Obstetric units have dramatically decreased adverse events that harm women in labor and their newborns—and the costly malpractice claims that sometimes follow—by consistently using three sets of process bundles, a 14-hospital collaboration has found after studying outcomes in 145,000 births.
"The hospitals that decided to do this work together realized that perinatal harm drives up 50% of the liability expense for many hospitals," said Susan DeVore, President and CEO of Premier, a 2,700-hospital healthcare alliance that set up the collaboration in 2008 based in part on its previous work with the Institute for Healthcare Improvement and Ascension Health.
"What we see from the data is that there has been a 25% reduction in birth hypoxia and asphyxia, which can cause infant brain damage, a 22% reduction in neonatal birth trauma, and for just these 14 hospitals over just this short period of time, (2008—2010 compared with the project's first phase, from 2008 to 2010) there have been 30 fewer babies that have experienced these harms," she said during a news briefing Wednesday.
For maternal harm, there also was a reduction of up to 15% in cardiac arrests, cardiac complications and postpartum hemorrhage, "even in an environment where the Centers for Disease Control and Prevention is reporting that postpartum hemorrhage rates have doubled among U.S women between 1998 and 2009."
Newborn deliveries that develop complications cost about twice as much as stays without complications, especially when they require admission to the hospital. Nationally, DeVore said, they account for approximately $17.4 billion in hospital costs each year in the U.S. and involve hospital stays that average about one day more.