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The Institute for Healthcare Improvement (IHI)

The Institute for Healthcare Improvement (IHI) is a not-for-profit organization leading the improvement of health care throughout the world. The Institute helps accelerate change in health care by cultivating promising concepts for improving patient care and turning those ideas into action. Their aim is to improve the lives of patients, the health of communities, and the joy of the health care workforce.

IHI works toward:

  • Safety
  • Effectiveness
  • Patient-centeredness
  • Timeliness
  • Efficiency
  • Equity

IHI reports that according to industry research, five recurring clinical issues are responsible for the majority of perinatal harm and the associated obstetrical liability:

  • failure to recognize non-reassuring fetal status
  • failure to effect a timely cesarean birth
  • failure to properly resuscitate a depressed baby
  • inappropriate use of oxytocin and misoprostil
  • inappropriate use of vacuum and forceps

Reviews of perinatal care have consistently pointed to failures of communication among the care team and documentation of care as common factors in adverse events that occur in labor and delivery. They are also prime factors leading to malpractice claims.

The four key components of IHI's current perinatal efforts are:

  • The development of reliable clinical processes to manage labor and delivery
  • The use of principles that improve safety (i.e., preventing, detecting, and mitigating errors)
  • The establishment of prepared and activated care teams that communicate effectively with each other and with mothers and families
  • A focus on mother and family as the locus of control during labor and delivery

The following can be downloaded from the IHI website:

  • The white paper Idealized Design of Perinatal Care
  • The Perinatal Trigger Tool which provides instructions for conducting a retrospective review of patient records using triggers to identify possible adverse events causing any physical harm to the infant or mother
  • Pertinent perinatal improvement literature

For more information on the Obstetric Safety Initiative, or to offer suggestions for this site, contact us.