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SACIM
Assuring Safety & High Quality, Patient-centered services along the
continuum of perinatal care
Presented by:
Virginia Pressler, MD
Executive Vice President
Chief Strategic Officer
Nov 14, 2012
L’Enfant Plaza Hotel, Wash DC
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Kapi‘olani Medical Center for Women & Children - Quest for Safety & Quality
Outcomes• Evidence Based Care (Core measures)• Patient Experience• Harm Avoidance/Complications• Transitions of Care - readmissions• End of Life – Advance Care Planning• Innovations- Perinatal Harm/Ambulatory
OB (2013)
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Evidence Based Care
• Vermont Oxford Registry – largest national neonatal data base
• IHI Perinatal Collaborative
• The Joint Commission Perinatal Core Measures
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Harm Avoidance
• Ventillator Associated Pneumonia
• Central Line Associated Blood Stream Infection
• Perinatal Adverse Outcomes
• Catheter Associated UTI (2013)
• MRSA, C.Difficile (2013)
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TJC PCM Core Measure
Elective Delivery at 37 or 38 weeks Gestational Age
↓ Lower is Better
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TJC PCM Core Measure
C. Section for Nulliparous Women with Term, Singleton, Vertex Babies
↓ Lower is Better
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TJC PCM Core Measure
Patients at Risk of Preterm Delivery (24-32 Weeks) Receiving Antenatal Steroids Prior to Delivery
↑ Higher is Better
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TJC PCM Core Measure
Health Care Associated BSI in Newborns
↓ Lower is Better
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TJC PCM Core Measure
Newborns Who Were Fed Only Breast Milk Since Birth
↑ Higher is Better
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PCM CORE MEASURE
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NEC reduction
• Colostrum tube fed in NICU
• Encourage exclusive breast feeding
• Donor banked breast milk when needed
• Transfusion protocol changes – smaller aliquots of blood and holding tube feedings during blood transfusions
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AMA-PCPI ACOG/NCQA Maternity Care Measures Under Testing
• Establishment of gestational age• Prenatal Care Screening• Behavioral Health Risk Assessment• BMI Assessment & Weight Gain
Recommendations• Care Coordination: Prenatal Record Present at
time of delivery• Post Partum Follow up – breast feeding,
depression, family planning
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Following Best Practices
• Ongoing communication
• Best practices alerts on EMR
• Appropriate screens on EMR
• Easy/retrievable information
• Data collection & benchmarking
• Timely reporting of outcomes