2008-10) With Peter Lachman, Nikki
More informationMonday, August 15, :00 p.m. Eastern
Monday, August 15, 2016 2:00 p.m. Eastern Dial In: 888.863.0985 Conference ID: 34874161 Slide 1 Speakers Deb Kilday, MSN, RN Senior Performance Partner Performance Services Quality & Safety Premier, Inc.
More informationILPQC Neonatal Abstinence Syndrome Initiative Workgroup. July 17, :00 2:00 pm
ILPQC Neonatal Abstinence Syndrome Initiative Workgroup July 17, 2017 1:00 2:00 pm Overview NAS Illinois Data (from IDPH) NAS State Research Groups Massachusetts Ohio Tennessee Next Steps IDPH NAS Committee
More informationSafe Motherhood Initiative
Safe Motherhood Initiative District II IMPLEMENTATION OVERVIEW Engage Three Person Core Team The SMI aims to empower obstetric teams across New York State to share, assess, and implement strategies to
More informationData Collection and Reporting for MOM Initiative. Karen Fugate MSN RNC-NIC, CPHQ
Data Collection and Reporting for MOM Initiative Karen Fugate MSN RNC-NIC, CPHQ Presentation Objectives IRB and Data Use Agreements Baseline Data Collection and Submission Prospective Data Submission Sample
More informationReducing Length of Stay and Improving Family Centered Care for Narcotic Exposed Infants Background: Aims: Setting: Mechanisms/Drivers of Change
Reducing Length of Stay and Improving Family Centered Care for Narcotic Exposed Infants St. Vincent Healthcare (SVH) Billings, MT, USA Lacey Koenig RN, Dianne Kimm RN, Sammy Twito RN, Vicki Birkeland RN,
More information4/23/14. Healthy Start: Description of a Safety Net for Perinatal Support during Disaster Recovery*
Healthy : Description of a Safety Net for Perinatal Support during Disaster Recovery* Gloria Giarratano APRN, CNS, PhD Professor, School of Nursing LSU Health Sciences Center School of Nursing, New Orleans,
More informationCentering Pregnancy. Better Health Partnership Learning Collaborative April 13, 2018
Centering Pregnancy Celina Cunanan, CNM, MSN UH System Chief for Nurse-Midwifery Alison Tomazic Centering & Midwifery Program Manager Better Health Partnership Learning Collaborative April 13, 2018 No
More information24/7 Nurseline and Future Moms. Presenters: Blanche Callahan
24/7 Nurseline and Future Moms Presenters: Blanche Callahan Agenda Goal: Learn about 24/7 NurseLine and Future Moms including how to promote the programs in the workplace. Frequently Asked Questions: 24/7
More informationImproving Clinical Flow ECHO Collaborative Change Package
Primary Drivers (driver diagram) Change Concepts Change Ideas Examples, Tips, and Resources Engaged Leadership Develop culture for transformation Use walk-arounds and attendance at team meetings to talk
More informationIdaho Perinatal Project Newsletter
Idaho Perinatal Project Newsletter In This Issue Idaho Perinatal Nurse Leadership Summit July/August 2014 2014/2015 March of Dimes Chapter Community Grant Application Helpful Resources PTSD, Depression
More informationCPQCC. California Perinatal Quality Care Collaborative DESIGN AND ACCOMPLISHMENTS JEFFREY B. GOULD, MD, MPH
CPQCC California Perinatal Quality Care Collaborative DESIGN AND ACCOMPLISHMENTS 1997-2015 JEFFREY B. GOULD, MD, MPH DIRECTOR, PERINATAL EPIDEMIOLOGY AND OUTCOMES UNIT DEPARTMENT OF PEDIATRICS STANFORD
More informationBirth & Bereavement Support. Training & Certification
Birth & Bereavement Support Training & Certification serving millions of families globally since 2011 Adventure Learning Course Requirements Tuition & Written Essay Submit a brief essay, sharing your personal
More informationRequest for Proposal Congenital Syphilis Study
Request for Proposal Congenital Syphilis Study INTRODUCTION AND BACKGROUND The March of Dimes Foundation (MOD) is a national voluntary health agency whose mission is to improve the health of babies by
More informationSmooth Transitions: Enhancing the Safety of Hospital Transfers from Planned Community-Based Births. West Virginia Perinatal Summit November 14, 2016
Smooth Transitions: Enhancing the Safety of Hospital Transfers from Planned Community-Based Births West Virginia Perinatal Summit November 14, 2016 Presented by Melissa Denmark, LM CPM and Bob Palmer,
More informationFriday: April 4, 2014 Rutgers University Inn and Conference Center 178 Ryders Lane, New Brunswick, NJ
Updates on Best Practices for Managing Obstetrical Emergencies Presented by AWHONN New Jersey Section Association of Women s Health, Obstetric and Neonatal Nurses Friday: April 4, 2014 Rutgers University
More informationImproving Obstetric Triage: AWHONN s Maternal Fetal Triage Index
Improving Obstetric Triage: AWHONN s Maternal Fetal Triage Index Catherine Ruhl, MS, CNM Director, Women s Health Programs AWHONN @2015 AWHONN 2 1. Discuss the concept of triage as a nursing role and responsibility
More informationMaternity Initiatives
Quality Initiatives Agenda Maternity Initiatives Patient Surveys and Patient Satisfaction Healthcare Effectiveness Data and Information Set (HEDIS ) Gaps in Care Preventive Services Rewarding Excellence
More informationDeveloping a Curriculum in Patient Safety and Quality Improvement for Your Clerkship
Developing a Curriculum in Patient Safety and Quality Improvement for Your Clerkship Diane Levine, Wayne State University Allison Heacock, The Ohio State University Amy Shaheen, University of North Carolina
More informationSample plans for each core certification can be found within this guide
N A T I O N A L C E R T I F I C A T I O N C O R P O R A T I O N NCC Core Maintenance Program Education Plan Examples Continuing Competency Assessment Sample plans for each core certification can be found
More informationUsing Data for Quality Improvement in a Clinical Setting. Wadia Wade Hanna MD, MPH Technical Assistance Consultant Georgia Health Policy Center
Using Data for Quality Improvement in a Clinical Setting Wadia Wade Hanna MD, MPH Technical Assistance Consultant Georgia Health Policy Center Dr. W. Hanna, PLS, November 2015 Quality An organizational
More informationTRANSITION PREPARATION
Health Care Transition & Title V Care Coordination Initiatives: Webinar Series Webinar # 2 March 28, 2018 TRANSITION PREPARATION Michelle Jiggetts, MD, MS, MBA Program Administrator Complex Care Program
More informationReducing the risks for mother and baby
40th Annual Swanman Perinatal Conference 2017 Reducing the risks for mother and baby May 3 4, 2017 Legacy Women s Services Course description The 2017 Swanman Perinatal Conference will present two days
More information