Preventing Maternal Morbidity from Obstetric Hemorrhage: Implications of a Provider Training Initiative

Michelle Kominiarek*, Shirley Scott, Abigail R. Koch, Maripat Zeschke, Yvette Cordova, Samadh F. Ravangard, Deborah Schy, Stacie E. Geller

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage. Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related. Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010. Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalAmerican Journal of Perinatology
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Obstetrics
Mothers
Hemorrhage
Morbidity
Intensive Care Units
Therapeutics

Keywords

  • hemorrhage
  • maternal morbidity
  • provider education
  • provider training

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Kominiarek, Michelle ; Scott, Shirley ; Koch, Abigail R. ; Zeschke, Maripat ; Cordova, Yvette ; Ravangard, Samadh F. ; Schy, Deborah ; Geller, Stacie E. / Preventing Maternal Morbidity from Obstetric Hemorrhage : Implications of a Provider Training Initiative. In: American Journal of Perinatology. 2017 ; Vol. 34, No. 1. pp. 74-79.
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Preventing Maternal Morbidity from Obstetric Hemorrhage : Implications of a Provider Training Initiative. / Kominiarek, Michelle; Scott, Shirley; Koch, Abigail R.; Zeschke, Maripat; Cordova, Yvette; Ravangard, Samadh F.; Schy, Deborah; Geller, Stacie E.

In: American Journal of Perinatology, Vol. 34, No. 1, 01.01.2017, p. 74-79.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preventing Maternal Morbidity from Obstetric Hemorrhage

T2 - Implications of a Provider Training Initiative

AU - Kominiarek, Michelle

AU - Scott, Shirley

AU - Koch, Abigail R.

AU - Zeschke, Maripat

AU - Cordova, Yvette

AU - Ravangard, Samadh F.

AU - Schy, Deborah

AU - Geller, Stacie E.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage. Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related. Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010. Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative.

AB - Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage. Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related. Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010. Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative.

KW - hemorrhage

KW - maternal morbidity

KW - provider education

KW - provider training

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