Changes in care associated with the introduction of a postpartum hemorrhage patient safety program.
OBJECTIVE
To determine whether the introduction of a postpartum hemorrhage (PPH) patient safety program was associated with changes in patient care or outcomes.


METHODS
A multipronged patient safety program regarding PPH was instituted at a tertiary care maternity hospital. Patient care and outcomes were assessed for 6 months prior to (period A) and 6 months after (period B) program institution.


RESULTS
In all, 278 and 341 women were diagnosed with PPH during periods A and B, respectively. Women who had a PPH after the program were more likely to receive more than one dose of prostaglandin F2 α (24% versus 9%, p = 0.01) and more than one type of uterotonic (34% versus 25%, p = 0.02) and to have a B-lynch suture placed (9.4% versus 4.7%, p = 0.03). The frequency of blood transfusion, hysterectomy, and intensive care unit admission were similar between periods.


CONCLUSIONS
Introduction of a PPH safety program resulted in several indications of a more quickly escalated response.
Department of Obstetrics and Gynecology, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Justin R
JR
Lappen
Dominika
D
Seidman
Carol
C
Burke
Kris
K
Goetz
William A
WA
Grobman
D001803:Blood Transfusion / Q000706:statistics & numerical data*; D057189:Checklist; D002985:Clinical Protocols; D015237:Dinoprost / Q000627:therapeutic use; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007362:Intensive Care Units / Q000706:statistics & numerical data; D061214:Patient Safety; D011181:Postnatal Care / Q000379:methods / Q000458:organization & administration*; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D011247:Pregnancy; D015397:Program Evaluation; D012189:Retrospective Studies; D016896:Treatment Outcome
D015237:Dinoprost