How is it that in the U.S., a country where we spend billions of dollars on healthcare using some of the most advanced medical treatments available, we have one of the worst maternal mortality rates in the developed world? Especially when it has been proven that at least half of the maternal deaths in our country are preventable.
With maternal death rates that have more than doubled in the past 20 years, our country now has the worst rising rate among industrialized nations. In fact, a woman in the U.S. is three times more likely to die as a result of pregnancy than a woman in Canada and six times more likely than a woman in Italy.
We’re spending nearly $100 billion on childbirth each year, yet an estimated 1,200 U.S. women suffer complications during pregnancy or childbirth that will ultimately become fatal and another estimated 60,000 suffer complications that are near-fatal with lifelong health implications.
A few known factors are contributing to high rates of maternal mortality and morbidity in the US.
- A lack of a standardized approach to managing known obstetric complications and emergencies related to pregnancy and childbirth.
- An increasing number of pregnant women presenting with chronic conditions, such as hypertension, diabetes and obesity, which contribute to pregnancy-related complications.
- A lack of comprehensive clinical data on maternal health outcomes. Less than half of U.S. states have maternal mortality review boards with the manner that this data is being collected, leading to systematic undercounting of pregnancy-related deaths. Coded data for known causes of maternal death and harm such as hemorrhage, is not routinely monitored or tracked.
- A gap in knowledge about preventable maternal harm and death, including reliable strategies and processes to mitigate unintended outcomes.
What’s being done?
The key to improving maternal death rates and preventing complications is to create a standard approach to healthcare processes that reduces variation in care. However, this must be done through highly-reliable, evidence-based clinical practices and continuous quality improvement efforts that are sustained overtime.
At Premier, we are working with the Council on Patient Safety in Women’s Health Care, which has developed key maternal patient safety bundles targeting the most common reasons for maternal death and harm. These bundles are an outline of what every birthing facility in the U.S. should do, and provide resources and tools to help clinicians and healthcare organizations develop reliable strategies to improve outcomes.
Through Premier’s partnership with the Council, Alliance for Innovation on Maternal Health (AIM) and the American College of Obstetricians and Gynecologists, we have supported the development of and are implementing these bundles within hospitals and women’s healthcare facilities on a rolling basis across the U.S. Through a series of educational modules, we’ve developed core training materials for AIM that are publicly available on their website and HealthSTREAM. The goal is to reduce severe maternal morbidity by 100,000 events and maternal mortality by 1,000 deaths by 2018.
Standardizing highly-reliable practices pays off.
Almost immediately after a hospital in Louisiana implemented a massive transfusion policy based on the AIM module for post-partum hemorrhage, which Premier helped support, a new mother presented with post-partum hemorrhage. Because of the new, standardized policy, their clinicians and nurses were able to save the new mother’s life, and continue to attribute lives saved to the AIM educational modules.
A true culture of maternal safety warrants collaboration, education and the standardization of data-driven, highly-reliable care delivery practices. As the implementation of the maternal patient safety bundles and other quality improvement efforts are scaled across the industry, we can start to impact maternal mortality rates in the U.S., one new mother at a time.
Have questions about best practices in childbirth? Check out the AIM educational modules or contact QualitySolutions@PremierInc.com.