Assessing patient autonomy in the context of TeamBirth, a quality improvement intervention to improve shared decision-making during labor and birth.

Background: Respectful maternity care includes shared decision-making (SDM). However, research on SDM is lacking from the intrapartum period and instruments to measure it have only recently been developed. TeamBirth is a quality improvement initiative that uses team huddles to improve SDM during labor and birth.

Understanding social needs in pregnancy: Prospective validation of a digital short-form screening tool and patient survey.

Background: Social determinants of health significantly affect health outcomes, yet are infrequently addressed in prenatal care.

Objective: This study aimed to improve the efficiency and experience of addressing social needs in pregnancy through: (1) testing a digital short-form screening tool; and (2) characterizing pregnant people's preferences for social needs screening and management.

Study Design: We developed a digital short-form social determinants of health screening tool from PRAPARE (Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences), and a survey to query patients' preferences for addressing social needs.

Impact of an educational program and decision tool on choice of maternity hospital: the delivery decisions randomized clinical trial.

Background: Reducing cesarean rates is a public health priority. To help pregnant people select hospitals with lower cesarean rates, numerous organizations publish publically hospital cesarean rate data. Few pregnant people use these data when deciding where to deliver.

Improving communication and teamwork during labor: A feasibility, acceptability, and safety study.

Background: TeamBirth was designed to promote best practices in shared decision making (SDM) among care teams for people giving birth. Although leading health organizations recommend SDM to address gaps in quality of care, these recommendations are not consistently implemented in labor and delivery.

Methods: We conducted a mixed-methods trial of TeamBirth among eligible laboring patients and all clinicians (nurses, midwives, and obstetricians) at four high-volume hospitals during April 2018 to September 2019.

Implementation strategies within a complex environment: A qualitative study of a shared decision-making intervention during childbirth.

Background: Shared decision-making (SDM) may improve communication, teamwork, patient experience, respectful maternity care, and safety during childbirth. Despite these benefits, SDM is not widely implemented, and strategies for implementing SDM interventions are not well described. We assessed the acceptability and feasibility of TeamBirth, an SDM solution that centers the birthing person in decision-making through simple tools that structure communication among the care team.

The design of "TeamBirth": A care process to improve communication and teamwork during labor.

Background: Despite evidence that communication and teamwork are critical to patient safety, few care processes have been intentionally designed for this purpose in labor and delivery. The purpose of this project was to design an intrapartum care process that aims to improve communication and teamwork between clinicians and patients.

Methods: We followed the "Double-Diamond" design method with four sequential steps: Discover, Define, Develop, and Deliver.

The Transformative Potential of Strategic Partnerships to Form a Health Equity Network of the Americas.

Health inequities across the Americas are avoidable and unjust yet continue to persist. Systemic social determinants of health, which could be addressed at the policy level, are root causes of many inequities and prevent marginalized individuals and at-risk populations from reaching optimal health and well-being. In this article, we describe our approach to promote health equity through the intersectoral partnerships that were forged, and strategies that were shared, during the convening entitled "Summit 2017: Health Equity in the Americas" and the resulting emergence of the Health Equity Network of the Americas (HENA).

Does comparing cesarean delivery rates influence women's choice of obstetric hospital?

Objectives: Despite public reporting of wide variation in hospital cesarean delivery rates, few women access this information when deciding where to deliver. We hypothesized that making cesarean delivery rate data more easily accessible and understandable would increase the likelihood of women selecting a hospital with a low cesarean delivery rate.

Study Design: We conducted a randomized controlled trial of 18,293 users of the Ovia Health mobile apps in 2016-2017.

An Exploratory Study of the Relationship between Facility Design and the Provision of Childbirth Care.

Introduction: Across health care, facility design has been shown to significantly affect quality of care; however, in maternity care, the mechanisms of how facility design affects provision of care are understudied. We aim to identify and illustrate key mechanisms that may explain how facility design helps or hinders clinicians in providing childbirth care.

Methods: We reviewed the literature to select design elements for inclusion.

Assessing the Feasibility of Measuring Variation in Facility Design Among American Childbirth Facilities.

Objective: To assess the feasibility of quantifying variation in childbirth facility design and explore the implications for childbirth service delivery across the United States.

Background: Design has been shown to impact quality of care in childbirth. However, most prior studies use qualitative data to examine associations between the design of patient rooms and patient experience.

Evaluating Community Partnerships Addressing Community Resilience in Los Angeles, California.

Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience in the Los Angeles Community Disaster Resilience project.

Common challenges managing bed and staff availability on labor and delivery units in the United States: A qualitative analysis.

Background: Managers of labor and delivery units need to ensure that their limited supply of beds and nursing staff are adequately available, despite uncertainty with respect to patient needs. The ability to address this challenge has been associated with patient outcomes; however, best practices have not been defined.

Methods: We conducted a secondary analysis of 96 interviews with nurse and physician managers from 48 labor and delivery units across the United States.

Building a National Culture of Health: Background, Action Framework, Measures, and Next Steps.

Because health is a function of more than medical care, solutions to U.S. health problems must encompass more than reforms to health care systems.