Birthing hospitals promote better outcomes by implementing "hard-stop" policies

The Kansas Healthcare Collaborative is pleased to announce that 49 Kansas hospitals have adopted a “hard-stop” policy in their patient safety work to reduce elective, early-term deliveries and achieve better outcomes for mothers and newborns. The American College of Obstetricians and Gynecologists advises against deliveries prior to 39 weeks of gestation unless there is a medical necessity to delivery early.

Reduction of early elective deliveries is one of the 10 areas of focus to improve quality of care and patient safety through the national Partnership for Patients Hospital Engagement Network (HEN) initiative started in 2011. Through the collective efforts of Kansas hospitals, the achievement in policy adoption by hospitals to prevent and reduce early elective deliveries is a demonstrative success.

As of December, 100 percent of birthing hospitals participating in the Kansas HEN, have implemented a “hard stop” policy to prevent early elective deliveries unless medically necessary. “Hard stop” means no elective deliveries before 39 weeks gestation. The result is fewer caesarean sections performed, fewer neonatal intensive care unit (NICU) admissions, fewer complications for newborns, and lower costs to public and private payers.

For example, Sumner Regional Medical Center, Wellington, Ks, is one of the Kansas HEN hospitals with a “hard stop” policy. The hospital delivers approximately 140 babies a year, and they adopted a “hard-stop” policy in January 2013. Prior to the “hard-stop” policy, their rate of babies born prior to 39 weeks was 67 percent. In the first seven months of 2013, the rate dropped dramatically and the hospital reported only one birth prior to 39 weeks.

The Kansas HEN has 93 participating hospitals; 49 of those hospitals are birthing hospitals. The Kansas HEN is part of the American Hospital Association (AHA) / Health Research and Educational Trust (HRET) HEN that includes more than 1,500 hospitals in 31 states. According to AHA-HRET, collective efforts to reduce early elective deliveries through the HEN through 2013 have resulted in 13,340 babies who were not electively delivered and 640 babies who avoided NICU at a cost savings of $3,132,000.