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“Care Bundle” Strategies May Help Hospitals Prevent Birth Injuries

delivery room.jpgGiven the state of our high-tech delivery rooms, it might seem contradictory that most major birth injuries occur as a result of simple human communication problems.

We like to assume ALL doctors know exactly what they’re doing, at all times. Especially during the high-stress experience of labor.

But study after study has proved that teamwork breakdowns are more threatening to a baby’s health than anything else – simply because there’s so much to keep track of, at such a risky time.  

In 2008, a group of 16 hospitals called “the Premier Alliance” tried to change that, by implementing what they called “care bundles.” Care bundles are a series of protocols that apply to a singular birth event, and work best when used a team, in tandem.

“What we were trying to do is to make care delivered in the birth process more effective,” said Susan DeVore, Premier’s chief operating officer. “Our goal is to get [the injury rate] to as close to zero as possible, with zero being the only acceptable number.”

Care bundles can apply to any number of birth situations, but they’re most often used for two events: The decision whether or not to use pitocin to induce labor, and the use of vacuum extractors in more difficult vaginal deliveries.

In the case of a vacuum extraction birth, a “care bundle” would consist of:

  • An in-depth discussion of between the doctor and patient about the risks and benefits of the procedure
  • A documentation of the conversation
  • An exam to ensure that the baby’s properly positioned
  • Plans for emergency staffers to be on call, should a C-section be required

According to a recent Wall Street Journal article, Premier Alliance experienced an eleven precent drop in birth injuries since it started its care bundle programs.  It also reduced the number of babies with insufficient oxygen by 31 percent.

Recently, the federal government awarded $3 million each to two groups working on improving obstetrical safety – St. Louis-based Ascension health, and Minneapolis-based Fairview Health Services.

“I have a mental checklist now of what to do,” said Dr. Paul Burstein, a doctor at an Ascension Health hospital in Milwaukee. “It’s given me more confidence. And I know other members of the team are on the same page.”

Related entries from Child Injury Laws blog:

Lights, Camera, Baby Delivery! Are Parents Entitled To Film The Birth Of Their Children?

Is the rush to induce labor, jepordizing the safety of mother and baby?

Are Cesarean Sections Helping Or Hindering The Health Of Mother & Infant?

Birth Asphyxia: A Doctor’s Delay, A Lifetime Of Medical Complications

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