Establishment of a Perinatal Quality Network

Abstract

The guiding premise of care at University Hospitals is based on high reliability organization (HRO) principles. With the acquisition of six community hospitals that provided obstetric services and an established regional perinatal leader, the opportunity was created to integrate standardized practice to decrease variation and improve patient outcomes. The establishment of an obstetric network that fosters collaborative inter- and intrahospital efforts and partnerships that promoting HRO principles. These partnerships form the basic governance of the UH OB Network. The foundation of this unique network is the equal ownership of vision and design shared by the chief of systems quality, obstetrics, and the senior quality improvement nurses. This team recruited self-identified obstetric champions (nurses, providers, quality and risk) from each institution to generate consensus and lead process improvement at the local level The adoption of multidisciplinary care guidelines informed by best evidence and internal expert opinion serves as the lynchpin for consensus-driven practice. Customization of the electronic record to reflect care guidelines provides additional crucial support integral to their implementation. The formation of robust local quality assurance committees focused on perinatal care identifies unique risk to drive process improvement. Participation in an online learning and individual risk assessment is required for all nurses and providers. The inception of rigorous quality assurance processes has led to a significant decrease in the rate of patient serious safety events (SSE) using the American Society for Healthcare Management preventable-harm classification system. A reduction in the number of malpractice suits and a decrease in total obstetric litigation costs occurred after the formation of the UH OB Network. Clinician knowledge and judgment scores demonstrated improvement in all modules of the system’s online learning platform. The interprofessional collaborative approach to perinatal care advances the science of health and the art of compassion while maximizing team cohesiveness. The shared partnership model engenders equal ownership of patient care and subsequent patient outcomes. The multidisciplinary approach empowers nurses to advocate and innovate on behalf of patients and their families in achieving best possible outcomes.