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Using the Institute of Healthcare Improvement model to assess the occurrence of perinatal safety issues at Saint Joseph East Hospital, a team was developed to identify preventable events that could lead to adverse outcomes; the team examined current practice to improve neonatal and maternity care outcomes.

The implementation of Perinatal Care Bundles was an attempt to group evidence based interventions related to the care process that when executed provides results with better outcomes then when implemented on an individual basis.  The goals were determined to help lead to better outcomes in perinatal care that would lead to decreases in birth trauma, improve teamwork, communication and documentation.

Saint Joseph East Hospital (SJE) conducted a gap analysis to establish what practices would benefit the hospital’s practice in perinatal care.  With the data obtained SJE was able to identify areas of concern.  SJE implemented the use of elective induction, cesarean section and augmentation bundles to monitor how the use of oxytocin in relationship to the gestational age for all inductions and cesarean sections.  The new bundles identified the need for a design change and trigger tools to enhance the process.  In building a perinatal safety program following building blocks were established; (1) engage patients and families; (2) establish reliable techniques of communication handoffs; (3) establish a common EFM language and training; (4) implement techniques for effective communication; (5) design standardized interventions.  Using the committed physician, staff and foundation resources we were able to: mandate AWHONN guidelines and educational courses to provide a standardized tool for the training of common language; establish standardized techniques of communication with the SBAR tool; the reduce variation in response with the implementation of emergency drills in crisis situations; set guidelines for the scheduling of elective inductions and cesarean sections, eliminated  elective procedures prior to 39 weeks gestation without medical indications; and, standardize care with approved order sets, guidelines and treatment algorithms for non-reassuring FHR and the practice of discontinuing oxytocin. 

Saint Joseph East Hospital has made a committed effort to provide excellent perinatal care.  We strive to look for the improvement of patient care through every avenue available.  The use of standardized guidelines, orders and techniques of communication in our hospital has helped to achieve these goals.  Our vision was to expand these standardized processes and techniques throughout our Saint Joseph Health System’s (SJHS) perinatal community.