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Washington State Perinatal Collaborative Update on Quality Improvement Initiatives

Washington State Perinatal Collaborative Update on Quality Improvement Initiatives Elective Deliveries 37-<39 wks Episiotomies Breast Milk Feeding Thomas Benedetti, MD, MHA University of Washington Medical Center Department of Obstetrics and Gynecology a nd Jean O’Leary, MPH , RD

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Washington State Perinatal Collaborative Update on Quality Improvement Initiatives

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  1. Washington State Perinatal Collaborative • Update on Quality Improvement Initiatives • Elective Deliveries 37-<39 wks • Episiotomies • Breast Milk Feeding • Thomas Benedetti, MD, MHA • University of Washington Medical Center • Department of Obstetrics and Gynecology • and • Jean O’Leary, MPH, RD • Nutrition Consultant • Washington State Department of Health • WIC Nutrition Program • November 19, 2013 Presented at Washington State Hospital Association Safe Table 11/19/2013

  2. 90%reduction in Early Elective Deliveries between 37 to 39 weeks. $5 million in cost savings. Over1,900 fewerearly deliveries!

  3. Percentage of Hospitals Under 5% by Quarter Baseline: 16% Q1 2011: 35.5% Q2 2011: 44.4% Q3 2011: 51.2% Q4 2011: 54.9% Q1 2012: 69.5% Q2 2012: 66.7% Q3 2012: 69.1% Q4 2012: 88.5% Q1 2013: 88.2%

  4. Presented at Washington State Hospital Association Safe Table 11/19/2013

  5. Presented at Washington State Hospital Association Safe Table 11/19/2013

  6. Presented at Washington State Hospital Association Safe Table 11/19/2013

  7. Optimizing Episiotomy Rates Review Methods and Components 2012-2013 • Statewide voluntary project • Regionally promoted by WSPC, WSHA-Partnership for Patients, PRN coordinators and physician champion • Measure: Episiotomy rate for spontaneous vaginal deliveries • (National Quality Forum-based Measure; excludes shoulder dystocia, forceps, vacuum) • Distribute baseline vs. blinded hospital peer 2011 data to hospitals (WSHA Nov 2012: data source CHARS) • Hospitals will validate baseline data • 2012-2013 Target rate < 5% (Note: target rate is Not 0%) • Quarterly 2012-2013 hospital rates provided by WSHA • Hospitals encouraged to track related episiotomy rate with instrument and third and fourth degree perineal lacerations Presented at Washington State Hospital Association Safe Table 11/19/2013

  8. Presented at Washington State Hospital Association Safe Table 11/19/2013

  9. Presented at Washington State Hospital Association Safe Table 11/19/2013

  10. Presented at Washington State Hospital Association Safe Table 11/19/2013

  11. Presented at Washington State Hospital Association Safe Table 11/19/2013

  12. Presented at Washington State Hospital Association Safe Table 11/19/2013

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