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

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)

Evidence Based Care

• Vermont Oxford Registry – largest national neonatal data base

• IHI Perinatal Collaborative

• The Joint Commission Perinatal Core Measures

Harm Avoidance

• Ventillator Associated Pneumonia

• Central Line Associated Blood Stream Infection

• Perinatal Adverse Outcomes

• Catheter Associated UTI (2013)

• MRSA, C.Difficile (2013)

TJC PCM Core Measure

Elective Delivery at 37 or 38 weeks Gestational Age

↓ Lower is Better

TJC PCM Core Measure

C. Section for Nulliparous Women with Term, Singleton, Vertex Babies

↓ Lower is Better

TJC PCM Core Measure

Patients at Risk of Preterm Delivery (24-32 Weeks) Receiving Antenatal Steroids Prior to Delivery

↑ Higher is Better

TJC PCM Core Measure

Health Care Associated BSI in Newborns

↓ Lower is Better

TJC PCM Core Measure

Newborns Who Were Fed Only Breast Milk Since Birth

↑ Higher is Better

PCM CORE MEASURE

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

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

Following Best Practices

• Ongoing communication

• Best practices alerts on EMR

• Appropriate screens on EMR

• Easy/retrievable information

• Data collection & benchmarking

• Timely reporting of outcomes