Thank you again for attending the HQI Conference Maternity
Session on Sunday, October 28. It was a privilege for HQI to have
the session led by an all-star panel of CMQCC’s Elliott Main and
Terri Deeds, UCSF’s Melissa Rosenstein, Providence St. Joseph
Health’s David LaGrew, and HQI’s own, Kim Werkmeister. This
session was made possible by the generous support and commitment
to maternity care from Blue Shield of California and the
California Health Care Foundation.
If you missed the session, there are several materials and
resources free for your staff and patients:
A 31 year-old Gravida 6 Para 5 (6 pregnancies, 5 births) at
40 weeks gestation arrived at her local hospital with ruptured
membranes and uterine contractions every 3-5 minutes. On exam by
the nurse, the mother was 5 cms dilated, 75 percent effaced,
cephalic presentation at -2 station. The amniotic fluid was clear
and the fetal heart tone tracing was Category I (normal). She
denied any significant health history or major surgeries,
including prior cesarean births.
Under the Healthy People 2020 initiative, hospitals are
encouraged to reduce rates of elective cesarean deliveries for
low-risk, first-time births to less than 23.9 percent. Since
2016, Smart
Care California has included hospitals that have achieved
that milestone on its hospital honor roll. The honor roll — a
collaborative effort among stakeholders that represent policy,
purchases, providers and quality improvement organizations — will
be announced the week of Oct. 22.
One of every eight babies born in the United States is born in
California. Of those births, three in 10 are delivered by
cesarean. Many California hospitals, big and small, have
instituted processes to maintain low cesarean delivery
rates.
HQI is offering registration scholarships for the 2017 HQI Annual
Conference to the 30 birthing hospitals
that participated in the Promoting Optimal NTSV Delivery
Rates (PONDR) survey. There are a total of 10 scholarships
available.
The HQI Annual Conference takes place on November 1-3 in
Monterey, CA. Details about the conference are available by
clicking
here.
Case: A 28-year old G1 P0 (first pregnancy, no prior births)
at 39 weeks is thought to have a large baby. The ultrasound
estimated fetal weight (EFW) is 9 lbs. The patient was considered
overweight with a BMI of 29 and the total weight gain during
pregnancy of 45 lbs. The patient’s glucose screen was
negative. The physician recommended a primary Cesarean delivery
because the baby was “big” and the mother will most likely
end up with a Cesarean regardless. At delivery the baby
weighted 7 pounds, 8 ounces.
The California Maternal Quality Care Collaborative (CMQCC) is
excited to announce the kick off of the 2017 statewide quality
improvement collaborative “Supporting Vaginal Birth and
Reducing Primary Cesareans.” Your hospital is invited
to participate in this initiative at no cost thanks to funding by
the California Health Care Foundation.
The American College of Obstetricians and Gynecologists
(ACOG) District IX is pleased to announce an opportunity for
hospitals in California to participate in a statewide quality
improvement project to Promote Vaginal Birth and Reduce
Primary Cesarean Births. The first 35 hospitals in the
state to sign up will receive their training at no
cost.
The Toolkit is a comprehensive, evidence-based “how-to” guide
designed to educate and motivate maternity clinicians to apply
best practices for supporting vaginal birth. Cesarean births
among low-risk, first-time mothers have been the largest
contributor to the recent rise in cesarean rates, and accounts
for the greatest variation in cesarean rates between
hospitals.
The Toolkit contains key strategies and resources to:
Secretary Diana Dooley of the California Health and Human
Services Agency recognized 104 hospitals with a 2016 award for
achieving the Healthy People 2020 goal for low-risk, first-birth
Cesarean sections (C-sections). These hospitals reached the goal
in 2015.
