Financial incentives generally are a great way to inspire action, but information, at least in health care, can be influential as well.
An example of that can be found at Ascension Health, which achieved startling success in reducing its rate of early-elective deliveries, largely as a result of challenging its physicians and nurses. Early-elective deliveries, which are induced or C-sectioned deliveries before 39 weeks, result in higher rates of complications for babies and their mothers.
I already wrote about Ascension’s restructuring to take advantage of its large size, but their results were too good to pass up.
As of February 2012, Ascension’s early-elective delivery rate was a little more than 3.5 percent, a rate that was quite good relative to the 10 to 15 percent estimate for deliveries quoted by the Centers for Medicare & Medicaid Services.
But that rate was not good enough for Ascension, as described by Ann Hendrich, R.N., senior vice president, chief quality/safety officer and chief nursing officer for Ascension Health. Even with that fairly low rate of early-elective deliveries, a too-large percentage of newborns were going into the neonatal ICU, Hendrich said, speaking at a session on the Partnership for Patients quality effort at the American College of Healthcare Executives 2015 Congress on Healthcare Leadership.
Ascension, which ran its own Hospital Engagement Network within Partnership for Patients, set a target of zero early-elective deliveries and used its EED rates to convince clinicians to cut back as part of its efforts. “We shared the data with doctors and nurses and asked them, ‘Are you satisfied?’ ”
Its current rate of early-elective delivery? 0.6 percent. That number caught my eye, in part because my wife works as a certified nurse-midwife, so I’ve heard a bit about the risks of early-elective deliveries over the years.
The system also added to its patient education efforts, describing to expectant mothers the decreased brain development that can occur in too-early deliveries. And Ascension clinicians do that education early in a woman's pregnancy, before she gets too eager to give birth.
Other HEN participants have reduced their early-elective delivery rates too, including some in the American Hospital Association’s HEN, such as Exeter Hospital in New Hampshire and a number of Indiana hospitals working with the assistance of the Indiana Hospital Association.