Women and expectant mothers have a trend-setting hospital in Texas in the national effort to curb maternal deaths and severe maternal complications from deliveries—Harris Health System’s Ben Taub Hospital.
In March, Ben Taub Hospital became the first in Texas to successfully enroll in the Alliance for Innovation on Maternal Health (AIM), a national data-driven maternal safety and quality improvement initiative that offers hospital staffs evidence-based guidelines and practices to provide expectant mothers with the best healthcare outcomes.
According to AIM, the United States has the highest maternal mortality rates of any industrialized country in the world and aside from Afghanistan and Sudan—one of the few with a still rising death rate. The goal of AIM is to ultimately eliminate preventable maternal deaths or severe maternal complications from deliveries (prenatal and postpartum up to a year after a baby’s birth).
Championing the efforts at Ben Taub Hospital are Dr. Carey Eppes, chief, Obstetrics, and Suzy Lundeen, director of nursing, Women and Infants Services.
“We started with discussions among the obstetricians surrounding patient outcomes, but we realized we don’t make enough progress with this strategy,” says Eppes, also an assistant professor, Division of Maternal Fetal Medicine, Baylor College of Medicine. “Tools and evidence-based practice are only the foundation. We needed to focus on data and implementation. Now, almost all of our initiatives involve all our stakeholders—nursing, administration, anesthesia, pediatrics and obstetrics—all the specialties in Women and Infants Services.”
AIM offers 11 tried and tested maternal safety bundles (guidelines) that can be used by hospitals to improve their services. The bundles are straightforward and user-friendly in all facets of implementation. Ben Taub Hospital now employs two of AIM’s safety bundles for its mostly frequently seen cases—women suffering from hemorrhaging and hypertension.
“These safety guidelines have been completely transformative for our service,” Eppes reports. “They’ve helped us improve our outcomes, the way we interact with each other and how we communicate and respond to things.”
Ben Taub Hospital began using the safety bundle on hemorrhaging in 2016. To date, AIM guidelines have yielded a 20-percent reduction in severe maternal complications for patients.
“Armed with this information, we have been successful in developing buy-in, empowering the team and incorporating the changes into the culture of the units,” says Lundeen, PhD, RNC-OB, NEA-BC. “By using the continuous quality improvement process as outlined by the AIM bundles, we are proud to have successfully improved the care our patients receive.”
While AIM is available for all hospitals and birthing centers, each facility’s leadership must commit to embracing the guidelines and share the data. Each guideline offers several process steps including readiness, recognition and prevention, response, reporting and systems learning.
Eppes says the state hopes to have a 75-percent participation rate in AIM.
“Once people start seeing how successful it is and how important it is, people will start jumping on the bandwagon,” she says.
AIM is coordinated through state teams and health systems to align national-, state- and hospital-level quality improvement efforts and is funded through a cooperative agreement with the Health Resources and Services Administration’s Maternal and Child Health Bureau through August 2018.