The Institute for Healthcare Improvement (IHI) led the 5 Million Lives Campaign to improve the quality of American health care by “protecting patients from five million incidents of medical harm” (Institute For Health Care Improvement, 2007).   Following the guides provided by IHI the Obstetrical Department established a Perinatal Performance Improvement Committee (PPIC) to identify quality and patient safety issues and to ensure effective improvement initiatives were implemented.
            This committee co-chaired by the OB Medical Director and The Nursing Director of Women’s and Children’s Services was responsible to provide leadership, create a culture of safety and performance improvement, select priorities for patient safety, triage issues to appropriate forums, be a link to the Perinatal Case Conference, define measures and indicators for tracking and trending, identifying and ensuring that the trends were effectively reviewed, addressed and that there was accountability for performance improvement efforts of both nursing staff and medical staff as it pertained to perinatal patient care. 
            This committee determines the priorities for clinical performance improvement and patient safety activities for the perinatal service, it reports to the hospital quality council, as well as to the OB/GYN Section, Family Medicine Section, Pediatric Section, Anesthesia, and the Nursing Clinical Operations Committee.  The committee led several safety initiatives within the department, including the development of a Perinatal Trigger Tool, as defined by IHI as, “the use of triggers or tools to identify adverse events “(2005) by conducting a random manual review of selected patient charts.  Based on this review clinical practices were changed and criteria were developed to measure the level of success of the implementation of the practice changes.  The results are reported in a report card format to the PPIC.  The committee, consisting of nursing and medicine  meets every month, reviews the report card , looks at the outcome criteria and changes practices, both nursing and medicine, accordingly to ensure the safety of delivering women and their babies.
            The committee oversees the quality of clinical practice and since its inception the division has seen a reduction in Postpartum hemorrhage, emergent C/Sections performed in less than 30 minutes, a reduction of noscomial infection in all areas of the department, along with a reduction in significant maternal and infant complications. New protocol and policies govern practice, such as augmentation and induction protocols based on best practice and standard of care. Nursing staff, Medical staff and a Family Advisory Council all work together as a team to ensure patient safety in the perinatal department.