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Perinatal Collaborative Stories


Upper Chesapeake Medical Center

Upper Chesapeake Medical Center has focused on improving and strengthening communication and accountability among all team members, with powerful results, according to Nancy Howard, MS, RN, Project Coordinator, Performance Improvement,  who related an event concerning a communication between a nurse and physician regarding a post-partum patient. The nurse contacted the physician to provide a report on a change in condition of a patient whom the nurse believed to be at risk, and to request that the physician come in to personally evaluate the patient. The physician was initially hesitant, but the nurse persisted and eventually the physician agreed to come in to assess the patient. The patient ended up going to surgery for additional treatment and, as a result, had a positive outcome.

“This was in large part a result of our work with the Maryland Patient Safety Center Perinatal Collaborative. Through our participation, we have had many opportunities to work on team building and communication. Because of this, the nurse felt empowered to hold her ground. She knew that she had the support of her managers and other team members,” continued Howard. “Nurses feel that their input is valued and, as a result, communication is improved.  Improved communication and teamwork benefit both the mother and baby.”

Also largely resulting from participation in the Collaborative, Howard reported an “improved, more organized response to emergent situations. Through regular drill trainings, team members practice their responses and strengthen their teamwork. When a real situation arises, they are prepared to handle it,” said Howard.

Howard described the results thus far of enforcing the recommended 39-week minimum rule for inductions except in cases of medical necessity. “The policy was implemented a year ago and although not all providers embraced the policy there was acceptance of it.  As a result, there has been 100 percent compliance with this policy in the past seven months. Many practitioners actually appreciate the fact that this policy is now in writing. When patients ask, they can explain that this is hospital policy and is in the best interest of patient safety,” said Howard.

According to Howard and her team, one of the most valuable elements of participation in the Collaborative has been gaining access to experts who have gone down this road before.

“We were able to tap into three experts in the field, who actually came on site and presented data and other information on best practices to our team members,” said Howard. This helped put forth concepts that the Collaborative was promoting in a way that team members could embrace.

“These experts shared stories about how important changes resulted in positive outcomes for their own institutions, and this inspired our participants to become more interested in the project. It’s great to have the involvement of everyone on the team. Indeed, getting good results makes any change worth the effort,” said Howard.