TY - JOUR
T1 - Postpartum hemorrhage protocols and benchmarks
T2 - improving care through standardization
AU - Federspiel, Jerome J.
AU - Eke, Ahizechukwu C.
AU - Eppes, Catherine S.
N1 - Funding Information:
Overall support for this work was provided by the NCATS under award number TL1TR002555 and the NICHD of the NIH under the award number K23HD104517.
Funding Information:
J.J.F. is supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) under award number UL1TR002553. A.C.E. is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the NIH under award number K23HD104517. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/2
Y1 - 2023/2
N2 - Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Several state maternal morbidity and mortality committees have reviewed areas of opportunity concerning postpartum hemorrhage management and found that common patterns include delays in recognition and response to hemorrhage. Hospital systems and state perinatal quality collaboratives have found that comprehensive, interdisciplinary response to postpartum hemorrhage care improves patient outcomes and, in some instances, reduces racial disparities. A key component of this focus involves the implementation of stage-based hemorrhage protocols for postpartum hemorrhage management. Stage-based hemorrhage protocols are designed to reduce delays in the diagnosis and management and avoid the pitfalls of cognitive biases. These protocols are complex, and their effectiveness is tied to the quality of their implementation. Systematic benchmarking and development of quality metrics for adherence to postpartum hemorrhage bundles would be expected to improve clinical outcomes, but evidence regarding the effectiveness of this practice in the literature is limited. Here, key features of stage-based interventions and evidence regarding the use of quality metrics for postpartum hemorrhage protocol adherence have been outlined.
AB - Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Several state maternal morbidity and mortality committees have reviewed areas of opportunity concerning postpartum hemorrhage management and found that common patterns include delays in recognition and response to hemorrhage. Hospital systems and state perinatal quality collaboratives have found that comprehensive, interdisciplinary response to postpartum hemorrhage care improves patient outcomes and, in some instances, reduces racial disparities. A key component of this focus involves the implementation of stage-based hemorrhage protocols for postpartum hemorrhage management. Stage-based hemorrhage protocols are designed to reduce delays in the diagnosis and management and avoid the pitfalls of cognitive biases. These protocols are complex, and their effectiveness is tied to the quality of their implementation. Systematic benchmarking and development of quality metrics for adherence to postpartum hemorrhage bundles would be expected to improve clinical outcomes, but evidence regarding the effectiveness of this practice in the literature is limited. Here, key features of stage-based interventions and evidence regarding the use of quality metrics for postpartum hemorrhage protocol adherence have been outlined.
KW - maternal death
KW - obstetrical labor complications
KW - postpartum hemorrhage
KW - pregnancy
KW - quality improvement
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U2 - 10.1016/j.ajogmf.2022.100740
DO - 10.1016/j.ajogmf.2022.100740
M3 - Review article
C2 - 36058518
AN - SCOPUS:85147679716
SN - 2589-9333
VL - 5
JO - American journal of obstetrics & gynecology MFM
JF - American journal of obstetrics & gynecology MFM
IS - 2
M1 - 100740
ER -