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• W2781777881 abstract "To determine the adequacy of obstetric hemorrhage (OBH) protocols within a health system, investigate differences based on hospital delivery volume, and identify areas for improvement. Gap analysis was used to identify the differences between existing obstetrical hemorrhage protocols and recommendations established by the National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage in a western Pennsylvania health system. The analysis was performed from January 2016 to June 2016. The hospital system encompassed 8 hospitals that ranged from a small rural hospital to a quaternary care center. Hospitals were categorized as high (>2000), medium (>500-2000), and low (<500) volume. A consensus team analyzed current protocols in 13 areas pertaining to OBH including readiness, recognition and prevention, reporting, and systems learning (see Table). The findings of the gap analysis were then used to implement a system-wide OBH improvement initiative. The most common gaps identified were lack of immediate access to OBH kits, OBH drills, active third stage management, team huddles, and debriefing procedures. Of note, no hospitals performed ongoing adjusted OBH risk assessment or continued cumulative blood loss during the peripartum and postpartum periods. All hospitals had an OBH response team, and the majority had a hemorrhage cart, although contents were not standardized. Hospitals also varied in their preparedness and management of OBH based on annual delivery volume. The one low-volume hospital achieved significantly fewer elements (only 1 of the 13 evaluated). Medium volume hospitals demonstrated wide variation in achievement of the 13 elements examined. The most robust readiness and response systems were found at the high volume hospitals, though significant gaps were still identified at these locations. This gap analysis of OBH management identified areas for improvement among all hospitals in the health system regardless of annual delivery volume. In particular, our analysis identified low volume hospitals to be at greatest risk for lack of preparedness. This systematic approach to evaluation of current protocols and identification of improvement targets with implementation strategies could significantly improve maternity outcomes." @default.
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• W2781777881 date "2018-01-01" @default.
• W2781777881 modified "2023-09-23" @default.
• W2781777881 title "922: When the Blood Hits the Floor: Lessons Learned From a Gap Analysis of Obstetrical Hemorrhage Protocols Across a Health System" @default.
• W2781777881 doi "https://doi.org/10.1016/j.ajog.2017.11.509" @default.
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