Labor and Delivery

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Product Overview

The Labor and Delivery Advanced Application is aimed at Women and Newborn clinical directors, operational directors, clinical program guidance teams, and operational guidance teams. The application focuses on providing data for a hospital system’s pregnancy cohort. It aids in tracking and reporting The Joint Commission Perinatal Core Measures (administration of antenatal steroids, decreasing inappropriate cesarean sections and preventing early induction of labor) and helps identify opportunities for improving care in these areas. It also provides data about the antepartum care of C-section patients. In-Development

Features

  • All Deliveries Dashboard: Provides an overview of all deliveries in a health system with emphasis on number of deliveries, specifically the number of C-sections, current C-section rate, average LOS, 30 day readmission rate and mortality.
  • PC-01 Elective Deliveries Dashboard: Provides regulatory metrics and associated details for elective deliveries.
  • PC-02 C-Section Dashboard: Provides regulatory metrics and associated details for NTSV patients.
  • PC-03 Antenatal Steroids: Provides regulatory metrics and associated details for administration of corticosteroids to women at risk of preterm deliveries.
  • Antepartum C-section Dashboard: Provides data about the antepartum course for C-section patients and allows user to track key interventions such as timing of antibiotic administration and skin prep completion.

Benefits

Benefits Include:

  • Fewer NTSV C-sections.
  • Fewer early inductions.
  • Increased use of antenatal steroid administration to mothers in preterm labor.
  • Lower rate of C-section complications.

Measures

Available Measures Include:

  • Number of C-Sections
  • NTSV rate (for all C-Sections)
  • Joint Commission Perinatal Core Measures (administration antenatal steroids, decreasing appropriate cesarean sections and preventing early induction of labor)

Data Sources

  • EMR
  • Finance
  • Labor & Delivery

Labor Management Explorer: A Deeper View

Background

Each of the 4 million births in the United States each year involves some risk. To help manage this risk, The Joint Commission has elected to monitor several best perinatal care practices in all hospitals that perform more than 1000 deliveries per year; over time, hospitals will be required to demonstrate significant reductions in practices associated with increased risk to mothers and babies:

  • Cesarean delivery—a major surgery that is generally riskier and more costly than vaginal delivery—has become one of the most common procedures performed in the United States, increasing from 22 to 33% of all deliveries.
  • Elective labor induction before 39 weeks also has been shown to increase risk; it’s associated with more NICU admissions, respiratory distress, and difficulty maintaining neonate temperature.

Failure to appropriately administer a full course of corticosteroids to women at risk of preterm birth; antenatal steroids have been shown to reduce morbidity and mortality rates among newborns.

What types of problems does Labor and Delivery address?

To improve care of pregnant women, organizations benefit from a bird’s-eye view of the data on key metrics, particularly in areas related to accepted best practice: cesarean rates for deliveries assumed to be low risk, numbers of inappropriate elective inductions, and administration of antenatal corticosteroids to women at risk for delivering before term.

Use Cases

  • A hospital wants to use data to help improve NTSV rates in their Women’s and Newborn population.
  • A hospital’s executive team identifies the need to lower early induction rates to meet The Joint Commission PC-02 requirements.
  • A hospital system wants to lower complication rates on preterm infants by using data to identify compliance to an antenatal steroid protocol.

Anticipated Improvements

  1. Fewer NTSV C-sections.
  2. Fewer early inductions.
  3. Increased use of antenatal steroid administration to mothers in preterm labor.
  4. Lower rate of C-section complications.

Success Measure Examples

There are 3 types of success measures:

Opportunity Identification:

  • Potential $ saved from reduction in clinical variation and standardization of care.

Process Improvements:

  • Evaluate and change documentation processes.

Outcomes Improvement:

  • NTSV: Decrease risk of surgical complications for mothers and infants; decrease health care costs (an average C-section is almost twice as much as a vaginal delivery); acquire value-based contracts based on low C-section rates.
  • Early Induction: Decrease infant complications such as NICU admissions, ventilator support, and hypothermia.
  •  Antenatal Steroids: Decrease infant complications such as NICU admissions and ventilator support.
  • Antepartum C-section Care: Decrease surgical site infections and postsurgical complications.