- Front-line Staff
- Hospital Leadership
- Medical Students
- Nursing Leadership
- Nursing Staff
- Patient Advocates
- Professional Administrators
- Trustees and Governance Boards
I was involved with the IHI/Premier Perinatal Improvement and Perinatal Innovations Communities. Drawing on that experience, I helped develop the Premier Perinatal Safety Initiative and have been involved in that collaborative since its launch in 2008. In 2010 the project was awarded an AHRQ grant to continue the improvement work through 2013. The project helps hospitals implement three clinical bundles for Pitocin augmentation and induction, and for vacuum assisted deliveries while working to improve their communication and teamwork by way of a unique training which combines TeamSTEPPS and in situ simulation.
As part of the project design team, I helped to develop and implement the High Reliability Perinatal Assessment. This two day on-site assessment is designed to assist the hospital in identifying best practices, as well as potential opportunities for improvement. The hospital also has the ability to utilize these scores as a baseline to measure its progress toward becoming a High Reliability Perinatal Service.
Characteristics often cited for "high reliability perinatal services" include*:
? An organizational culture where patient safety is promoted, supported and understood throughout the organization
? Strong interdisciplinary leadership
? Professional team interaction that promotes the communication of important patient information and expedites the prompt delivery of medical attention during emergencies
? Multidisciplinary rehearsal of emergencies
? Adoption of common language to describe fetal well-being during labor among healthcare providers and nurses
? Policies and procedures which are supported by national professional standards, evidence-based medicine and best practices supporting patient safety
? Standardization and simplification of clinical protocols and unit operations
The "High Reliability Characteristics" categories that are assessed and scored in the risk assessment are:
? Team work and communication
? Reliability concepts
? Situational awareness
? Fetal monitoring
? Care bundles
? Critical event management
? Risk & liability exposure
*Sources:  G. Eric Knox, MD, Kathleen Rice Simpson, Ph.D., RNC, FAAN and Kathryn Eblen Townsend, JD, RN, ARM, High Reliability Perinatal Units: Further Observations and A Suggested Plan for Action, ASHRM Journal, Fall 2003, pg. 17-21.
 Barbara J. Youngberg, BSN, MSW, JD, FASHRM, Assessing Your Organization's Potential to Become a High Reliability Organization, ASHRM Journal 2004, Vol. 24,No.3, pg. 13-19.)
Report of findings and benchmarking:
With the narrative report, the organization receives a table displaying the criteria evaluated and scored for each characteristic, and benchmarked against the results of Premier's Perinatal Safety Initiative hospitals, along with pertinent recommendations. The criteria used to evaluate each hospital's progress are derived from certain industry standards of several professional organizations including, but not limited to, ACOG, AWHONN, AAP, AORN, ASA, and certain accreditation organizations (e.g. The Joint Commission), and regulatory agencies (e.g. CMS, FDA, DEA, NPDB).
I would be happy to tell folks about any aspect of our perinatal patient safety collaborative, and/or the High Reliability Perinatal Assessment, if that is a service a hospital or healthcare system is interested in. In the interst of full disclosure, the assessment is provided by Premier risk consultants on a fee-for-service basis.
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A background in nursing led to a career in hospital and physician professional liability claims management. A career in professional liability led to increasing involvement in healthcare quality improvement projects and achieving my CPHQ. Intellectual curiosity led to a deep interest in collaboration and healthcare reform. My search for ways to organize at a grassroots level to leverage the power of collaboration and to lead reform led to a deeper interest in social media. Study and use of social media has led to a passion for innovation in its use both within the organization and as part of Web 2.0 and 3.0. An underlying passion for art powers the need for innovation. What's next? Who knows. But I can't wait to find out.
The Premier Perinatal Safety Initiative was launched in 2008, and in 2010 the project was awarded an AHRQ grant to continue the improvement work through 2013. The project helps hospitals implement three clinical bundles for Pitocin augmentation and induction, and for vacuum assisted deliveries. It also includes ongoing work with perinatal units to improve their communication and teamwork by way of a unique training which combines TeamSTEPPS and in situ simulation.
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