Publications by authors named "Cheryl Raab"

Article Synopsis
  • A formal review process for severe maternal morbidity (SMM) was established at Yale-New Haven Hospital, analyzing cases over a 4-year period.
  • Out of 156 SMM cases, the SMM rate was found to be 0.49%, with leading causes being hemorrhage (44.9%) and nonintrauterine infection (14.1%).
  • Two-thirds of the cases were considered preventable, primarily due to issues linked to healthcare professionals (79.4%) and systemic factors (58.8%), prompting changes to improve care practices.
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Article Synopsis
  • The study investigates the impact of updated guidelines on labor arrest and failed induction on the rates of primary cesarean deliveries in a large academic medical center between 2010 and 2013.
  • Results showed a decrease in overall primary cesarean delivery rates from 23.5% to 21.1%, with a significant drop in cesarean deliveries attributed to labor arrest and failed induction.
  • Despite some improvements, 65.2% of cesarean deliveries at the end of the study still did not meet the updated guidelines for labor arrest, highlighting ongoing issues in adherence to these criteria.
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Article Synopsis
  • The study aimed to identify factors related to a decline in primary cesarean delivery rates at an academic medical center between 2009 and 2013, focusing on physician-documented indications for cesarean deliveries.
  • The cesarean delivery rate decreased from 36.5% to 31.4%, with 74% of this decline due to fewer primary cesarean births, primarily influenced by reductions in cases of labor arrest, abnormal fetal heart rates, and preeclampsia.
  • The findings suggest that changes in how labor arrest and fetal monitoring were defined and approached at the institution significantly impacted the rates of cesarean deliveries.
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Objectives: We sought to report the frequency of, circumstances surrounding, and outcomes of newborn falls in our hospital. We evaluated the impact of specific interventions on the frequency of newborn falls and the time between falls.

Methods: We performed a retrospective study of newborn falls reported on our postpartum unit over a 13-year period.

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Objectives: Complete and accurate documentation by the delivering provider in cases of shoulder dystocia is critical for providing clinical information and care to the patient and protecting providers from litigation risks. Standardized forms improve inclusion of certain data elements in the medical record, but the impact on subsequent narrative notes is unknown. We aimed to determine if implementation of a standardized shoulder dystocia documentation form improves obstetric provider written narrative delivery notes.

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Begun in 2003, the Yale-New Haven Hospital comprehensive obstetric safety program consisted of measures to standardize care, improve teamwork and communication, and optimize oversight and quality review. Prior publications have demonstrated improvements in adverse outcomes and safety culture associated with this program. In this analysis, we aimed to assess the impact of this program on liability claims and payments at a single institution.

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Objective: Visual estimation of blood loss is often inaccurate and imprecise. Obstetric bleeding requires expedient identification and intervention to prevent maternal morbidity and mortality. We aimed to create a visual aid to improve accuracy of estimated obstetric blood loss.

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Interprofessional collaboration is critical to the provision of safe patient care and provider satisfaction. Collaboration is an active process that can help maximize positive patient outcomes. Three academic institutions implemented collaborative processes as part of their perinatal patient safety initiatives based on anecdotal experiences and safety culture surveys that demonstrated positive outcomes.

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There is increased attention to the issue of patient safety in the care of pregnant women and their infants. The Joint Commission has issued sentinel event alerts regarding infant and maternal morbidity and mortality. Hospitals and healthcare systems are implementing perinatal patient safety programs to minimize the risk of preventable patient harm.

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Objective: The purpose of this study was to determine the effect of an obstetrics patient safety program on staff safety culture.

Study Design: We implemented (1) obstetrics patient safety nurse, (2) protocol-based standardization of practice, (3) crew resource management training, (4) oversight by a patient safety committee, (5) 24-hour obstetrics hospitalist, and (6) an anonymous event reporting system. We administered the Safety Attitude Questionnaire on 4 occasions over 5 years (2004-2009) to all staff members that assessed teamwork and safety cultures, job satisfaction, working conditions, stress recognition, and perceptions of management.

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Objective: We implemented a comprehensive strategy to track and reduce adverse events.

Study Design: We incrementally introduced multiple patient safety interventions from September 2004 through November 2006 at a university-based obstetrics service. This initiative included outside expert review, protocol standardization, the creation of a patient safety nurse position and patient safety committee, and training in team skills and fetal heart monitoring interpretation.

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Medical malpractice premiums and costs of obstetric claims, settlements, and jury awards are at an all-time high. This article describes one professional liability company's initiative to promote safer perinatal care and decrease costs of claims, including the development of the perinatal patient safety nurse role. The primary responsibility of the perinatal patient safety nurse is to promote safe care for mothers and babies by keeping patient safety as a focus of all unit operations and clinical practices.

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