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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e255-e261
DOI: 10.1055/s-0040-1714713
Case Report

Implementation of a Postpartum Hemorrhage Safety Bundle at an Urban Safety-Net Hospital

Naima T. Joseph 
1   Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
,
Nikkia H. Worrell
2   Department of Quality, Grady Health System, Atlanta, Georgia
,
Janice Collins
3   Department of Obstetrics and Gynecology, Morehouse University School of Medicine, Atlanta, Georgia
,
Melanie Schmidt
4   Department of Pharmacy, Grady Health System, Atlanta, Georgia
,
Grace Sobers
5   Department of Nursing, Grady Health System, Atlanta, Georgia
,
Kathlyn Hutchins
5   Department of Nursing, Grady Health System, Atlanta, Georgia
,
E. Britton Chahine
6   Division of General Obstetrics and Gynecology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
,
Christine Faya
7   Department of Anesthesia, Emory University School of Medicine, Atlanta, Georgia
,
Luanne Lewis
8   Health Information Management, Grady Health System, Atlanta, Georgia
,
Victoria L. Green
6   Division of General Obstetrics and Gynecology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
,
Penny Z. Castellano
6   Division of General Obstetrics and Gynecology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
,
Michael K. Lindsay
1   Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
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Abstract

Background Postpartum hemorrhage (PPH) is a leading cause of preventable maternal morbidity and mortality. Standardized response to obstetric hemorrhage is associated with significant improvement in maternal outcomes, yet implementation can be challenging.

Objective The primary objective is to describe the methodology for program implementation of the Alliance for Innovation on Maternal Health Safety Bundle on PPH at an urban safety-net hospital.

Methods Over an 18-month period, interventions geared toward (1) risk assessment and stratification, (2) hemorrhage identification and management, (3) team communication and simulation, and (4) debriefs and case review were implemented. Hemorrhage risk assessment stratification rates were tracked overtime as an early measure of bundle compliance.

Results Hemorrhage risk assessment stratification rates improved to >90% during bundle implementation.

Conclusion Keys to implementation included multidisciplinary stakeholder commitment, stepwise and iterative approach, and parallel systems for monitoring and evaluation Implementation of a PPH safety bundle is feasible in a resource-constrained setting.

Keywords

postpartum hemorrhage - obstetric hemorrhage - safety-bundle - safety-net hospital


Publication History

Received: 01 December 2019

Accepted: 21 May 2020

Article published online:
02 September 2020

© .

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

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