Oral

Despite American College of Obstetricians and Gynecologists guidelines recommending against non-medically (elective) deliveries prior to 39 weeks gestation, these deliveries have increased and have contributed to increasing rates of labor induction and cesarean delivery. In response to these increasing rates and concern about adverse outcomes associated with them, the March of Dimes collaborated with a group of 25 hospitals from five states – CA, FL, IL, NY and TX – to implement a 18-month quality improvement program to eliminate early term (37 0/7 – 38 6/7 weeks gestation) elective deliveries. These states represented nearly 40 percent of all births and nearly 40 percent of preterm births in the United States. These hospitals participated in a pilot project to implement a toolkit, entitled Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age. The toolkit was created in partnership with the California Maternal Quality Care Collaborative, the California Department of Public Health and the March of Dimes. It includes a step-by-step guide for implementation, a guide for measuring and tracking quality improvement effectiveness and March of Dimes educational tools for clinicians and staff. The implementation phase began in January 2011. Participating hospitals collected scheduling and outcome information on all scheduled deliveries in the hospital. Data were entered into a web-based data entry form similar to the scheduling form. The hospitals were provided with summary process and outcome indicators on a monthly basis to track and monitor their progress. Recognizing that public health can play an important role in reducing early elective deliveries, the March of Dimes developed partnerships on the national level and fostered site-specific collaborations at the community and state level around this issue. The presentations will discuss the successes and impact of the toolkit and lessons learned through the implementation process

Session Objectives: - Identify the key elements of the toolkit, entitled Elimination of Non-medically indicated (Elective) Deliveries Before 39 Weeks Gestational Age - Understand the quality improvement components of this project including data collection and evaluation - Describe the results of the initiative. - Analyze how to implement a quality improvement program to eliminate non-medically indicated deliveries before 39 weeks gestational age that include a clinical intervention as well as public health and education components

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)