Washington State’s Health Care Authority has released a toolkit for health care providers that will promote evidence-based obstetrical practices, which has been the target of a public-private initiative in recent years.
The toolkit is a collaborative effort by the Health Care Authority, the Optimizing Birth Outcomes Workgroup and the Center for Evidence-based Policy at Oregon Health and Science University. It includes chapters on evidence-based strategies, innovative models, how to manage change, and additional resources available before and during labor.
In an introductory message, HCA Chief Medical Officer Daniel Lessler, M.D., noted that the nation experienced an increase in labor inductions and c-sections.
“These increases occurred without a clear medical need or rationale and without any associated improvement in outcomes,” Dr. Lessler noted, predicting that the information and models in the tool kit will help providers act on solid, evidence-based standards. “This toolkit will help to make maternal and infant care more evidence-based, consistent and measured, reducing variation in care across Washington State,” he added.
The tool kit supplements a series of efforts to improve birth outcomes, dating back to the formation of a Washington State Perinatal Collaborative in 2008. Other collaborations:
· Partners in the overall effort included the March of Dimes, which launched a “Healthy Babies are Worth the Wait” awareness campaign in 2011.
· The Robert Bree Collaborative, which issued a set of maternity/obstetrics recommendations, including attempts to limit non-medically indicated inductions and early-term births. The Bree Collaborative was created by the state Legislature in an effort to identify and endorse evidence-based standards in an ongoing review of current medical practices.
· The Medicaid program, which now pays for slightly more than half of the births in the state, and the Washington State Hospital Association also collaborated on safety-net assessment quality measures, including reduced pre-term inductions. The Legislature rewards top-performing hospitals with extra funding.
FOR MORE INFORMATION OR BACKGROUND:
The Toolkit for Reducing Caesarean Deliveries website
The Bree Collaborative website
WSHA hospital specific data on Caesarean-section rates
HCA First Steps data (birth data)