The next year, the insurer funded five hospital-based perinatal patient safety nurses to implement the OB initiative, including one for Hopkins Medicine. The major components of the initiative were:
- teamwork training—such as Veterans Health Administration, Med Teams and TeamStepps programs—for all members of the perinatal care team to improve the quality of collaboration and communication.
- use of consistent protocols for safe use of oxytocin for induction and augmentation of labor
- adoption of nationally recognized nomenclature for interpretation of all electronic fetal monitoring (National Institute of Child Health and Human Development nomenclature)
- required certification in electronic fetal monitoring for all obstetrical physicians, nurse midwives and nurses, by utilizing the National Certification Corporation examination
- use of high-fidelity simulators
- workgroups focused on chain of command, shoulder dystocia documentation and maternal injuries—issues associated with past patient safety incidents
The results were impressive: Over the course of the initiative, Johns Hopkins Health System hospitals experienced a 29 percent decrease in claim cost and a 28 percent decrease in claim frequency.