Quality and safety have become strategic imperatives for an increasing number of health care organizations. One key objective for these organizations is to successfully reduce leading causes of Florida’s maternal mortality and morbidity. Therefore, the FPQC, District XII American College of Obstetricians and Gynecologists, Association of Women’s Health, Obstetric, and Neonatal Nurses, Florida Council of Nurse Midwives, Florida Hospital Association, and the Florida Department of Health have partnered to develop a Florida Obstetric Hemorrhage Initiative (OHI).
Although there is no clear trend in Florida’s pregnancy-related mortality ratio, hemorrhage was one of the top causes of maternal mortality, accounting for 15% of deaths between 2005 and 2009 (FL Pregnancy Associated Mortality Review or PAMR). Recent studies from the California Department of Health and North Carolina have reported that hemorrhage is considered to be highly preventable. The most important factor for this prevention has been identified as improved quality of medical care, including earlier treatment or diagnosis, more effective management and inclusion of proper preventive measures.
Hemorrhage is a relatively rare phenomenon so many hospitals do not have a hemorrhage protocol in place and do not perform drills. Even hospitals that do have protocols in place may not include or regularly apply all evidence-based strategies. Obstetric teams have “consistently failed to recognize, be ready, and respond” to hemorrhage situations that often end in maternal morbidity and mortality. Changes in clinical practices utilizing evidence-based quality improvement (QI) practices could have a large effect on preventing hemorrhage.
Having contracted with the Florida Department of Health, the FPQC is convening a group of maternal health, public health, and QI leaders to work on a maternal mortality prevention initiative, including our new OHI focused specifically on Florida hospitals. The FPQC will begin recruiting hospitals in July to implement our first OHI designed using evidence-based strategies.
For more information on this initiative, please contact firstname.lastname@example.org.
Annette Phelps, ARNP, MSN
Emily A. Dunn, MA, MPH