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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 33 Research Studies DisplayedZhong J, Simpson KR, Spetz J
Linking patient safety climate with missed nursing care in labor and delivery units: findings from the LaborRNs Survey.
The objective of this study was to explore the association of nurses' perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units. Nurse respondents were recruited via email distribution of an electronic survey; hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data. Measures included the Safety Attitudes Questionnaire Safety Climate Subscale and the Perinatal Missed Care Survey. The results suggested that improving safety climate through means such as better teamwork and communication may improve nursing care quality during labor and birth through decreasing missed nursing care. Strategies to reduce missed care may also conversely improve the safety climate.
AHRQ-funded; HS025715.
Citation: Zhong J, Simpson KR, Spetz J .
Linking patient safety climate with missed nursing care in labor and delivery units: findings from the LaborRNs Survey.
J Patient Saf 2023 Apr 1;19(3):166-72. doi: 10.1097/pts.0000000000001106.
Keywords: Maternal Care, Pregnancy, Labor and Delivery, Nursing, Patient Safety, Provider: Nurse
Pineles BL, Harris AD, Goodman KE
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
This study compared adverse maternal and delivery outcomes of pregnant 10- to 13-year-olds vs 14- to 17-year-olds and 18- to 19-year-olds. This cross-sectional study looked at all patients aged 10 to 19 years who delivered at hospitals in the Premier Healthcare Database from January 2019 through May 2021. The study included 90,876 deliveries across 655 US hospitals. Controlling for patient race and ethnicity, insurance type, and obesity status: 10- to 13-year-olds had significantly higher risks of preterm delivery and cesarean delivery compared with 14- to 17-year-olds. The risk of preeclampsia was not higher for 10- to 13-year-olds compared to 14- to 17-year-olds. There was a higher risk of preterm delivery for 10- to 13-year-olds compared to 18- to 19-year-olds, but not significantly different for cesarean delivery and preeclampsia.
AHRQ-funded; HS028363.
Citation: Pineles BL, Harris AD, Goodman KE .
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
JAMA 2022 Nov 1;328(17):1766-68. doi: 10.1001/jama.2022.18340..
Keywords: Children/Adolescents, Pregnancy, Labor and Delivery, Women, Outcomes, Adverse Events, Maternal Care
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Associations between state-level severe maternal morbidity and other perinatal indicators.
This study used the HCUP State Inpatient Databases (HCUP-SID) to determine the correlation between state-level severe maternal morbidity (SMM) rates and perinatal indicators. HCUP-SID was analyzed from 2017 to 2019 using revised code sets for 20 indicators excluding blood transfusions. Perinatal indicators used included prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, infant mortality, and maternal mortality. HCUP-SID data for 10,542,942 maternal deliveries and 11,394,752 live births from the National Vital Statistics System (NVSS) were aggregated for state-level analysis. SMM rates were significantly correlated with 2 of the 7 perinatal indicators: prepregnancy hypertension and low-risk cesarean deliveries. All other perinatal indicators were significantly associated with at least 4 of 7 other indicators, and most correlations were higher in magnitude. Maternity mortality rates were highest in the southeast.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Associations between state-level severe maternal morbidity and other perinatal indicators.
JAMA Netw Open 2022 Jul;5(7):e2224621. doi: 10.1001/jamanetworkopen.2022.24621..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
This study evaluated national and state trends in severe maternal morbidity (SMM) rates from 2012 to 2019, and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015. This repeated cross-sectional analysis examined delivery hospitalizations in the HCUP’s National Inpatient Sample and State Inpatient Databases. There were almost 6 million delivery hospitalizations in the national sample representing a weighted total of 29.8 million deliveries with a mean maternal age of 28.6 years. SMM rates increased from 69.5 per 10,000 deliveries to 79.7 per 10,000 in 2019 without a significant change across the ICD-10-CM/PCS transition. OF 20 SMM indicators, rates for 10 indicators increased while 3 significantly decreased with 5 of those changes associated with the ICD-10-CM/PCS transition. Acute kidney failure had the largest increase, from 6.4 to 15.3 per 10,000 delivery hospitalizations, with no change associated with ICD transition. Disseminated intravascular coagulation had the largest decrease from 31.3 to 21.2 per 10,000, with a significant drop associated with ICD transition. State SMM rates significantly decreased for 1 state and significantly increased for 21 states from 2012 to 2019 and with varying associations with ICD transition.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
JAMA Netw Open 2022 Jul;5(7):e2222966. doi: 10.1001/jamanetworkopen.2022.22966..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Dude AM, Schueler K, Schumm LP
Preconception care and severe maternal morbidity in the United States.
This study’s objective was to measure the association between preconception care and the odds of severe maternal morbidity among women with Medicaid using a secondary analysis of Medicaid claims using Medicaid Analytic Extract files. Findings showed that contraceptive services in the year before conception and routine exams for women with chronic disease were associated with decreased odds of severe maternal morbidity or death for Medicaid enrollees.
AHRQ-funded; HS027027.
Citation: Dude AM, Schueler K, Schumm LP .
Preconception care and severe maternal morbidity in the United States.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100549. doi: 10.1016/j.ajogmf.2021.100549..
Keywords: Maternal Care, Pregnancy, Women, Labor and Delivery, Sexual Health
Lyndon A, Simpson KR, Spetz J
Psychometric properties of The Perinatal Missed Care Survey and missed care during labor and birth.
The purpose of this study was to confirm reliability and validity of the Perinatal Missed Care Survey in a large sample of nurses and hospitals, test construct validity with confirmatory factor analysis, and describe the prevalence of missed nursing care during labor and birth. The study found the survey to be a valid and reliable adaptation of the original MISSCARE instrument. This survey could potentially be used to measure nursing care quality and to assess the effectiveness of structural interventions to improve quality and safety.
AHRQ-funded; HS025715.
Citation: Lyndon A, Simpson KR, Spetz J .
Psychometric properties of The Perinatal Missed Care Survey and missed care during labor and birth.
Appl Nurs Res 2022 Feb;63:151516. doi: 10.1016/j.apnr.2021.151516..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women
Admon LK, Dalton VK, Kolenic GE
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
This study analyzed data from 2016 to 2017 on delivery-related, early, and late postpartum severe maternal morbidity (SMM) among individuals with commercial insurance by race and ethnicity and perinatal mood and anxiety disorder (PMAD) status. This cross-sectional study of deidentified claims data from the Optum Clinformatics Data Mart evaluated rates of SMM during 3 pregnancy periods among individuals aged 15 to 44 years. The study sample comprised of 100,982 individuals with a mean age of 31.6 years. SMM rates were compared for pregnancies with and without complications, with blood transfusions being the number one indicator for pregnancy and postpartum periods with SMM. Rates of SMM with and without blood transfusion varied by race and ethnicity and PMAD status. Higher rates of SMM were identified among Black individuals compared with White individuals for the pregnancy, early postpartum, and late postpartum periods, respectively. Higher rates of blood transfusion were also identified in each of the 3 periods among individuals with PMADs compared to individuals without PMADs.
AHRQ-funded; HS027640.
Citation: Admon LK, Dalton VK, Kolenic GE .
Comparison of delivery-related, early and late postpartum severe maternal morbidity among individuals with commercial insurance in the US, 2016 to 2017.
JAMA Netw Open 2021 Dec;4(12):e2137716. doi: 10.1001/jamanetworkopen.2021.37716..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Pregnancy, Health Insurance, Racial and Ethnic Minorities, Anxiety
Biel F, Darney B, Caughey A
Medical indications for primary cesarean delivery in women with and without disabilities.
The purpose of this study was to examine the associations between maternal disability status and type, mode of delivery, and medical indications for cesarean delivery in California deliveries. Findings showed that women with disabilities were less likely to labor, and these unlabored cesarean deliveries were less likely to have a medical indication for cesarean, compared to women without disabilities.
AHRQ-funded; HS022981.
Citation: Biel F, Darney B, Caughey A .
Medical indications for primary cesarean delivery in women with and without disabilities.
J Matern Fetal Neonatal Med 2020 Oct;33(20):3391-98. doi: 10.1080/14767058.2019.1572740..
Keywords: Labor and Delivery, Pregnancy, Disabilities, Women, Maternal Care
Simpson KR, Lyndon A, Spetz J
Missed nursing care during labor and birth and exclusive breast milk feeding during hospitalization for childbirth.
The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. The investigators indicate that the results support exclusive breast milk feeding as a nurse-sensitive quality indicator.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Missed nursing care during labor and birth and exclusive breast milk feeding during hospitalization for childbirth.
MCN Am J Matern Child Nurs 2020 Sep/Oct;45(5):280-88. doi: 10.1097/nmc.0000000000000644..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Breast Feeding, Inpatient Care, Nursing, Women
Malhamé I, Mehta N, Raker CA
Identifying cardiovascular severe maternal morbidity in epidemiologic studies.
This study’s goal was to identify cases of cardiovascular severe maternal morbidity (CSMM) for use in epidemiologic studies. CSMM has become the leading cause of maternal mortality. The authors analyzed delivery hospitalizations at an obstetric teaching hospital from 2007 to 2017. A subset of indicators developed by the CDC based on ICD codes were utilized to form the composite variable for CSMM. Two expert clinicians manually reviewed all qualifying events using a standardized tool to determine if they were true CSMM events. They also estimated the number of CSMM cases among delivery hospitalizations without qualifying ICD codes by manually reviewing all severe preeclampsia cases and a random sample of 1000 hospitalizations without severe preeclampsia. Among 91,355 delivery admissions, they captured 113 potential CSMM cases. Of those 65 (57.5%) were true CSMM cases. Indicators for acute myocardial infarction, cardiac arrest, and cardioversion had 100% true-positive rates. An additional 70 CSMM cases in the 2102 admissions with severe preeclampsia were found.
AHRQ-funded; HS025013.
Citation: Malhamé I, Mehta N, Raker CA .
Identifying cardiovascular severe maternal morbidity in epidemiologic studies.
Paediatr Perinat Epidemiol 2020 Jul;34(4):452-59. doi: 10.1111/ppe.12571..
Keywords: Cardiovascular Conditions, Pregnancy, Women, Maternal Care, Labor and Delivery
Dombrowski M, Illuzzi JL, Reddy UM
Trial of labor after two prior cesarean deliveries: patient and hospital characteristics and birth outcomes.
This study’s goal was to examine utilization, success rate, and maternal and neonatal outcomes of trial of labor among women with two prior cesarean deliveries. Linked hospital discharge and birth certificate data were used for a retrospective analyses of a cohort of women in California with nonanomalous, term, singleton live births, two prior cesarean deliveries, and no clear contraindications for trial of labor. Findings showed that, among women with two prior cesarean deliveries, trial of labor was rarely attempted and was successful in 39.4% of attempts. Trial of labor in this population was associated with a modest increase in severe neonatal morbidity.
AHRQ-funded; HS023801.
Citation: Dombrowski M, Illuzzi JL, Reddy UM .
Trial of labor after two prior cesarean deliveries: patient and hospital characteristics and birth outcomes.
Obstet Gynecol 2020 Jul;136(1):109-17. doi: 10.1097/aog.0000000000003845.
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Keywords: Labor and Delivery, Pregnancy, Women, Maternal Care, Outcomes
Sherman JP, Hedli LC, Kristensen-Cabrera AI
Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth.
There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. In this study, the investigators employed design thinking methodology to understand how the design of labor and delivery units impacted safety and identified spaces and systems where improvements are needed.
AHRQ-funded; HS023506.
Citation: Sherman JP, Hedli LC, Kristensen-Cabrera AI .
Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth.
Am J Perinatol 2020 May;37(6):638-46. doi: 10.1055/s-0039-1685494..
Keywords: Labor and Delivery, Pregnancy, Patient Safety, Maternal Care, Women, Newborns/Infants
Guglielminotti J, Rosenberg H, Li G
Prevalence of malignant hyperthermia diagnosis in obstetric patients in the United States, 2003 to 2014.
The goal of this study was to assess the prevalence of malignant hyperthermia (MH) diagnosis and associated factors in obstetric patients. Using data from the Nationwide Inpatient Sample, results showed that the prevalence of MH-susceptibility is about 1 in 125,000 in cesarean deliveries, similar to the prevalence reported in non-obstetrical surgery inpatients. The findings of this study suggest that stocking dantrolene in maternity units is justified.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Rosenberg H, Li G .
Prevalence of malignant hyperthermia diagnosis in obstetric patients in the United States, 2003 to 2014.
BMC Anesthesiol 2020 Jan 20;20(1):19. doi: 10.1186/s12871-020-0934-0..
Keywords: Healthcare Cost and Utilization Project (HCUP), Pregnancy, Maternal Care, Women, Diagnostic Safety and Quality, Labor and Delivery
Lundsberg LS, Main EK, Lee HC
Low-interventional approaches to intrapartum care: hospital variation in practice and associated factors.
This study compared hospitals in California with low and high-interventional practices for labor and delivery. A total of 185 California hospitals completed a survey of intrapartum care, including questions on low- versus high-interventional practices. They identified 2 distinct groups of hospitals that tended to use low- or high-interventional practices. Hospitals that used low-interventional practices tended to have midwife-led or physician-midwife collaborative labor management or were in rural locations. High-interventional practice hospitals had a higher proportion of women covered by Medicaid or other safety-net programs as well as hospitals located in counties with higher liability insurance premiums. Both sets of hospitals had comparable morbidity rates but low-intervention hospitals had lower rates of cesarean birth and episiotomies. Only one-quarter of hospitals were found to use low-interventional practices.
AHRQ-funded; HS023801.
Citation: Lundsberg LS, Main EK, Lee HC .
Low-interventional approaches to intrapartum care: hospital variation in practice and associated factors.
J Midwifery Womens Health 2020 Jan;65(1):33-44. doi: 10.1111/jmwh.13017..
Keywords: Labor and Delivery, Pregnancy, Women, Maternal Care, Hospitals, Quality of Care
Carlson NS, Breman R, Neal JL
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
The primary goal of this study was to examine associations between midwifery unit-level presence and unplanned cesarean birth in women with different body mass index (BMI) ranges. Data from the Consortium on Safe Labor was used to analyze information on low-risk, healthy women who labored and gave birth in medical centers with or without the unit-level presence of midwives. Results indicate that the odds of unplanned cesarean birth among women who gave birth in centers with midwives were 16% lower than the odds of cesarean birth among similar women who gave birth at centers without midwives. However, women whose BMI was above 35.00 kg/m at labor admission had similar odds of cesarean birth, regardless of unit-level midwifery presence. Although integration of midwives into the caregiving environment of medical centers in the United States was associated with overall decrease in the incidence of cesarean birth, increased maternal BMI nevertheless remained positively associated with these outcomes.
AHRQ-funded; HS024733
Citation: Carlson NS, Breman R, Neal JL .
Preventing cesarean birth in women with obesity: influence of unit-level midwifery presence on use of cesarean among women in the Consortium on Safe Labor data set.
J Midwifery Womens Health 2020 Jan;65(1):22-32. doi: 10.1111/jmwh.13022..
Keywords: Labor and Delivery, Pregnancy, Obesity, Women, Prevention, Maternal Care
Neal JL, Carlson NS, Phillippi JC
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
This study compared labor care and birth outcomes between medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). A retrospective cohort study was conducted using Consortium on Safe labor data from low-risk nulliparous women who birthed in interprofessional (7393) or noninterprofessional (6982). Women at interprofessional medical centers were 74% less likely to undergo labor induction and 75% less likely to have oxytocin augmentation. In addition, the cesarean rate was 12% lower.
AHRQ-funded; HS024733.
Citation: Neal JL, Carlson NS, Phillippi JC .
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
Birth 2019 Nov 11;46(3):475-86. doi: 10.1111/birt.12407..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women, Outcomes
Lewkowitz AK, Rosenbloom JI, Keller M
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
This study analyzed whether women experiencing a stillbirth had a higher risk of psychiatric morbidity and/or substance misuse within 1 year of delivery compared to women having a live birth. Higher risk was found for both using data from the Florida State Inpatient and State Emergency Department databases from 2005-2014. Women with an ICD-9 classification of stillbirth at or greater than 23 weeks gestation were included. Emergency department encounters or admissions with a diagnosis code of a psychiatric disorder were used.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI, Keller M .
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
Am J Obstet Gynecol 2019 Nov;221(5):491.e1-91.e22. doi: 10.1016/j.ajog.2019.06.027..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Behavioral Health, Women, Labor and Delivery
Carlson NS, Neal JL, Tilden EL
Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: a Consortium on Safe Labor study.
The authors analyzed the association between midwifery presence in maternity care teams and the birth processes and outcomes of low-risk parous women. They found that parous women have significantly higher rates of vaginal birth, including vaginal birth after cesarean, and a lower likelihood of labor induction when cared for in centers with midwives. They concluded that their findings support integrated, team-based models of perinatal care to improve maternal outcomes.
AHRQ-funded; HS024733.
Citation: Carlson NS, Neal JL, Tilden EL .
Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: a Consortium on Safe Labor study.
Birth 2019 Sep;46(3):487-99. doi: 10.1111/birt.12405..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women, Outcomes
Simpson KR, Lyndon A, Spetz J
Adaptation of the MISSCARE Survey to the maternity care setting.
This paper examines the feasibility of using the Missed Nursing Care (MISSCARE) Survey to study missed nursing care during labor and delivery. This survey has not been used to examine childbirth care although it is the most common reason for hospitalization in the United States. A modified version called the Perinatal Missed Care Survey appears to be the most feasible and promising instrument to evaluate missed nursing care during labor and delivery.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adaptation of the MISSCARE Survey to the maternity care setting.
J Obstet Gynecol Neonatal Nurs 2019 Jul;48(4):456-67. doi: 10.1016/j.jogn.2019.05.005..
Keywords: Labor and Delivery, Maternal Care, Nursing, Pregnancy, Women
Triebwasser JE, Kamdar NS, Langen ES
Hospital contribution to variation in rates of vaginal birth after cesarean.
The purpose of this retrospective cohort study was to determine the influence of delivery hospital on the rate of vaginal birth after cesarean (VBAC). Claims data were obtained from Blue Cross and Blue Shield of Michigan and included women with a prior cesarean and a singleton live birth. Hospital-specific risk-standardized VBAC rates and the median odds ratio as a measure of variation were calculated. From their results, the authors conclude that the individual delivery hospital contributes to the significant variation in rates of VBAC, after adjustment for patient and hospital characteristics.
AHRQ-funded; HS025465.
Citation: Triebwasser JE, Kamdar NS, Langen ES .
Hospital contribution to variation in rates of vaginal birth after cesarean.
J Perinatol 2019 Jul;39(7):904-10. doi: 10.1038/s41372-019-0373-2..
Keywords: Hospitals, Labor and Delivery, Maternal Care, Pregnancy, Women
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G .
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women
Vanderlaan J, Rochat R, Williams B
Associations between hospital maternal service level and delivery outcomes.
This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. The investigators concluded that for the group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Rochat R, Williams B .
Associations between hospital maternal service level and delivery outcomes.
Womens Health Issues 2019 May - Jun;29(3):252-58. doi: 10.1016/j.whi.2019.02.004..
Keywords: Maternal Care, Labor and Delivery, Pregnancy, Women, Outcomes, Hospitals, Quality of Care, Newborns/Infants, Mortality
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Gourevitch RA, Mehrotra A, Galvin G
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
This study examined whether pregnant women who use cesarean delivery rate data from hospitals influences their choice of obstetric hospital. A randomized controlled trial of 18,293 users of the Ovia Health mobile app from 2016-2017 was conducted. Enrollees were given an explanation of the cesarean rate data and were randomized to an intervention group who also were given an interactive tool to display data for the 10 closest hospitals with obstetric services. There was no significant difference between the intervention and control groups in their hospital selection.
AHRQ-funded; HS000055.
Citation: Gourevitch RA, Mehrotra A, Galvin G .
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
Am J Manag Care 2019 Feb;25(2):e33-e38..
Keywords: Pregnancy, Women, Hospitals, Maternal Care, Labor and Delivery