Promoting healthy outcomes is among the top priorities identified by the Maryland Department of Health and Mental Hygiene (DHMH) for improving healthcare in the state.
The Maryland Patient Safety Center (MPSC) "Perinatal Collaborative" began an initiative in 2007 to test, adopt, and implement evidence-based improvement strategies to improve patient safety in the labor and delivery units of 33 hospitals in Maryland and the District of Columbia. The state-wide program was managed by the Delmarva Foundation in partnership with DHMH. The Perinatal Collaborative worked with the participating hospitals to develop multidisciplinary teams to improve team communication, staff competency, the orientation and training process, and adequate fetal monitoring. Hospital teams participated in state-wide meetings to share their successes and "lessons learned" in improving patient safety at their facilities.
The MPSC contracted with NPIC/QAS, the data partner for this project, to analyze baseline and post-training data for participating hospitals. These data included the administrative data sets submitted to the Maryland Health Services Cost Review Commission (HSCRC) or District of Columbia Hospital Association (DCHA) along with supplemental files with a select number of perinatal variables. The data was processed, analyzed and reported on by NPIC/QAS using the Adverse Outcome Index (AOI) developed by the Harvard Risk Management Strategies Foundation Team Performance Plus (TPP™) program and the original principals at Beth Israel Deaconess Medical Center, Drs. Benjamin Sachs, Susan Mann, Ronald Marcus and Stephen Pratt.
Each participating hospital received comparative outcome data for the baseline period (the period prior to the initiation of the perinatal initiative), and ten follow-up AOI Quarterly Monitoring Reports for the post implementation period. The project received additional funding, analyzing data on discharges through Q1 2011. Reports profiled their count of adverse events, their Adverse Outcome Index (AOI), Weighted Adverse Outcome Score (WAOS) and Severity Index (SI) compared to a target benchmark. Each report displayed a 90% confidence interval around the hospital's quarterly rate, as well as an analysis to determine if there was a statistically significant change from baseline to follow-up. In addition to hospital specific reports, aggregate data summary reports were provided to the project’s Planning Committee and NPIC/QAS staff participated in writing a report summarizing the success of the teams’ efforts and the project as a whole.
» "Improving Culture and Team Work: Maryland Perinatal Collaborative" (May 2010)
» "Supporting Culture and Team Work: Perinatal Collaborative" (December 2007)