Maternal Quality Improvement Program

Blog post by Ella Clark, Lamaze Family Center intern

ACOG and ASA Team Up to Create a Maternal Quality Improvement Program

                                       

The American Congress of Obstetricians and Gynecologists (ACOG), and the American Society of Anesthesiologists (ASA) are currently working together to create a unified system of reporting and measuring the results of maternity care in the United States, which will be known as the Maternal Quality Improvement Program.  By tracking the quality and outcomes of care on a national level health officials hope this will encourage transparency among hospitals, and help researchers learn which medical practices result in the fewest medical complications for mothers and babies, which health officials hope will result in a raise in the standard of care across the country.  

A University of Rochester's research study published in the August issue of Health Affairs prompted an increased interest in the creation of a national reporting system.  According to the Rochester study, complications related to c-sections performed in hospitals which were considered low performing happened at five times the rate of hospitals that were considered high performing.  For mothers who delivered vaginally, complications in hospitals that were considered low performing happened at twice the rate of hospitals that were considered high performing.   Though most of the complications mentioned in the Rochester study were not considered life threatening, it is important to note that a steep divide in the outcomes of maternal care still exists between hospitals, a divide that the Maternal Quality Improvement Program hopes to gap.  As ACOG pointed out in a recent statement on the Rochester study, hard data proving that extreme difference in care exists between hospitals proves the value of creating resources such as the Maternal Quality Improvement Program.  

Currently, the Michigan Health and Hospital Association (MHA) Keystone Center is working together with participating Michigan hospitals to create an environment of transparency and accountability for hospitals in our state.  Each hospital involved with the MHA Keystone project makes use of evidence-based practices which has resulted in lower rates of early elective birth as well as lower rates of neonatal ICU admissions.  The MHA Keystone website provides information on how to select a hospital that’s right for you, and includes information on how your hospital’s performance compares to that of other participating Michigan hospitals, as well as select hospitals nationwide.  

Though a comprehensive national hospital reporting program does not currently exist, people expecting a child and those supporting them can work independently to educate themselves about the care providers and birthing facilities in their area.  Taking a tour of local hospitals and birthing centers is one way of gathering information similar to what the Maternity Quality Improvement Program will provide in the future.  The Lamaze International site offers a few suggestions on the types of questions to ask during your tour:

-What supportive measures does the facility provide (ex: pain management, birthing balls, birthing tubs, doulas etc.)

-What interventions are considered routine

-What interventions are available

-What are the rates of specific interventions

-Does this facility support your birth philosophy

-What sort of breastfeeding support does the facility offer

For a more indepth look at hospital tours Lamaze International published a webinar on the subject.  Speaker Allison Walsh, a Lamaze Certified Childbirth Educator, Board Certified Lactation Consultant, and Manager of Parent Education and Lactation Services at Beth Israel Hospital New York discusses the importance of tours, the best questions to ask tour guides and how to communicate your needs to your care providers.