Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.

Background: The Safety Program for Perinatal Care (SPPC) seeks to improve safety on labor and delivery (L&D) units through three mutually reinforcing components: (1) fostering a culture of teamwork and communication, (2) applying safety science principles to care processes; and (3) in situ simulation. The objective of this study was to describe the SPPC implementation experience and evaluate the short-term impact on unit patient safety culture, processes, and adverse events.

Methods: We supported SPPC implementation by L&D units with a program toolkit, trainings, and technical assistance.

Integrated Approach to Reduce Perinatal Adverse Events: Standardized Processes, Interdisciplinary Teamwork Training, and Performance Feedback.

Objective: To improve safety practices and reduce adverse events in perinatal units of acute care hospitals.

Data Sources: Primary data collected from perinatal units of 14 hospitals participating in the intervention between 2008 and 2012. Baseline secondary data collected from the same hospitals between 2006 and 2007.

Decreasing Malpractice Claims by Reducing Preventable Perinatal Harm.

Objective: To evaluate the association of improved patient safety practices with medical malpractice claims and costs in the perinatal units of acute care hospitals.

Data Sources: Malpractice and harm data from participating hospitals; litigation records and medical malpractice claims data from American Excess Insurance Exchange, RRG, whose data are managed by Premier Insurance Management Services, Inc. (owned by Premier Inc.

A perinatal care quality and safety initiative: are there financial rewards for improved quality?

Background: Although costs of providing care may decrease with hospital initiatives to improve obstetric and neonatal outcomes, the accompanying reduced adverse outcomes may negatively affect hospital revenues.

Methods: In 2008 a Minnesota-based hospital system (Fairview Health Services) launched the Zero Birth Injury (ZBI) initiative, which used evidence-based care bundles to guide management of obstetric services. A pre-post analysis of financial impacts of ZBI was conducted by using hospital administrative records to measure costs and revenues associated with changes in maternal and neonatal birth injuries before (2008) and after (2009-2011) the initiative.

A model for developing high-reliability teams.

Aim: To develop a model for high reliability in health care quality and patient safety.

Background: A high-reliability health organization (HRO) has measurable near perfect performance in quality and safety. High reliability is necessary in health care where the consequences of error are high and the frequency is low.

In situ simulation: a method of experiential learning to promote safety and team behavior.

The healthcare system has an inconsistent record of ensuring patient safety. One of the main factors contributing to this poor record is inadequate interdisciplinary team behavior. This article describes in situ simulation and its 4 components--briefing, simulation, debriefing, and follow-up-as an effective interdisciplinary team training strategy to improve perinatal safety.