Principles Of Care Research Articles

Neuro-Affirming Practices for Voice Care

Purpose: The purpose of this article is to educate speech-language pathologists (SLPs) on the role of neuro-affirming care in voice and upper airway interventions. This publication provides an introduction and background for neuro-affirming care, rationale for its inclusion in the areas of voice and upper airway, current limitations in providing neuro-affirming care in traditional voice centers, and case scenarios to provide examples of neuro-affirming practices in voice interventions (Appendix B). Conclusions: Given that neurodivergence often co-occurs with myriad conditions, it is likely SLPs across scope of practice, including voice and upper airway, will encounter neurodivergent individuals with voice and communication needs and will require greater awareness of neuro-affirming care to adequately serve these populations. Descriptions of neuro-affirming care principles, limitations and adaptations needed for neuro-affirming care in traditional voice settings, and case scenarios illustrating implementation of certain principles are provided. Future directions for neuro-affirming care in voice and upper airway should include neurodivergent researchers and clinicians in the investigation and implementation of these interventions.

Early integration of palliative care and oncology (EIPCO): A low-maintenance, easy-to-implement program to address palliative care shortages in oncology.

192 Background: With demand for palliative care rising and increasing cancer survival rates, there is an urgent need to train future healthcare professionals in palliative care principles, especially for oncology. Prior work has focused on adding modules or rotations to medical school curriculums. However, this approach provides insufficient or late exposure to specific trainees, such as undergraduate and medical students that are less aware of palliative care. Here, we report on the successful development and implementation of a program that educates early trainees in palliative care and oncology topics while immediately benefiting patients and healthcare teams. Methods: The pilot version of the EIPCO (Early Integration of Palliative Care and Oncology) program was initiated at Stanford in 2021 by a single medical student and faculty advisor. Recruited medical, graduate, and undergraduate student trainees first complete an online, didactic course as a self-paced, safe introduction to palliative care and oncology. A member of EIPCO leadership (officer) then interviews trainees one-on-one to discuss course takeaways, remaining questions, and what follow-up opportunities are most relevant for each trainee. Next, EIPCO facilitates trainee boarding into their respective opportunities, such as shadowing, volunteering, talks, or research projects, to stimulate further learning and excitement. Involved trainees may then also apply to become officers. EIPCO was reliably maintained and expanded by a small team, even when all officers had significant time constraints. Results: EIPCO was received positively by trainees, especially for providing access to rare opportunities where they could directly help patients. Trainees reported the most interest in shadowing (88% of trainees, e.g. inpatient or at tumor boards), providing companionship (96% of trainees, e.g. spiritual care visits or for actively dying patients), and helping patients complete advanced care directives (85% of trainees). These experiences solidified crucial concepts and cultivated interest in palliative care and oncology. Resources have also been developed for the flexible implementation of EIPCO at other institutions. Conclusions: EIPCO serves as a low-maintenance and easy-to-implement model to address a growing need in medical education. EIPCO benefits healthcare teams and patients while exposing early trainees to how palliative and cancer care can be integrated. Further work has begun to expand the program to other institutions to enhance training on a broader scale.

Stewarding Contextual Integrity in Data Services for Indigenous Scholarship

ABSTRACTThe CARE Principles for Indigenous Data Governance provide essential guideposts for the stewardship of Indigenous data. To put CARE into practice in libraries and repositories, resources are needed to support implementation and integration into current research data services (RDS). Based on analysis of case studies with scholars of Indigenous language and culture, this paper articulates specific Indigenous research and data practices to guide metadata work and other areas of responsibility in RDS. The cases surface the richness of relationships and the significance of accountability in the research process—demonstrating the “relational accountability” inherent in Indigenous research methods. Robust representation of relationality is essential to retaining integrity of context in metadata for Indigenous research data. We consider the practical implications of documenting relational context with current descriptive metadata approaches and challenges in achieving CARE adherent metadata, which we argue is the backbone for broader application of CARE for Indigenous RDS.

Post-growth agrifood systems: Towards an emancipatory politics

Abstract A world without hunger demands a post-growth rewiring of the global agrifood system predicated on emancipatory politics that enables reform of actors and institutions outside agriculture. This is necessary to shift out of the prevalent growth-hegemonic framing of agriculture and its contributions to economic growth, where the structural injustice of hunger is rendered invisible. Recent International Relations (IR) scholarship highlights the institutional arrangements underpinning global agrifood problems. This paper uses critical IR theory to understand the structural mechanisms and relations of power through which the growth-hegemonic theorisation of agriculture is produced and reproduced, sustaining hunger within an exceedingly financialised agro-industrial complex. The structural power of knowledge shaping the interlocking structures of finance, production, and security is evident in the extremely high multilevel concentration in modern agrifood systems. This structural power evident in local decentralised agroecological systems and in transnational agrarian movements reflects post-growth principles of sufficiency, shared prosperity, care, ecological and social justice.Together, they are the counter-hegemonic voices, cooperative social systems, and class interests championed by post-growth politics.

Content that Promotes Intent to Change: Asynchronous and Synchronous Professional Development for Family Doctors in Continuing Medical Education

Background In 2020, a medical school in northern Ontario launched “Overcoming Barriers to Safe Opioid Prescribing,” a continuing professional development program consisting of an asynchronous online module followed by a series of optional synchronous videoconferences, which together formed a virtual community of practice (VCoP). The videoconferences followed a structured format, where a case study was introduced by one of the participants from their practice, followed by group reflections on the case and the development of strategies for implementing the learnings in their practices. Methods Mixed methods data was collected from participants utilizing a variety of tools and at different times before, during and after their engagement in the program. Qualitative data analysis produced a list of key themes that were cross-validated by anonymized, aggregated program evaluation data to identify further, module-specific themes. Results This paper examines the learning experiences and outcomes of primary care providers that participated in the online modules and synchronous videoconferences and proposes content design strategies that led to these educational experiences. The online module created a baseline of knowledge, increased participants’ familiarity with practice guidelines, comfort and confidence in prescribing and deprescribing behaviours, and increased participants’ familiarity with tools, resources, and strategies for safe opioid prescribing in their practices. The synchronous videoconferences developed a community of learning through modeling, experiential learning and the sharing of experiences and best practices. Conclusions The combination of the online module and synchronous videoconferences led to an increase in the intent to change practice, particularly with enhanced the principles of patient-centred care through their focus on practical, real-world strategies and physician-patient communication techniques. Participants noted that the foundational knowledge and resources provided in the online course was supported and contextualized through the synchronous discussions.

Technical Communication's Fight Against Extractive Large Language Modeling by Applying FAIR and CARE Principles of Data

This article assesses the data practices of Grammarly, the prominent AI-assisted writing technology, by applying data principles that advocate for empowering Indigenous data sovereignty. The assessment is informed by the authors’ work with an Inuit tribal organization from rural Arctic Alaska that generated data and metadata about potentially sacred tribal activities. Their analysis of Grammarly's large-language modeling practices demonstrates how technical communication can hold businesses to principled data practices created by Indigenous nations and communities that understand how to create more just futures.

Registered nurse case managers’ work experiences with a person-centered collaborative healthcare model: an interview study

BackgroundMultimorbidity is increasingly acknowledged as a significant health concern, particularly among older individuals. It is associated with a decline in quality of life and psychosocial well-being as well as an increased risk of being referred to multiple healthcare providers, including more frequent admissions to emergency departments. Person-centered care interventions tailored to individuals with multimorbidity have shown promising results in improving patient outcomes. Research is needed to explore how work practices within integrated care models are experienced from Registered Nurse Case Managers’ (RNCMs) perspective to identify areas of improvement. Therefore, the aim of this study was to describe RNCMs’ work experience with a person-centered collaborative healthcare model (PCCHCM).MethodsThis study used an inductive design. The data were collected through individual interviews with 11 RNCMs and analyzed using qualitative content analysis.ResultsData analysis resulted in four generic categories: ‘Being a detective, ‘Being a mediator’, ‘Being a partner’, and ‘Being a facilitator of development’ which formed the basis of the main category ‘Tailoring healthcare, and social services to safeguard the patient’s best.’ The findings showed that RNCMs strive to investigate, identify, and assess older persons’ needs for coordinated care. They worked closely with patients and their relatives to engage them in informed decision-making and to implement those decisions in a personalized agreement that served as the foundation for the care and social services provided. Additionally, the RNCMs acted as facilitators of the development of the PCCHCM, improving collaboration with other healthcare professionals and enhancing the possibility of securing the best care for the patient.ConclusionsThe results of this study demonstrated that RNCMs tailor healthcare and social services to provide care in various situations, adhering to person-centered care principles and continuity of care. The findings underline the importance of implementing integrated care models that consider the unique characteristics of each care context and adapt different case managers’ roles based on the patient’s individual needs as well as on the specific needs of the local setting. More research is needed from the patients’ and their relatives’ perspectives to deepen the understanding of the PCCHCM concerning its ability to provide involvement, security, and coordination of care.

Syphilis and pregnancy.

•Although congenital syphilis has a known etiological agent, accessible diagnosis and low-cost, effective treatment with low fetal toxicity, it continues to challenge obstetric and antenatal care services. •The increasing rates of syphilis in the general population have direct repercussions on the increase in cases of congenital syphilis, a situation of objective interest for public health. •Although transforming the recording of syphilis and congenital syphilis into notifiable diseases improved the records and has made it possible to measure the occurrence of these diseases and create solutions, no effects on reducing their frequency have been reached yet. •The failure to control syphilis/congenital syphilis is multifactorial, and associates variables that range from the deficiency in teaching about these diseases in schools and in the training system of the various health professional segments, as well as the lack of rigid policies for quality control from antenatal care until the clinical follow-up of children exposed to Treponema pallidum during pregnancy. •To date, benzathine penicillin is the only antimicrobial accepted as effective by the main health authorities on the planet for the treatment of syphilis in pregnant women. •The fear of anaphylaxis in response to the treatment of syphilis with benzathine penicillin is an important factor hindering the prompt and correct treatment of pregnant women with syphilis, even though health authorities have made efforts to face the problem with solid arguments, still insufficient to resolve the question. •Although specific protocols are published, the failure to control the treatment of syphilis in pregnant women is still observed with high frequency, indicating and reinforcing a failure in the quality control of these care principles. The National Specialized Commission on Infectious Diseases of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) endorses this document. Content production is based on scientific evidence on the proposed topic and the results presented contribute to clinical practice.

An in-Depth Exploration of Consumer and Consumer Representative Views on Chronic Pain Management in Australia: A Key Informant Interview Study

Chronic pain affects millions of Australians. Despite guidelines recommending non-pharmacological approaches as the first line treatment, opioid medications remain among the most common treatments. This study interviewed consumers and consumer representatives (i.e., representatives of peak pain advocacy organizations in Australia) to gain first-hand perspectives on chronic pain treatment in Australia. Individual semi-structured Key Informant Interviews (KIIs) with three consumers and three representatives were undertaken. Interviews were transcribed, and thematic analysis applied. Results showed that consumers and consumer representatives identified critical treatment access barriers. Another shared theme related to overarching principles of care, with sub-themes pertaining to the need for an interdisciplinary approach and pain education. A further shared theme focused on typical medical interventions, with one shared subtheme regarding the benefits and drawbacks of pain medications. Both groups highlighted the importance of a biopsychosocial approach with consideration of mental health, particularly related to perceived stigma and comorbidities. These findings highlight that chronic pain remains both undertreated and inadequately treated in Australia. There is a critical need to use novel approaches to overcome access barriers and stigma, and to advance precision medicine to match patients to the treatment most likely to be of benefit as early as possible in their journey.

Contextualising samples: supporting reference genomes of European biodiversity through sample and associated metadata collection

The European Reference Genome Atlas (ERGA) consortium aims to generate a reference genome catalogue for all of Europe's eukaryotic biodiversity. The biological material underlying this mission, the specimens and their derived samples, are provided through ERGA’s pan-European network. To demonstrate the community’s capability and capacity to realise ERGA’s ambitious mission, the ERGA Pilot project was initiated. In support of the ERGA Pilot effort to generate reference genomes for European biodiversity, the ERGA Sampling and Sample Processing committee (SSP) was formed by volunteer experts from ERGA’s member base. SSP aims to aid participating researchers through (i) establishing standards for and collecting of sample/specimen metadata; (ii) prioritisation of species for genome sequencing; and (iii) development of taxon-specific collection guidelines including logistics support. SSP serves as the entry point for sample providers to the ERGA genomic resource production infrastructure and guarantees that ERGA’s high-quality standards are upheld throughout sample collection and processing. With the volume of researchers, projects, consortia, and organisations with interests in genomics resources expanding, this manuscript shares important experiences and lessons learned during the development of standardised operational procedures and sample provider support. The manuscript details our experiences in incorporating the FAIR and CARE principles, species prioritisation, and workflow development, which could be useful to individuals as well as other initiatives.

A Behavior-Based Model to Validate Electronic Systems Designed to Collect Patient-Reported Outcomes: Model Development and Application.

The merits of technology have been adopted in capturing patient-reported outcomes (PROs) by incorporating PROs into electronic systems. Following the development of an electronic system, evaluation of system performance is crucial to ensuring the collection of meaningful data. In contemporary PRO literature, electronic system validation is overlooked, and evidence on validation methods is lacking. This study aims to introduce a generalized concept to guide electronic patient-reported outcome (ePRO) providers in planning for system-specific validation methods. Since electronic systems are essentially products of software engineering endeavors, electronic systems used to collect PRO should be viewed from a computer science perspective with consideration to the health care environment. On this basis, a testing model was blueprinted and applied to a newly developed ePRO system designed for clinical use in pediatric dentistry (electronic Personal Assessment Questionnaire-Paediatric Dentistry) to investigate its thoroughness. A behavior-based model of ePRO system validation was developed based on the principles of user acceptance testing and patient-centered care. The model allows systematic inspection of system specifications and identification of technical errors through simulated positive and negative usage pathways in open and closed environments. The model was able to detect 15 positive errors with 1 unfavorable response when applied to electronic Personal Assessment Questionnaire-Paediatric Dentistry system testing. The application of the behavior-based model to a newly developed ePRO system showed a high ability for technical error detection in a systematic fashion. The proposed model will increase confidence in the validity of ePRO systems as data collection tools in future research and clinical practice.

How national healthcare change initiatives balance emergent and deliberate change: A principles-focused evaluation.

Principles-focused evaluation reflects on the change process itself through examination of its underlying principles. The Centre for Advancing Collaborative Healthcare & Education (CACHE) worked to build interprofessional education programs and tools that attended to the Team Primary Care (TPC) principles. Our internally directed principles-focused evaluation, presented here, asks how CACHE adhered to these principles in the programs and tools it delivered to the TPC project. The article's main contribution is the creation of a new concept, organizational critically reflective practice, which describes an approach health leaders can use to mitigate the limitations of short-term initiatives while pursuing transformational change. We propose specific tools and steps that will help health leaders attempting to enact organizational critically reflective practice.

Enhanced train-the-trainer program for registered nurses and social workers to apply the founding principles of primary care in their practice: a pre-post study

BackgroundA train-the-trainer approach can effectively support the integration of new practice standards for health and social services professionals. This study describes the effects of an enhanced train-the-trainer program to support registered nurses and social workers working in primary care clinics in their understanding of the fundamental principles of primary care.MethodsWe implemented an enhanced train-the-trainer program for registered nurses and social workers in six primary care clinics. We conducted a pre-post study using quantitative and qualitative data to assess trainers’ and trainees’ intention, commitment, and confidence in applying acquired knowledge.ResultsWe trained 11 trainers and 33 trainees. All the trainers and trainees were satisfied with the program. Trainers were less confident in their abilities as trainers following the training, especially regarding tailored coaching (p = 0.03). Trainees’ commitment to becoming familiar with the functioning of their clinic (p = 0.05) and becoming part of the team increased significantly (p = 0.01); however, their intention to use their knowledge decreased (p = 0.02). Trainers and trainees identified organizational and professional barriers that may explain the observed decrease.ConclusionAn enhanced train-the-trainer program positively impacted registered nurses’ and social workers’ assimilation of the fundamental principles of primary care. Further research is needed to understand the long-term effects of train-the-trainer programs on primary care trainees and how these effects translate into patient care.

Evaluating cancer patient-reported experience measures against health literacy best practices.

Positive patient experiences can lead to better adherence to cancer treatment and greater patient health outcomes. The primary aim of this descriptive study was to determine whether commonly used cancer PREMs have been developed according to health literacy best practices. The secondary and third aims were to examine the development of PREMs and to assess their comprehensiveness against principles of patient-centered care. To assess adherence to best practice literacy principles regarding readability and understandability of commonly used cancer PREMs, three validated readability calculators and a validated instrument were utilized. To better understand how PREMs were developed, data about survey items, patient involvement, and expert consultation were collected. Finally, the Picker framework was used to evaluate the comprehensiveness of PREMs against principles of patient-centered care. Thirty-five PREMs studies met inclusion criteria for the study. The mean reading grade level of cancer PREMs was 9.7 (SD = 0.75, range = 8.2-11.2) with best practice recommendation being a grade 6 reading grade level. Twenty-eight PREMs were rated on understandability, with a mean score of 74% (SD = 10.6, range = 46-93%, with optimal score of greater than 80%). The mean number of items across PREMs was 49 (SD = 31, range = 13-136). Recommendations for the number of items to include in a questionnaire is 25-30 items. Most PREMs (n = 33, 94.3%) asked ≥ 1 double-barreled question. All PREMs addressed ≥ 2 patient-centered care principles. Cancer PREMs included in this study did not meet evidence-informed thresholds for readability and understandability. As such, it is possible that there may be gaps in how we understand the care experiences of low health literacy populations. Future development of PREMs should engage patients with low health literacy to ensure their perspectives are accurately captured and that PREMs are designed to meet the needs of all patients.

Psychometrics of the modified family-centered care assessment short version for childhood obesity

BackgroundIncorporating principles of family-centered care into pediatric weight management interventions can improve the effectiveness and quality of treatment and reduce attrition rates. To assess the family-centeredness of interventions, reliable, valid, and easy-to-administer scales are needed. The purpose of the study was to develop a shortened version of the modified Family Centered Care Assessment (mFCCA) and assess its psychometric properties.MethodsThe mFCCA, a scale to assess the family-centeredness of interventions for childhood obesity, was administered to families following the Connect for Health randomized control trial evaluating the effectiveness of a primary care-based pediatric weight management intervention. We iteratively removed items from the mFCCA and used Rasch modeling to examine the reliability and validity of the shortened scale.ResultsWe included data from 318 parents and the exploratory factor analysis showed the presence of a single factor. The results of the Rasch modeling demonstrated acceptable internal consistency of the scale (0.7) and strong validity as evidenced by the overall model fit and range of item difficulty. Following the psychometric analyses, we reduced the number of items from 24 to 8 items.ConclusionThe mFCCA short version demonstrates good psychometrics and can be used to evaluate the family-centeredness of childhood obesity interventions with reduced participant burden, thereby improving outcomes for children with obesity.Trial registrationClinicaltrials.gov NCT02124460 registered on April 24, 2014.

DSD-related attitudes and beliefs held by pediatric endocrinologists and urologists: Insights from the North American disorders/differences of sex development (DSD) clinician survey

Disorders/Differences of Sex Development (DSD) encompass congenital conditions with atypical development of chromosomal, gonadal, or anatomical sex. Due to the rarity and complexity of these conditions, strong evidence for clinical practices is scarce, leading to controversies in management. This study, part of a broader project, examines changes over time in the attitudes and beliefs of DSD healthcare providers, focusing on factors contributing to patients' life satisfaction and the influence of medical specialty, gender, and age. Participants included active members of the Pediatric Endocrine Society (PES) and the Societies for Pediatric Urology (SPU) at three time points: 2003-2004 (T1), 2010-2011 (T2), and 2020 (T3). A survey covering predictors of patient life satisfaction, attitudes and beliefs regarding DSD care and outcomes, and participant characteristics was administered. Data were analyzed using descriptive statistics and Generalized Estimating Equations (GEE). Demographics: Participation rates were 56% (PES) and 64.7% (SPU) at T1, 41.1% (PES) and 52.3% (SPU) at T2, and 25.6% (PES) and 51.2% (SPU) at T3. Most participants were male (T1: 70.6%, T2: 61.7%, T3: 70.6%). Factors Affecting Life Satisfaction: Both endocrinologists and urologists ranked "gender identity consistent with assigned sex" as most important. Over time, the endorsement of some factors, such as performing genital surgery at Centers of Excellence, increased, while others, like the influence of prenatal androgen exposure determining gender identity, varied by specialty and gender. Attitudes and Beliefs: Across 18 statements, responses indicated three clusters with strong agreement, moderate agreement, and strong disagreement. Statements on the importance of family background and avoiding gender discordance were consistently endorsed, while those on delaying hypospadias repair until consent were least endorsed. The study highlights variability in beliefs about DSD management over time, influenced by specialty, gender, and age. Despite consensus on some care principles, discrepancies remain, particularly regarding the impact of prenatal androgens and the timing of surgical interventions. These findings underscore the need for regular interdisciplinary communication to align clinical practices with evidence-based guidelines and address subjective beliefs. The survey illustrates evolving perspectives among DSD healthcare providers, emphasizing the need for continued dialogue and education to bridge gaps between clinical evidence and practice. Collaborative efforts, such as the international I-DSD and the U.S. DSD Translational Research Network, are crucial for advancing patient-centered care in this field.

Burn injuries in clinical practice: Principles and management for general physicians

ABSTRACT Burn injuries, although largely preventable, continue to pose a significant global health burden and substantially contribute to morbidity and mortality. This study emphasises the pivotal role of timely and effective burn care in mitigating the adverse consequences of these injuries. General physicians often serve as frontline responders to burn incidents, highlighting the importance of proficiency in burn management for accurate diagnosis, prognosis and appropriate referral to specialised burn units. Prompt initiation of acute burn care is paramount, with first-aid interventions playing a crucial role in shaping patient outcomes and reducing morbidity and it highlights the essential principles of burn care that general physicians should apply to enhance patient care outcomes. This emphasises the critical role of general physicians in implementing these principles effectively. In addition, it underscores the necessity of a multidisciplinary approach, advocating collaboration between general physicians and specialised burn care teams to ensure comprehensive patient management and rehabilitation. Ultimately, effective burn care enhances individual patient outcomes and reduces the overall burden of burn injuries on healthcare systems and society.

Integrating the Principles of Academic Freedom and Patient-Centered Care to Promote Tolerant Listening Skills in Health Care Providers.

Collaboration is a vital skill that needs to be developed in health professions students. Developing tolerance for differing viewpoints and valuing an understanding of others' lived experiences are instrumental skills in learning to provide patient-centered care. Fostering the expression of diverse viewpoints and working through uncomfortable and distressful situations are a part of the experience in acquiring these skills. It is the educator's duty to facilitate these encounters in a way that upholds the tenants of academic freedom and civility to create optimal educational outcomes. Doing so creates opportunities for transformative learning and the facilitation of higher cognitive development when compared with the avoidance of exposing students to divergent viewpoints. It is through freedom of discussion that one must teach students that ultimately the pursuit of truth, even when it may be unwelcome, disagreeable, or deeply offensive, greatly outweighs the discomfort the process of discovering it may bring.

Towards Establishing Quality Standards on Human Rights for Services in Dementia Care.

People with dementia often experience violations of fundamental human rights and impeded access to healthcare. This study aims to investigate the views of experts regarding the use of the United Nations Convention on the Rights of People with Disabilities (CRPD) principles as quality standards for human rights-based care. A single-round Delphi e-consultation with 15 dementia experts was designed to evaluate each CRPD principle and collect feedback on their views about the application of the CRPD principles in dementia care. The CRPD principles were fully endorsed as quality standards; however, several experts commented on the complexities of the use of CRPD principles in relation to information disclosure, capacity assessment, stakeholders' involvement in decision-making, respecting needs and preferences, holistic approaches in care practice, and protection against abuse, neglect and discrimination. These findings indicate the CRPD quality standards were fully applicable for people with dementia although some clarification around interpretation could assist in their use. Future research should elaborate on further points of support and guidance for dementia care providing examples of good practice from across the globe, and develop a concordant, human rights-based scheme for the implementation and evaluation of dementia services. This study suggests that the CRPD can serve as a benchmark for human rights-based practices in dementia services globally that could enhance nursing care practice. Nursing staff are encouraged to consider human rights in relation to the complexities associated with people with dementia, their caregivers, and other services involved in their care.

Implementing an obstetric sepsis bundle in a large academic hospital system

For the purposes of this review, obstetric sepsis refers to sepsis (from all causes, including non-obstetric such as pneumonia) in pregnant or postpartum patients, which was previously described as maternal sepsis. Obstetric sepsis poses a significant threat to pregnant, birthing, and postpartum individuals, contributing prominently to maternal mortality and morbidity despite being largely preventable1. In response to identified gaps in sepsis management, particularly the lack of specific protocols tailored to obstetric populations, New York-Presbyterian undertook a system-wide initiative to implement a comprehensive sepsis bundle. This initiative included the development of new criteria for identifying sepsis in obstetric patients, the creation of electronic medical record (EMR) alerts aligned with obstetric-specific indicators, and the establishment of a structured sepsis management algorithm.The project involved collaboration across eight hospital campuses within the New York-Presbyterian system, aiming to standardize and improve the early recognition and treatment of sepsis in maternal care. Key components included rigorous data analysis to select appropriate sepsis criteria, simulation-based training to familiarize clinical teams with the new algorithm, and continuous refinement of alert systems to mitigate alarm fatigue and enhance responsiveness.Post-implementation evaluation revealed a significant reduction in preventable morbidity related to sepsis, accompanied by the identification of additional gaps in fever and chorioamnionitis management. These findings prompted the development of new clinical guidelines to further enhance patient safety. Challenges encountered included adapting sepsis criteria to balance sensitivity and specificity, as well as integrating trauma-informed care principles into clinical practice.This project underscores the effectiveness of tailored quality improvement efforts in maternal health, emphasizing the critical role of proactive interventions in enhancing patient outcomes and safety within obstetric settings. Ongoing efforts focus on monitoring process metrics through a dedicated sepsis dashboard and advancing education on trauma-informed care principles, highlighting the continued commitment to sustained improvement in maternal health outcomes.