Significant reduction seen in elective scheduled early-term deliveries to less than 5 percent
WEDNESDAY, April 10 (HealthDay News) -- A multistate collaborative process improvement program can reduce the rate of elective scheduled singleton early-term deliveries, according to a study published online April 5 in Obstetrics & Gynecology.
Bryan T. Oshiro, M.D., from the Loma Linda University School of Medicine in California, and colleagues examined whether implementation of a process improvement program could reduce the rate of elective scheduled singleton early-term deliveries (37 0/7 to 38 6/7 weeks of gestation) using data from 29,030 scheduled singletons, delivered at 34 weeks of gestation or higher, and delivered in 26 hospitals. Policies and procedures were implemented for scheduling inductions and cesarean deliveries, and education was provided for patients and health care providers.
The researchers found that there was a significant decrease in elective scheduled early-term deliveries, from 27.8 percent in the first month to 4.8 percent in the 12th month. In addition, there were significant decreases in the rates of elective scheduled singleton early-term inductions and cesarean deliveries. The rate of medically indicated or unscheduled early term deliveries did not change. Among scheduled early-term singletons there was a nonsignificant decrease in neonatal intensive care unit admissions (from 1.5 to 1.2 percent; P = 0.24). No increase was noted in the rate of term fetal mortality.
"This type of multistate collaborative program not only has the potential to be replicated, implemented, and disseminated nationwide to reduce early elective deliveries, but may also be used to rapidly and successfully promulgate other evidence-based practices," the authors write.
Abstract (http://journals.lww.com/greenjournal/Abstract/publishahead/A_Multistate_Quality_Improvement_Program_to.99850.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/greenjournal/Abstract/publishahead/A_Multistate_Quality_Improvement_Program_to.99850.aspx )