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Obstetrical unit at Yale-New Haven Hospital achieves dramatic improvement in patient safety
May 04, 2009Maternal and newborn outcomes were greatly improved when doctors implemented a series of simple clinical interventions at Yale-New Haven Hospital's obstetrical unit. Yale School of Medicine researchers report their results in the May issue of the American Journal of Obstetrics & Gynecology.
Starting in 2004, the researchers sought to determine if improving communication between medical staff and standardizing procedures would reduce the number of adverse outcomes. First author Christian Pettker, M.D., senior author Edmund Funai, M.D., and their colleagues attacked the problem from many different angles. They designed and implemented clinical patient safety interventions that included communication training for hospital staff, standardizing interpretation of fetal monitoring, and creating a novel staff role-the patient safety nurse.
In tracking and analyzing 14 markers for adverse outcomes, the team found that the rate of adverse events decreased by about 60 percent over 2.5 years, while the staff's own perception of the overall safety climate increased by 30 percent, according to a survey given by a third party.
"We used these basic principles to make obstetrical care a great deal safer and they can also be applied to other areas of care as well," said Pettker, senior research scientist in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine.
Funai, associate professor in the medical school's Department of Obstetrics, Gynecology & Reproductive Sciences and section chief, maternal-fetal medicine at Yale-New Haven Hospital said, "Interventions of this sort involve fundamental culture change, requiring enormous effort and persistence, but the benefits to our patients are priceless."
"We found that implementing various safety techniques could reduce unanticipated adverse outcomes in an obstetrical unit," said Pettker. "After taking these steps to improve safety, both patients and staff report that the care is more seamless and better organized."
Pettker said the next steps in the research are to implement more safety measures, particularly in the operating room, and standardizing practices with checklists to improve efficiency in the unit.
Yale University
"We used these basic principles to make obstetrical care a great deal safer and they can also be applied to other areas of care as well," said Pettker, senior research scientist in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine.
Funai, associate professor in the medical school's Department of Obstetrics, Gynecology & Reproductive Sciences and section chief, maternal-fetal medicine at Yale-New Haven Hospital said, "Interventions of this sort involve fundamental culture change, requiring enormous effort and persistence, but the benefits to our patients are priceless."
"We found that implementing various safety techniques could reduce unanticipated adverse outcomes in an obstetrical unit," said Pettker. "After taking these steps to improve safety, both patients and staff report that the care is more seamless and better organized."
Pettker said the next steps in the research are to implement more safety measures, particularly in the operating room, and standardizing practices with checklists to improve efficiency in the unit.
Yale University
Obstetrics Gynecology Current Events and Obstetrics Gynecology News RSSPregnancy complications are a stress test for future maternal health and pregnancies
Predicting whether pregnancy complications affect long-term maternal health as well as future pregnancies is at the heart of two studies conducted by researchers in the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale School of Medicine.
Debate on administration of magnesium sulfate to pregnant women to prevent cerebral palsy in preterm infants
Cerebral palsy (CP) is the most prevalent chronic childhood motor disability with an estimated lifetime cost of nearly $1 million per individual.
Moms who breastfeed less likely to develop heart attacks or strokes
The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease, report University of Pittsburgh researchers in a study published in the May issue of Obstetrics & Gynecology.
New ultrasound-guided biopsy method allows improved diagnosis of endometrial disease
A procedure used in conjunction with a vaginal ultrasound might make it easier to visualize and diagnose diseases in the lining of the uterus, researchers at UT Southwestern Medical Center have found.
Pregnancy disorder signals need to screen for heart disease, study shows
High blood pressure experienced during pregnancy could be a woman's earliest warning that she is at risk of developing heart disease - the number one killer of Canadian women - says Queen's University professor of Obstetrics and Gynecology, Graeme Smith.
'Superbug' breast infections controllable in nursing mothers, researchers find
Many nursing mothers who have been hospitalized for breast abscesses are afflicted with the "superbug" methicillin-resistant Staphylococcus aureus, or MRSA, but according to new research by UT Southwestern Medical Center physicians, conservative treatment can deal with the problem.
Genetic mutation increases risk of preterm birth
Genetic mutations in the Toll-like receptor 4 (TLR4) gene appear to have significant association with inflammatory injury to the placenta and developing baby, researchers from the University of Pittsburgh's department of obstetrics, gynecology and reproductive sciences report at the 28th annual meeting of the Society for Maternal-Fetal Medicine
Bacterial infections in premature babies more common than previously realized
Premature babies are subject to a host of threats that can result in fetal/neonatal disease. In a study published in the January 2008 issue of the American Journal of Obstetrics & Gynecology, researchers from the University of Alabama-Birmingham Medical School and the Drexel University College of Medicine found that genital mycoplasmas are a frequent cause of congenital fetal infection. 23% of neonates born between 23 and 32 weeks of gestation have positive umbilical blood cultures for two genital mycoplasmas (bacteria lacking cell walls): Ureaplasma urealyticum and Mycoplasma hominis.
Common drug for stopping preterm labor may be harmful for babies
A drug commonly used to halt premature labor may be associated with brain damage and intestinal issues in premature babies, according to a new analysis of studies on the issue published today in American Journal of Obstetrics and Gynecology.
Malpractice concerns may deter Florida medical students from entering obstetrics and gynecology
The medical malpractice climate in Florida is discouraging medical students from pursuing careers in obstetrics and gynecology - a trend that could further reduce patients' access to obstetric care, a survey by the University of South Florida College of Medicine found.
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