Impact of a multi-hospital, multi-state initiative to eliminate non-medically indicated (elective) deliveries before 39 weeks gestational age

To address the problem of high rates of non-medically indicated (elective) deliveries, the March of Dimes, the California Maternal Quality Care Collaborative, and the California Department of Public Health, Maternal, Child, and Adolescent Health Division collaborated to develop and disseminate a toolkit, entitled “Elimination of Non-medically Indicated (elective) Deliveries Before 39 Weeks Gestational Age.” A group of 25 hospitals from five states – CA, FL, IL, NY and TX –participated in a pilot project to implement the toolkit's multi-pronged approach with implementation beginning in January 2011.

To assess the impact of the pilot program, a web-based data entry form similar to the scheduling form was developed and data were collected in a standardized way. Participating hospitals collected scheduling and outcome information on all scheduled deliveries. The hospitals were provided with summary process and outcome indicators on a monthly basis to monitor their progress and inform the quality improvement process.

At this presentation, process and outcome measures from the pilot project will be shared, including the percent of early term deliveries that were non-medically indicated over the project period. From this demonstration project, valuable lessons were learned to facilitate implementation of the initiative in other hospitals in the future.