Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes

Burstein, Paul D.; Zalenski, David M.; Edwards, J. L.; Rafi, Ishrat Z.; Darden, Jennifer; Firneno, Cassandra; Santos, Palmira

doi:10.1111/1475-6773.12589

Cited by 5 publications

(6 citation statements)

References 43 publications

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“…Other methods and indicators used to assess change in healthcare providers’ clinical practice after training included retrospective analysis of clinical records Clark et al , 2010), audit of clinical records or databases (Harris et al , 1995; Dijkman et al , 2010; Markova et al , 2012) and review of the partograph (Taylor, 1996; Berglund et al , 2010). Measures assessed include change in labour augmentation rate (Berglund et al , 2010), change in episiotomy rate (Spitzer et al , 2014; Dresang et al , 2015), change in post-partum haemorrhage rate (Sørensen et al , 2011; Spitzer et al , 2014; Dresang et al , 2015), number of perimortem caesarean sections per year (Dijkman et al , 2010), caesarean section rate (Berglund et al , 2010; Makuwani et al , 2010; Sørensen et al , 2011; Van de Ven et al , 2016), vacuum delivery rate (Sørensen et al , 2011; Dresang et al , 2015), change in obstetric referral pattern (Ronsmans et al , 2001; Nielsen et al , 2007; Makuwani et al , 2010; Nyamtema et al , 2016; Rahman et al , 2017), diagnosis and management of EmOC complications (Varghese et al , 2016), quality of face mask ventilation (Mazza et al , 2017), degree of implementation of protocols (Deering et al , 2004; Xu et al , 2014; Burstein et al , 2016; Kim et al , 2016; Van de Ven et al , 2016) and documentation of achievement of strategic goals to change practice post-training (Walker et al , 2012, 2014). At the health system level, the availability and/or change in EmOC signal functions were assessed in three studies (Evans et al , 2009; Ameh and van den Broek, 2015; Dresang et al , 2015).…”

Section: Resultsmentioning

confidence: 99%

“…Health outcomes assessed include Neonatal Mortality Rate (Carlo et al , 2010; Sørensen et al , 2011; Msemo et al , 2013; Walker et al , 2016), perinatal mortality rate (Spitzer et al , 2014), case fatality rate (CFR) (Nyamtema et al , 2011; Spitzer et al , 2014; Ni Bhuinneain and McCarthy, 2015), institutional maternal mortality ratio (iMMR) (Dresang et al , 2015; Ni Bhuinneain and McCarthy, 2015), fresh stillbirth rate (Nyamtema et al , 2011; Msemo et al , 2013), stillbirth rate (Draycott et al , 2006; Carlo et al , 2010; Nyamtema et al , 2011; Sørensen et al , 2011), maternal mortality due to post-partum haemorrhage (Burstein et al , 2016; Van de Ven et al , 2016), incidence of birth asphyxia (Draycott and Crofts, 2006; MacKenzie et al , 2007; Carlo et al , 2010; Xu et al , 2014; Varghese et al , 2016), occurrence of neonatal complications after shoulder dystocia (Inglis et al , 2011; MacKenzie et al , 2007; Grobman et al , 2014; Van de Ven et al , 2016) and retrospective assessment of Apgar scores, stillbirth rates and hypoxia ischaemic encephalopathy (Ameh et al , 2012).…”

Section: Resultsmentioning

confidence: 99%

“…Two retrospective cohort studies (Inglis et al , 2011; Van de Ven et al , 2016), one standard-based review (Burstein et al , 2016), post-training simulation (Maslovitz et al , 2007) and one before–after study (Grobman et al , 2014), showed improved competency, adherence to management protocols (Maslovitz et al , 2007; Inglis et al , 2011; Burstein et al , 2016) and improved documentation of procedures (Grobman et al , 2014; Burstein et al , 2016; Van de Ven et al , 2016). Varghese et al (2016), in a quasi-experimental study, implemented and evaluated training in four intervention and four control sites.…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of training in emergency obstetric care: a systematic literature review

Ameh

Mdegela

White

et al. 2019

Health Policy and Planning

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Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n = 44) and randomized controlled trials (RCTs) (n = 15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effectiveness of training in emergency obstetric care: a systematic literature review

Ameh

Mdegela

White

et al. 2019

Health Policy and Planning

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“…First is that two of the three demonstration projects achieved some positive impacts on patient safety outcomes (Burstein et al. ; Riley et al. ,b).…”

Section: Findings From Psml Demonstration Sitesmentioning

confidence: 99%

Progress at the Intersection of Patient Safety and Medical Liability: Insights from the AHRQ Patient Safety and Medical Liability Demonstration Program

Ridgely

Greenberg

Pillen

et al. 2016

Health Services Research

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Objective. To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. Data Sources/Study Setting. On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015. Study Design. The seven grantees implemented complex, broad-ranging innovations addressing both patient safety and medical liability in "real-world" contexts. Some projects featured novel approaches, while others implemented adaptations of existing models. Each project was funded by AHRQ to collect data on the impact of its interventions. In addition, AHRQ funded a cross-cutting qualitative evaluation focused on lessons learned in implementing PSML interventions. Data Collection/Extraction Methods. Site visits and follow-up interviews supplemented with material abstracted from formal project reports to AHRQ. Principal Findings. The PSML demonstration projects focused on three broad approaches: (1) improving communication around adverse events through disclosure and resolution programs; (2) preventing harm through implementation of clinical "best practices"; and (3) exploring alternative methods of settling claims. Although the demonstration contributed to accumulating evidence that these kinds of interventions can positively affect outcomes, there is also evidence to suggest that these interventions can be difficult to scale. Conclusions. In addition to producing at least preliminary positive outcomes, the demonstration also lends credence to the idea that targeted interventions that improve some aspect of patient safety or malpractice performance may also contribute more broadly to institutional culture and the alignment of all parties around reducing risk

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“…discuss a sustainable intervention to reduce perinatal harm (shoulder dystocia) after implementing a multipronged approach that includes teamwork training (Burstein et al. ).…”

Section: Contents Of This Special Issuementioning

confidence: 99%

Paving the Way for Progress: The Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative

Battles

Reback

Azam

2016

Health Services Research

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Changing Labor and Delivery Practice: Focus on Achieving Practice and Documentation Standardization with the Goal of Improving Neonatal Outcomes

Abstract: System and site management teams implemented a standardized shoulder dystocia protocol that fostered effective teamwork and obstetric team readiness for managing shoulder dystocia emergencies.

Cited by 5 publications

References 43 publications

The effectiveness of training in emergency obstetric care: a systematic literature review

The effectiveness of training in emergency obstetric care: a systematic literature review

Progress at the Intersection of Patient Safety and Medical Liability: Insights from the AHRQ Patient Safety and Medical Liability Demonstration Program

Paving the Way for Progress: The Agency for Healthcare Research and Quality Patient Safety and Medical Liability Demonstration Initiative

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