title: Triggers, bundles, protocols, and checklists--what every maternal care provider needs to know.
abstract: The rise in maternal morbidity and mortality has resulted in national and international attention at optimally organizing systems and teams for pregnancy care. Given that maternal morbidity and mortality can occur unpredictably in any obstetric setting, specialists in general obstetrics and gynecology along with other primary maternal care providers should be integrally involved in efforts to improve the safety of obstetric care delivery. Quality improvement initiatives remain vital to meeting this goal. The evidence-based utilization of triggers, bundles, protocols, and checklists can aid in timely diagnosis and treatment to prevent or limit the severity of morbidity as well as facilitate interdisciplinary, patient-centered care. The purpose of this document is to summarize the pertinent elements from this forum to assist primary maternal care providers in their utilization and implementation of these safety tools.
authors.affiliation: Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH. Electronic address: Kavita.Shah.Arora@gmail.com.
authors.forename: Kavita Shah
authors.initials: KS
authors.lastname: Arora
authors.affiliation: Patient Safety, Dignity Health, San Francisco, CA; Maternal Fetal Medicine, Marian Regional Medical Center, Santa Maria, CA.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Shields
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
authors.forename: Mary E
authors.initials: ME
authors.lastname: D'Alton
authors.affiliation: Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Lappen
authors.affiliation: Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
mesh_terms: D057189:Checklist; D002985:Clinical Protocols; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008427:Maternal Health Services; D008428:Maternal Mortality; D009774:Obstetrics; D064872:Patient Care Bundles; D061214:Patient Safety; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011295:Prenatal Care / Q000458:organization & administration*; D011315:Preventive Medicine / Q000458:organization & administration*; D058996:Quality Improvement
keywords: obstetric quality; patient safety; quality improvement