Go the Full 40 - Labor & Delivery
One in three women delivers via cesarean in the U.S., and more than 90
percent of them have repeat operations in subsequent deliveries. Despite
numerous evidence-based guidelines and established best practices for
labor and delivery, clinical care varies widely for many practices. Labor
and delivery care varied at Thibodaux Regional Health System, causing
the organization to look for ways to standardize care.
Induction of labor, using medications or other methods to instigate labor,
has contributed to an increase in cesarean rates. The American Congress
of Obstetricians and Gynecologists recommends that induction not occur
at all prior to 39 weeks, and then, should only occur when the cervix
is “ready” for labor.
Thibodaux Regional Health System is driven by its commitment to excellence.
Among its top priorities is ensuring that it provides the highest quality
patient care, including looking for ways to create improvements in labor
and delivery. To better understand variations in care, and opportunities
to reduce its cost, a physician led Labor and Delivery Care Transformation
team was launched. Other physicians and hospital staff also participated
on the team.
Recognition:
Recipient of the 2017 LHA Trust Funds Safety Star Award
Improvements made:
- Standardization of Nursing Documentation to include documentation of the
Bishop Score (Scoring system to assist in predicting the readiness of
the cervix for induction of labor) on every patient.
- Revised physician order set to include documentation of the Bishop Score
prior to admission.
- Revised documentation of the scheduling department to include the Bishop Score
- Extensive education of physicians and staff on the importance of the Bishop
Score and favorable induction.
- Education of physician office staff on importance of full term instead
of near team delivery.
- Implemented the “Go the Full 40” Campaign to educate every
pregnant woman the benefits of a full term delivery.
- Hung “Go the Full 40” posters in every room both inside the
hospital and in each physician clinic
How have our patients benefited from the improvements Care?
- 18% increase in Favorable Induction Rate for first time pregnancies
- 54% increase in percent of Bishop Score > 8
- 3% reduction in C-Section Rate
- 4% reduction in use of cervical ripening agents
- 18% reduction in cost of vaginal and cesarean deliveries