Multistate Collaboration to Confidentially Review Unanticipated Perinatal Outcomes: Lessons Learned

Obstetrics and Gynecology
Kyla DonnellyVictoria Flanagan

Abstract

This commentary describes the development of The Northern New England Perinatal Quality Improvement Network's Confidential Review and Improvement Board and its lessons learned from reviewing cases of unanticipated perinatal outcomes between 2010 and 2013. The Confidential Review and Improvement Board is a multistate mechanism for rigorous and confidential case review of unanticipated perinatal outcomes among unaffiliated academic medical centers, community hospitals, and home birth midwives. We performed semistructured interviews with key individuals participating in the Confidential Review and Improvement Board since its inception and used inductive content analysis to analyze 22 consecutive case reviews. The Confidential Review and Improvement Board's case reviews involved five key clinical situations: second stage of labor management with neonatal depression, obstetric hemorrhage, uterine rupture, fetal demise, and maternal sepsis. A recurrent theme was failure to differentiate maternal from fetal heart rate associated with the birth of severely compromised newborns. Analysis of the Confidential Review and Improvement Board cases revealed opportunities for improvement in the following categories: 1) timely application of bes...Continue Reading

References

Feb 19, 2008·American Journal of Obstetrics and Gynecology·William M CallaghanCynthia J Berg
Oct 28, 2009·Health Care Management Review·Naresh KhatriLanis L Hicks
Feb 11, 2011·American Journal of Obstetrics and Gynecology·Steven L ClarkJonathan A Perlin
Aug 23, 2011·MCN. the American Journal of Maternal Child Nursing·Debra BinghamElliott K Main

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Citations

Mar 23, 2017·Current Opinion in Anaesthesiology·Rachel M Kacmar

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