A statewide initiative to reduce inappropriate scheduled births at 360/7–386/7 weeks' gestation

Abstract

We sought to reduce scheduled births between 36(0/7)-38(6/7) weeks that lack appropriate medical indication. Twenty Ohio maternity hospitals collected baseline data for 60 days and then selected locally appropriate Institute for Healthcare Improvement Breakthrough Series interventions to reduce the incidence of scheduled births. Deidentified birth data were analyzed centrally. Rates of scheduled births without a documented indication, birth certificate data, and implementation issues were shared regularly among sites. The rate of scheduled births between 36(0/7)-38(6/7) weeks without a documented medical indication declined from 25% to <5% (P < .05) in participating hospitals. Birth certificate data showed inductions without an indication declined from a mean of 13% to 8% (P < .0027). Dating criteria were documented in 99% of charts. A statewide quality collaborative was associated with fewer scheduled births lacking a documented medical indication. Copyright 2010 Mosby, Inc. All rights reserved.