The road to zero preventable birth injuries.
BACKGROUND
The Seton Family of Hospitals' experience in developing and implementing transformational practices in labor and delivery (L&D) units aimed at reducing the rate of birth trauma at our facilities was previously reported.


METHODS
Seton began its individual perinatal safety effort in earnest in October 2003. The endeavor brought together the four hospitals that offer obstetrical services, resulting in the establishment of an interdisciplinary team. The team meets monthly to develop and monitor best practices that are then shared, executed, and validated by each respective site's perinatal councils.


RESULTS
A 36% reduction in the use of vacuum and forceps (from a frequency of 7.4% to 4.7%) was previously reported; the current rate (fiscal year [FY] 2007-FY 2008 year-to-date; July 1, 2006-December 31, 2007) was 4.1%. The incidence of associated birth trauma decreased to 0% for the last 15 months (ending December 31, 2007). During the first three project years (FY 2004-FY 2006), the average length of stay for infants admitted to the neonatal intensive care unit for birth injury declined by 80% (as compared with the previous three years), from 15.8 to 3.1 days.


CONCLUSIONS
The perinatal safety team developed processes that have resulted in large and sustained reductions in the rate of serious birth trauma at all obstetric facilities.
Mazza
Frank
F
Seton Medical Center Austin, Texas, USA. FMazza@seton.org
Kitchens
Judy
J
Akin
Mark
M
Elliott
Byron
B
Fowler
Debbie
D
Henry
Elaine
E
Landers
Susan
S
Nix
Michael
M
Ourston
Susan
S
Sheppard
Celeste
C
Stallings
Danette
D
Weihs
Diana
D
D001363:Awards and Prizes; D001720:Birth Injuries / Q000453:epidemiology / Q000517:prevention & control*; D002985:Clinical Protocols; D006801:Humans; D007231:Infant, Newborn; D009096:Multi-Institutional Systems; D019982:Organizational Case Studies; D010348:Patient Care Team; D017751:Safety Management / Q000379:methods*; D013781:Texas / Q000453:epidemiology