The Scarborough Hospital is a two-site organization that consists of the General and Birchmount Campuses. Obstetricians, family practitioners, and midwives on the two campuses attend nearly 5000 births each year. The hospital recently set out to improve quality of care associated with key performance indicators on the BORN Maternal Newborn Dashboard. Their overall goal was to reduce unnecessary nursery admissions associated with early term delivery.
After reviewing data from the dashboard, a multi-disciplinary team was able to develop new processes and make changes to their cesarean section and induction protocols to meet best practice guidelines. The team discovered that estimated date of birth (EDB) based on last menstrual period was not being consistently updated to reflect the revised/final EDB when antenatal testing was available. Elective inductions were sometimes occurring prior to 41 weeks as a result, and elective cesarean sections scheduled before 39 weeks.
By ensuring the most accurate EDB was reflected in patient records, the team was able to reduce the number of elective inductions prior to 41 weeks for low-risk patients, as well as the rate of elective sections before 39 weeks. Nurses and booking clerks have been encouraged to question the patient’s due date and ask about the indications for delivery. Empowering staff with knowledge and resources, along with physician support for the initiative led to practice-changing results and improved care. Because of these changes, admissions to the nursery have decreased and more mothers and babies stay together immediately following birth.
The Scarborough Hospital team was able to achieve excellent results by giving everyone on the maternity care unit ownership of maintaining best practice. The Maternal Newborn Dashboard is now a standing item on the agenda for all maternity team meetings. Being able to monitor performance, view results, and track achievement allows the team to work together to deliver outstanding care.