Premier Wednesday announced a new national collaborative effort that aims to eliminate many birth injuries and deaths by improving communication between doctors, nurses, and patients and boosting compliance to evidence-based clinical interventions that can help avoid serious medical mishaps.
The effort in large part includes changing the behavior of clinicians, so that they regularly adhere to "evidence-based care bundles," which are specific groups of care and interventions that Premier says doctors should follow in infant deliveries in order to avoid potential death and medical problems with babies.
Those care bundles include a list of interventions that are known to improve the safety of births, such as avoiding elective inductions of deliveries before the 39th week of pregnancy; managing labor strategies and progress; and documenting the estimated fetal weight prior to delivery.
Technology is playing a pivotal role in the creation, collection, and analysis of data from the 16 hospitals in 12 states participating in the effort. Combined, those hospitals will deliver about 115,000 babies during the 21-month Perinatal Safety Initiative.
The hospitals will provide to Premier a variety of data from e-health record and other clinical systems including medical monitoring devices, as well as billing and administrative systems, for analysis of outcomes. The participants will identify and share information about best practices in their efforts to improve birth safety. Results of the initiative also will be shared publicly to help transform health care nationally, say Premier officials.
Premier will compare the data of the hospitals involved with the study to data collected from Premier-affiliated healthcare providers that are not involved with the initiative to help benchmark the results, says Kathy Connolly, a registered nurse and project lead of the initiative.
In addition to indentifying other clinical best practices through the data, Premier will also analyze the potential cost savings that these safety measures bring. Whenever a newborn experiences a birth injury that requires admission to a neonatal intensive care unit, the costs of caring for that baby skyrocket, says Frank Perez, president and CEO of Kettering Health Network, which operates Kettering Medical Center in Dayton, Ohio, which is participating in the initiative. "A stay in the neonatal ICU can cost hundreds of thousands of dollars," Perez says, aside from the lifelong health problems many birth-injured babies face and the emotional toll on families.
During a pilot run of the safety initiative at Kettering Medical Center, the hospital reduced by 50% the number of newborn admissions to special care nurseries by complying with evidence-based inventions and improving communication between clinicians, says Perez.
Premier currently captures and measures clinical, financial, staffing, and supply chain data from more than 700 hospitals in its network. Premier's Perspective data warehouse is based on Netezza and contains over 4 terabytes of data, 3 billion records, and information on 130 million patient discharges, says a company spokesman.
For the initiative, Premier will collect data in a number of ways, including through electronic reports and also via computer "screens" that prompt doctors to document key clinical information about mothers and babies, says Connolly.
Screen prompts can also help remind doctors and other clinicians to provide certain care services or to ask key questions of patients that can provide important information for making delivery-related decisions.
During the initiative, Premier will also analyze data for the costs involved with the hospital care of birth-injured babies, including medical supplies, special equipment, and neonatal staff, to help calculate the potential savings when mistakes are avoided and quality of care improved.
Obstetrics cases are the frequent focus of hospital malpractice suits, which also incur huge legal expenses and often end up with jury verdicts averaging $2.5 million, says Connolly.
The initiative also hopes to improve communication between nurses and doctors, who are often trained differently and use different terms to describe a medical situation, which can sometimes lead to dangerous misinterpretations or misunderstanding, says Maureen Bisognano, executive VP and chief operating officer of the Institute for Healthcare Improvement, a nonprofit organization championing health quality programs and working with Premier on the new safety campaign.
"The goal is to reduce the variables in care," says Bisognano. By adhering to clinical best practices, "we can reduce harm to babies and mothers," she says.