August 04, 2014
Statement on Obstetrical Complications and Maternal Outcomes
American Congress of Obstetricians and Gynecologists President John C. Jennings, MD, and American Society of Anesthesiologists® President Jane C.K. Fitch, MD, released the following statement today:
“The study published today in Health Affairs regarding variability in obstetrical complications demonstrates the need for constructive efforts to improve care for women and babies across America. Not surprisingly, the study found remarkable levels of variability between low-performing and high-performing hospitals. American women, and their families, deserve better.
“The American Congress of Obstetricians and Gynecologists (ACOG) and the American Society of Anesthesiologists (ASA) agree that an important way to improve care is by increasing our understanding of the causes of complications and other negative outcomes, as well as by emphasizing collaborative care among the obstetrical treatment team, including obstetricians, physician anesthesiologists, nurses, and hospital staff.
“This past spring, ACOG and ASA partnered to launch the Maternal Quality Improvement Program, a joint effort to develop a national obstetrical outcomes registry through ASA’s affiliated Anesthesia Quality Institute. Our goal is to provide hospitals with the information they need to understand and improve their outcomes. The program will provide a framework for reporting performance and outcomes measures for obstetrical care. The information gathered through this registry will help to inform obstetrical care in the future, improving the care provided to women and their babies and paving the way for better patient outcomes.
“Importantly, this project will help to address the variations in care that currently exist among American hospitals. Similar programs supported by other medical specialties have demonstrated the ways in which clinical registries can guide care in a meaningful way, leading to important improvements for patients.
“Right now, no national system for reporting maternal complications exists. Although the article by Glance and colleagues provides important insight into obstetrical variations, the limitations in the survey demonstrate the need for clinical data to inform quality improvement efforts. The registry will be based on more accurate and comprehensive clinical data.
“Moving forward, the registry and framework will be developed with two essential characteristics. First, performance and outcomes measures will be patient-centered. Second, they will rely on shared accountability, assigning responsibility to the entire treatment team rather than to individual providers. The use of team-based performance measures will incentivize treatment team members to work collaboratively to improve outcomes.
“By better assessing care throughout pregnancy and delivery, the program will provide treatment teams with the tools they need to evaluate and improve the care that they provide. Although this joint project is in its early stages, our shared goal is a health care system in which disparities in obstetrical care are mitigated, so that families have a healthy start. We are proud of our collaboration and look forward to providing updates about the project as it moves forward.”
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org