Clinical opinionObstetricsImproved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety
Section snippets
The problems
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Despite spending more of our gross domestic product on health care than any other industrialized country, the United States currently ranks 17th in the world in perinatal mortality rate, outcomes that, according to the World Health Organization, are largely due to obstetric causes.1 While there are certainly demographic differences between the United States and some of the world's countries with better perinatal outcomes, we have found it increasingly difficult to accept such differences as the
Our approach
Beginning in the year 2000 and continuing to the present date, HCA has evolved and implemented a unique, integrated approach to these issues, in conjunction with a clinical advisory board and work group consisting of practicing physicians and nurses at our facilities. This approach is based on the following 5 principles:
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Uniform processes and procedure result in an improved quality, including medical care. As a corollary, process variation generally leads to poor quality.
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Every member of the
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Can a 29% cesarean delivery rate possibly be justified?
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Cited by (144)
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2024, AJOG Global ReportsPulse pressure as a predictor of response to treatment for severe hypertension in pregnancy
2021, American Journal of Obstetrics and Gynecology MFMA Standardized Postpartum Oxytocin Protocol to Reduce Hemorrhage Treatment: Outcomes by Delivery Mode
2019, Joint Commission Journal on Quality and Patient SafetyA Standardized Oxytocin Administration Protocol After Delivery to Reduce the Treatment of Postpartum Hemorrhage
2019, Joint Commission Journal on Quality and Patient SafetyBenefits and implications of competing on process excellence: Evidence from California hospitals
2018, International Journal of Production EconomicsSonographic large fetal head circumference and risk of cesarean delivery
2018, American Journal of Obstetrics and Gynecology
Reprints not available from the authors.
Cite this article as: Clark SL, Belfort MA, Byrum SL, et al. Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety. Am J Obstet Gynecol 2008;199:105.e1-105.e7.