Enhancing Maternal Healthcare Remains Crucial in the United States
In a comprehensive analysis of over 7 million safety events submitted by healthcare providers nationwide, ECRI and the ISMP PSO have identified recurring challenges in maternal health care. The findings, presented in a document titled 'Patient Safety Event Data Snapshot for Maternal Health,' highlight the importance of improved anticipation and preparedness for emergent changes in maternal health patients in all care settings.
The analysis revealed that almost half of the safety events involved unanticipated medical emergencies, such as hemorrhage, eclampsia, and shoulder dystocia. Communication and hand-off issues during patient transitions, underlying medical conditions, and delayed response were identified as the top contributing factors to maternal health-related patient safety events. The majority of these events occurred during the transition between labor and delivery and the operating room.
Transitions between providers or between healthcare settings in maternal care can present safety vulnerabilities if key patient information is missed, incorrect, or delayed. To address this, a comprehensive, patient-centered approach to care coordination and communication is paramount to ensure safe, accurate, and timely care transitions in maternal care.
Since 2009, ECRI has worked with federal partners to provide resources, education, and tools on obstetrics and maternal safety to all federally funded community health centers nationwide. The organization also conducted a safety sprint aimed at improving safe maternal care transitions, which included actionable tools to create improvement plans and track progress with a focus on data-driven and evidence-based best practices.
The data showed that no root causes were found in 42% of the Root Cause Analyses (RCAs), suggesting that organizations may view serious maternal safety events as unavoidable. This underscores the need for a systematic approach to address these challenges.
In recent years, there has been a concerning increase in maternal mortality rates in the United States. In 2024, there were 19 maternal deaths for every 100,000 live births, an increase from the previous year. The World Health Organization named the United States one of seven countries that experienced a significant rise in maternal mortality over the last two decades.
The theme for World Patient Safety Day 2021 was 'Safe care for every newborn and every child.' In line with this, ECRI has published a white paper on the safety and effectiveness of the COVID vaccine for pregnant women. The organization also offers tools and resources such as the Maternal Health Driver Diagram, Improvement Plan Template, and various insights on best practices for improving maternal care.
While specific healthcare providers facing significant challenges in maternal care safety are not publicly detailed, large hospital systems and maternal health networks have been identified as collaborating with ECRI and ISMP PSO to improve practice standards.
These findings suggest recurring challenges that healthcare leaders should take a systematic approach to address. By focusing on improved anticipation and preparedness, effective communication, and data-driven best practices, we can strive to ensure safe and effective maternal care for all.
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