Evaluating the effectiveness of a Preterm Labor Assessment Toolkit model in improving maternal/neonatal outcomes in California

The Preterm Labor Assessment Toolkit (PLAT) is an evidence-based toolkit designed to standardize the assessment and disposition of patients presenting with the signs and symptoms of preterm labor through the use of an algorithm to evaluate cervical change and status of membranes to determine whether or not a woman is in active preterm labor. The Toolkit was developed by a workgroup of California health professionals in response to a statewide assessment of maternity hospitals which revealed a lack, and often an absence, of consistent practice and protocols.

PLAT was launched in 2005 as a collaboration between March of Dimes California Chapter and Sutter Medical Center, Sacramento. From 2008 - 2009, March of Dimes initiated a qualitative and quantitative evaluation of the effectiveness of the Toolkit in improving hospital practices & protocols on the following variables: 1) improve appropriate hospital admissions for patients at greatest risk for preterm delivery; 2) decrease hospital length of stay for patients who are not in true preterm labor; 3) promote effective transport of preterm labor patients when indicated to increase the rate of very low birthweight and preterm babies born at hospitals with the appropriate level of care 4) decrease inappropriate or unnecessary use of tocolysis and steroids. Initial anaylsis has shown favorable impact on the maternal and infant variables listed above. Currently, 15 hospitals across the state have adopted PLAT as a quality improvement initiative and are collecting pre- and post- implementation data. Final analysis will be reported during the summer of 2009.