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THA HEN/TIPQC
OB EED Webinar
October 27, 2014
A THA/TCPS TIPQC Collaborative
Inter-institutional Quality Improvement Project
Faculty
Course Director: Peter Grubb, MD, Assistant Professor of Pediatrics,
Vanderbilt University School of Medicine; Medical Director, TIPQC
Faculty: Brenda Barker, MEd, Project Director, TIPQC
Faculty: Chris Clarke, RN, Senior Vice-President, Tennessee Center
for Patient Safety, Tennessee Hospital Association
Planner/Speaker: Jackie Moreland, RN, Clinical Quality
Improvement Specialist, Tennessee Center for Patient Safety,
Tennessee Hospital Association
Speaker: Phil Toothman, State Director of Communications and
Marketing, March of Dimes
Speaker: Tamara Currin, MS, MCHES, Associate Director of Program
Services, Lead Public Affairs Staff, March of Dimes
Speaker: Valencia Mormon-Nelson, State Director of Program
Services, March of Dimes
Welcome!
Agenda for today:
• November is Prematurity Awareness
Month
• Data Performance Trends
• Team Successes
• Questions/Answers from Hospital
Teams
November is Prematurity
Awareness Month
Phil Toothman, State Director of Communications and
Marketing
~
Tamara Currin, MS, MCHES, Associate Director of Program
Services, Lead Public Affairs Staff
~
Valencia Mormon-Nelson
State Director of Program Services
Upcoming Events
th
6 Annual “Learning for Babies” Conference
Thursday November 6, 2014; 7:30a-4:30p CT
“The Factory at Franklin” in Franklin, TN
For more information, contact:
Tamara Currin at
615-399-3200 or tcurrin@marchofdimes.com
6th Annual “Learning for Babies”
Conference
• Diabetes and Pregnancy - Connie Graves, MD
• Chorioamnionitis: Maternal and Neonatal Perspective - Chris
Sizemore, DO and Travis Crook, MD
• Interesting Cases from the NICU - Sarah Hassell, MD
• Update on the Care of Babies with NAS - Stephen Patrick, MD
• Tips for Dealing with Difficult People - Evelyn Frye, PhD
• Care of the Parent Experiencing a Prolonged Antepartum and
Neonatal Stay - Jennifer Schiro, RN
• What Can You Really See on Fetal Ultrasound - Michael
DeRoche, MD
• Safe Sleep Practices - Carolyn Riviere, MS, RN
Upcoming Events
“Promoting Healthy Babies Conference”
Thursday November 13, 2014; 7:30am-3:45pm
Baptist Memorial Hospital Memphis – “Garrett
Auditorium”
For more information, contact:
Valencia Mormon-Nelson at
901-590-1722 or vnelson@marchofdimes.com
Promoting Healthy Babies Conference
• The Role of Prematurity Prevention in Improving Tennessee Birth
Outcomes – Dr. Michael Warren
• Using the Preterm Labor Assessment Toolkit: Strategies for
Success – Barbara Hughes
• One Family’s Story: Preterm Birth
• Current Tennessee Laws Regarding Maternal Opioid
Abuse/Neonatal Abstinence Syndrome (NAS): Effects on Children
and Families
• Break-out sessions on:
- Group Prenatal Care
- Long Acting Reversible Contraceptive Options
for Women
- Successfully Breastfeeding Babies Born Prematurely
&/or Affected by Neonatal Abstinence Syndrome (NAS)
- Ethical Issues Related to Long Term Consequences of Neonatal
Abstinence Syndrome (NAS)
Prematurity Awareness Month Logo
Healthy Babies are Worth the Wait
Billboards
Night of Purple Memphis
Prematurity Awareness Day
Facebook Header
Nashville Parthenon
Lit Up Purple
Parthenon on NBC News
Ruby Falls Lit Up Purple
Ruby Falls Pathway Signage
and Lit Purple
Tennessee Courthouse
Lit Up Purple
World Prematurity Day
Mark your calendars to recognize World
Prematurity Day on Monday November 17th
Prematurity Toolkit
To access and download March of Dimes resources
such as:
• Preterm labor assessment toolkit
• Less than 39 weeks toolkit
• Prematurity Prevention Resource Center
• Healthy Babies are Worth the Wait
• Much more….go to
http://www.marchofdimes.org/searchresults.aspx?search-text=prematurity toolkit
Questions
OB EED Data Trends
Working toward our goal of 5% or less
HEN OB Data Charts
HEN OB Data Charts
HEN OB Data Charts
HEN OB Data Charts
OB Statewide Data Charts
OB Statewide Data Charts
OB Statewide Data Charts
OB Statewide Data Charts
Questions
Sharing Our Successes
Congratulations!
Safe Sleep
• Safe Sleep education and book project launch
on Friday January 10th
• 100% of birthing hospitals in Tennessee signed
commitment pledge
Safe Sleep
ABC’s of Safe Sleep
Babies should sleep ALONE, on their BACK and in a
CRIB.
http://charlieskids.org/
Hospital Incentive Bundle
• Free “Sleep Baby, Safe and
Snug” board book for each
birth in your facility
• Free TDH “ABC’s of Safe Sleep”
materials
• Free Recognition on TDH
website
(http://safesleep.tn.gov)
• Signed certificate from TDH
Commissioner
• Press release template
Antenatal Steroids
Brenda Barker, M.Ed. Brenda.Barker@tipqc.org
National Partnership for
Maternal Safety
Recommends that every birthing facility in
the United States should have a Maternal
Safety Bundle for each of the following:
• Obstetric Hemorrhage
• Preeclampsia/ Hypertension
• Prevention of VTE in Pregnancy
OB Hemorrhage
Available OB Hemorrhage Toolkits
Preeclampsia
• CMQCC Preeclampsia Toolkit is now available @
https://www.cmqcc.org/preeclampsia_toolkit
OB VTE Safety Recommendations
• For pregnant women, risk of VTE 4-5 times high
than for non-pregnant women
• This risk is at least twice as much following
cesarean delivery
• Key emphasis in addressing risk and prevention
by PfP in 2011 as well as dually by ACOG &
Society of Maternal Fetal Medicine in 2014 as
part of The Maternal Harm Prevention Initiative*
*Managing Risk and Reducing Readmissions: New Safety Recommendations Prevent
Venous Thromboembolism in Maternal Patients by Michael Wong, JD and Lynn Razzano,
RN, MSN, ONCC @ http://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdf
OB VTE Safety Recommendations
•
•
•
•
Assess each pregnant woman for VTE risk
Initiate VTE prophylaxis
Reassess each pregnant patient
Initiate patient discharge protocols (education
to include S/S, prophylaxis post discharge as
indicated, long-term effects & prevention
strategies)*
*Managing Risk and Reducing Readmissions: New Safety Recommendations Prevent Venous
Thromboembolism in Maternal Patients by Michael Wong, JD and Lynn Razzano, RN, MSN,
ONCC @ http://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdf
Breastfeeding
Ten Steps to Successful Breastfeeding:
the Baby Friendly Hospital Initiative
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Have a written breastfeeding policy
Provide staff training in policy implementation
Provide breastfeeding education for pregnant women
Help initiate breastfeeding within 1 hour of birth
Show mothers how to initiate and maintain breastfeeding
(even if separated from infant)
Give no substitutes unless medically indicated*
Practice rooming in 24/7
Encourage breastfeeding on-demand
Give no artificial nipples/pacifiers to breastfed infants
Support and utilize support groups
*Hospitals should accept no free or heavily discounted formulas and/or feeding supplies
Tennessee Breastfeeding Hotline
• 24/7 breastfeeding
hotline!
Dr. Michael Warren, Director, Division
of Family Health and Wellness, TN DOH
Commissioner
John Dreyzehner, MD, MPH
Upcoming Events
• Next THA TCPS/TIPQC OB Monthly Team
Webinar— Monday November 24, 2014;
10:00am CT/11:00 ET.
• 2014 THA Leadership Summit
th
Wednesday November 5 at the Gaylord
Opryland Hotel and Convention Center in
Nashville in conjunction with THA’s Annual
Meeting. Go to http://www.tha.com/ for more
information and to register
Upcoming Events
November Maternal Affinity Group Call:
Tuesday November 11, 2014; 12:00-1:00pm CT/1:00-2:00pm ET
“New” Maternal Bundles
This session will provide an in-depth overview of the new National Maternal Safety Bundles including
suggested resources and recommendations on how to effectively implement these bundles into your
organization.
FACILITATORS:
Elliott Main, MD, FACOG
Medical Director of California Maternal Quality Care Collaborative
Chairman of the Department of Obstetrics and Gynecology of California Pacific Medical
Center and the California Maternal Mortality Review Committee
Deb Kilday, MSN, Senior Performance Partner, Premier Inc.
REGISTER NOW
Register for this call at http://events.premierinc.com/ei/getdemo.ei?id=510&s=_46W0GFBM6
Upcoming Events
th
6 Annual “Learning for Babies” Conference
Thursday November 6, 2014; 7:30a-4:30p CT
“The Factory at Franklin” in Franklin, TN
For more information, contact:
Tamara Currin at
615-399-3200 or tcurrin@marchofdimes.com
Upcoming Events
“Promoting Healthy Babies Conference”
Thursday November 13, 2014; 7:30am-3:45pm
Baptist Memorial Hospital Memphis – “Garrett
Auditorium”
For more information, contact:
Valencia Mormon-Nelson at
901-590-1722 or vnelson@marchofdimes.com
7th Annual Meeting
February 2-3, 2015
Upcoming Events
Pre-eclampsia Conference
Friday, February 20, 2015 – Save the Date!
nd
2 Annual OB Conference for nurses & physicians.
Guest speakers include Dr. Baha Sibai of the University of
Texas Houston and Dr. George Saade of the University of
Texas Medical Branch, Galveston
RSVP no later than November 30th to
Rebecca.marten@erlanger.org or traci.josephsen@erlanger.org or
call 423-778-3222 as venue change may need to occur
This conference is being sponsored by the University of Tennessee, Erlanger Health System,
storc (Solutions to Obstetrics in Rural Communities) and Regional Obstetrical Consultants.
IHI Open School 2014
•
•
•
•
•
1.
2.
3.
4.
THA is providing free access to the IHI Open School curriculum to employees and
trustees of our safety partner hospitals.
21 online, self-paced courses including 72 lessons and corresponding resources—
videos, case studies, podcasts, featured articles, exercises, networking
Free app for the iPhone and iPad by logging onto iTunes
Over 25 contact hours available for CME, CNE, CPHQ and ACPE credit
Certificate of completion
Register using instructions. Type “Tennessee Hospital Association” as your
facility to receive free membership.
Once registered, go to the course page: www.ihi.org/lms
Click the online learning tab and choose a lesson
Click Begin Lesson
Contact Taelor Barnette at tbarnette@tha.com 615-401-7414 for more information.
53
Resources
• All material will be posted on the THA HEN Community of
Practice (COP) http://www.HealthcareCommunities.org
– Contact tbarnette@tha.com for COP questions or if you
need registration and joining instructions.
• THA/TCPS Contacts:
– Chris Clarke, Sr. VP cclarke@tha.com
– Jackie Moreland, QI specialist jmoreland@tha.com
– Jessy Richter, Data Manager jrichter@tha.com
• TIPQC Contact:
– Brenda Barker, M.Ed. Brenda.Barker@tipqc.org
Resources
ACOG Statement
ACOG practice bulletin, "Induction of Labor" updated in 2010
Tool Kit
CMQCC / MOD Tool kit:
http://www.cmqcc.org/resources/1974
Websites
www.tnpatientsafety.com
user name: hospital
password:tnbabies
www.healthytennesseebabies.com
IHI Resources
Elective Induction and Augmentation Bundles
http://www.ihi.org/knowledge/Pages/Changes/ElectiveInductionandAugmentationBundles.aspx
How-to Guide: Prevent Obstetrical Adverse Events @
http://www.ihi.org/knowledge/Page s/Tools/HowtoGuidePreventObstetricalAdverseEvents.aspx
Articles
A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks' gestation
http://www.ncbi.nlm.nih.gov/pubmed/20207241
55
Resources
Articles Continued…
Improving Perinatal Care: A Focus on Patient-Centered Care and Evidenced-Based Measures
http://www.ihi.org/knowledge/Pages/ImprovementStories/ImprovingPerinatalCareAFocusonPati
entCenteredCareandEvidencedBasedMeasures.aspx
Reducing Birth-Related Trauma and Liability Exposure
http://www.ihi.org/knowledge/Pages/ImprovementStories/ReducingBirthRelatedTrauma.aspx
Neonatal and maternal outcomes associated with elective term delivery, http://ajog.org
Rationale for a 39-Week Elective Delivery Policy
http://sitesearch.aafp.org/?q=rationale+for+39+Weeks+policy&x=0&y=0&t1search=true&sp_cs=UTF-8
Reduction in elective delivery at <39 weeks of gestation: comparative effectiveness of 3
approaches to change and the impact on neonatal intensive care admission and stillbirth
http://www.ajog.org/article/S0002-9378(10)00679-4/fulltext
56
Resources
Patient Resources
March of Dimes Resources:
Healthy Babies Are Worth The Wait
http://www.marchofdimes.com/professionals/medicalresources_hbww.html
Get ready for labor
“Brain Card”
Why at least 39 weeks is best for your baby
http://www.marchofdimes.com/pregnancy/getready_atleast39weeks.html
AWHONN Resources:
Go the Full 40
http://www.awhonn.org
CMS Innovation Resources
Strong Start Toolkit Link
http://innovations.cms.gov/initiatives/strong-start/what-you-can-do-to-help.html
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Data Due Date!
Monthly data due by last date of following month!