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Quality improvement initiatives

Quality Improvement Initiative Can Cut NTSV Cesarean Rate

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Over eight years of intervention, decrease in rate of nulliparous term singleton vertex cesarean delivery
For infants at high risk of iron deficiency anemia

Delayed Clamping Reduces Anemia at 8, 12 Months of Age

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Reduced risk of anemia at 8 and 12 months for infants at high risk of iron deficiency anemia
Physicians working on a night float call system are more likely to have patients with a prior cesarean delivery undergo trial of labor and achieve vaginal birth

Higher Odds of Trial of Labor With Night Float Call System

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Increased likelihood of having patients with prior C-section undergo trial of labor, achieve vaginal birth
There is high satisfaction for a postpartum self-administered medication program on postpartum wards

Most Postpartum Moms OK With Self-Administered Pain Meds

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Eighty percent median overall improvement in pain; some users would prefer drug dispensing by nurse
Dry cord care is noninferior to the use of antiseptics in preventing omphalitis in full-term newborns in France

Antiseptics Not Needed for Cord Care in Developed Nations

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No significant differences found between dry cord care and use of antiseptics in full-term newborns
Delayed umbilical cord clamping is beneficial for most term and preterm infants

ACOG Recommends Delayed Umbilical Cord Clamping

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Beneficial for most term and preterm infants, with no link to increased postpartum hemorrhage
For women with a singleton pregnancy planning a repeat cesarean delivery

Universal Group B Streptococci Screening Not Cost-Effective

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Screening before repeat C-section may become cost-effective in populations with high GBS prevalence
Use of the Lean Six Sigma methodology is effective for reducing the cesarean section rate

Lean Sigma Six Methodology Can Cut Cesarean Rate

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Cesarean rate decreased from 41.83 to 32.00 percent 10 months after improvement measures
Introduction of the hard-stop policy in Oregon was associated with a reduction in elective early-term deliveries

Oregon’s Hard-Stop Policy Tied to Drop in Elective Early Delivery

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Reduction in rate of elective inductions before 39 weeks, and in elective early-term cesareans
For women undergoing induction

Faster Delivery for Induction With Misoprostol Plus Cervical Foley

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Combination methods result in faster time to delivery compared with misoprostol, Foley alone