Hospitals in pursuit of excellence

Cutting the Cord on Early Elective Deliveries

GOAL: Eliminate early elective deliveries <39 weeks gestation AIM: Change the labor and delivery culture education of colleagues, providers and patients about benefits of full-term deliveries PROBLEM: Experienced four to nine EED per month from July 2010 - July 2011 IMPROVEMENT TECHNIQUES: 1) Implemented EED policy 2) Applied administrative hard stop LESSONS LEARNED: 1) Colleague empowerment is critical 2) Prepare for resistance 3) Support from Leadership 4) Well-defined process CHANGE STRATEGY: 1) Team STEPPS training 2) Educated colleagues/providers/patients on benefits of full-term delivery CARE INTERVENTION CHANGES: 1) Scheduling procedures 2) Educating patients/families during outpatient visits and prenatal classes RESULTS: 1) Eliminated EEDs March 2012 - present 2) 75% reduction of total inductions and 60% reduction of inductions resulting in cesarean section 3) 88% improvement of overall newborn hearing screen referrals 4) 90% improvement of newborn well-baby referrals 5) 78% improvement of special care nursery referrals

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state.  These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)