Telemedicine to Improve Maternal Safety: A Statewide Survey of Hospitals in an Obstetric Hemorrhage Collaboration [5OP

Abstract

INTRODUCTION: Multidisciplinary obstetric hemorrhage patient safety bundles can improve response to hemorrhage and reduce maternal morbidity. Broad dissemination and implementation of these bundles, across institutions and geographic regions, has remained challenging. We implemented a novel, statewide, telemedicine-based education program and evaluated programmatic effect on self-assessed preparedness, prevention, response, and reporting domains within the obstetric hemorrhage patient safety bundle. METHODS: All Utah hospitals were invited to participate in the Obstetric Hemorrhage Collaborative, an evidence-based educational program aimed at facilitating implementation of the obstetric hemorrhage bundle. The program involved two in-person training meetings and twice-monthly teleconferencing with expert mentorship over 6 months. A statewide self-assessment survey of 38 bundle elements was administered before initiation of the project and after completion. Modified Likert scales were used to describe participant responses. Means and proportions were compared before and after the training. RESULTS: Twenty-seven (61%) of Utah’s obstetric hospitals, representing every hospital system in the state completed the needs-assessment survey. Fifteen (34%) participated in the Obstetric Hemorrhage Collaborative. Hospitals reported implementation, or progress toward implementation, of significantly more elements of the bundle after the educational program compared to before (33.3 vs 19.0, p < 0.001). Hospitals reported increased implementation of elements in all four bundle domains. All participants (100%) reported that teleconferencing sessions were “very helpful,” and 14 (93%) were “very satisfied” with the Collaborative. CONCLUSION: Utah hospitals report improved implementation of an obstetric hemorrhage bundle as result of a novel educational program using telemedicine. This represents a potentially cost-effective strategy to improve widespread adoption of obstetric hemorrhage bundles.