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Washington State Perinatal Collaborative Update on Quality Improvement Initiatives Elective Deliveries 37-<39 wks Episiotomies Breast Milk Feeding Thomas Benedetti, MD, MHA University of Washington Medical Center Department of Obstetrics and Gynecology a nd Jean O’Leary, MPH , RD

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  • Thomas Benedetti, MD, MHA

  • University of Washington Medical Center

  • Department of Obstetrics and Gynecology

  • and

  • Jean O’Leary, MPH, RD

  • Nutrition Consultant

  • Washington State Department of Health

  • WIC Nutrition Program

  • November 19, 2013

  • Presented at Washington State Hospital Association Safe Table 11/19/2013


    90%reduction in Early Elective Deliveries between 37 to 39 weeks.

    $5 million in cost savings.

    Over1,900 fewerearly deliveries!


    Percentage of Hospitals Under 5% by Quarter

    Baseline: 16%

    Q1 2011: 35.5%

    Q2 2011: 44.4%

    Q3 2011: 51.2%

    Q4 2011: 54.9%

    Q1 2012: 69.5%

    Q2 2012: 66.7%

    Q3 2012: 69.1%

    Q4 2012: 88.5%

    Q1 2013: 88.2%





    Optimizing episiotomy rates review

    Optimizing Episiotomy Rates Review Table 11/19/2013

    Methods and Components 2012-2013

    • Statewide voluntary project

    • Regionally promoted by WSPC, WSHA-Partnership for Patients, PRN coordinators and physician champion

    • Measure: Episiotomy rate for spontaneous vaginal deliveries

    • (National Quality Forum-based Measure; excludes shoulder dystocia, forceps, vacuum)

    • Distribute baseline vs. blinded hospital peer 2011 data to hospitals (WSHA Nov 2012: data source CHARS)

    • Hospitals will validate baseline data

    • 2012-2013 Target rate < 5% (Note: target rate is Not 0%)

    • Quarterly 2012-2013 hospital rates provided by WSHA

    • Hospitals encouraged to track related episiotomy rate with instrument and third and fourth degree perineal lacerations

    Presented at Washington State Hospital Association Safe Table 11/19/2013







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