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 Medical Center, 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 Medical Center 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