Obstetric Patient Safety: An Overview

William A. Grobman

doi:10.1055/s-0031-1285828

American Journal of Perinatology, Table of Contents

Am J Perinatol 2012; 29(01): 03-06
DOI: 10.1055/s-0031-1285828

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

Obstetric Patient Safety: An Overview

William A. Grobman

¹Department of Obstetrics and Gynecology and the Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

› Author Affiliations

Abstract

Patient safety, defined as “the absence of the potential for, or the occurrence of, health care associated injury to the patient,” is a part of the larger concept of health care quality. Achieving safe patient care has become an increasing focus of the obstetric community, in part due to the realization of the number of preventable adverse events that occur as well as the pressures of the professional liability climate. Studies of obstetric care have revealed that multiple factors contribute to the occurrence of adverse obstetric events, although communication is one factor that consistently has been found to prominently contribute to these events. The data that exist also suggest that although most women who give birth on a labor and delivery unit do so without a significant safety incident, a notable minority does experience an event that may compromise their ability to achieve an optimal outcome.

Keywords

obstetrics - patient safety - health care quality - communication

Full Text

References

References
1 Lohr KN, Schroeder SA. A strategy for quality assurance in Medicare. N Engl J Med 1990; 322: 707-712
2 Institute of Medicine. To Err Is Human: Building a Safer Health Care System. Washington, DC: : National Academy Press; ; 1999
3 DeFrances C, Hall M, Podgornik M. 2003 National Hospital Discharge Survey. Advance Data from Vital and Health Statistics; No. 359. Hyattsville, MD: : National Center for Health Statistics; 2005
4 Studdert DM, Mello MM, Sage WM , et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 2005; 293: 2609-2617
5 Yang YT, Mello MM, Subramanian SV, Studdert DM. Relationship between malpractice litigation pressure and rates of cesarean section and vaginal birth after cesarean section. Med Care 2009; 47: 234-242
6 Murthy K, Grobman WA, Lee TA, Holl JL. Obstetricians' rising liability insurance premiums and inductions at late preterm gestations. Med Care 2009; 47: 425-430
7 Joint Commission on Accreditation of Healthcare Organizations. Sentinel Event Alert. Joint Commission on Accreditation of Healthcare Organizations, Issue No. 30. Oak Brook, IL: The Joint Commission, 2004.
8 Geller SE, Rosenberg D, Cox SM , et al. The continuum of maternal morbidity and mortality: factors associated with severity. Am J Obstet Gynecol 2004; 191: 939-944
9 Berg CJ, Harper MA, Atkinson SM , et al. Preventability of pregnancy-related deaths: results of a state-wide review. Obstet Gynecol 2005; 106: 1228-1234
10 White AA, Pichert JW, Bledsoe SH, Irwin C, Entman SS. Cause and effect analysis of closed claims in obstetrics and gynecology. Obstet Gynecol 2005; 105 (5 Pt 1) 1031-1038
11 Hoff T, Jameson L, Hannan E, Flink E. A review of the literature examining linkages between organizational factors, medical errors, and patient safety. Med Care Res Rev 2004; 61: 3-37
12 Forster AJ, Fung I, Caughey S , et al. Adverse events detected by clinical surveillance on an obstetric service. Obstet Gynecol 2006; 108: 1073-1083
13 Clark SL, Belfort MA, Dildy GA, Meyers JA. Reducing obstetric litigation through alterations in practice patterns. Obstet Gynecol 2008; 112: 1279-1283