Delivery and Newborn Care
Having a baby can be one of life’s most exciting experiences. However, childbirth can come with risks for both parent and child. National organizations have identified proven processes to reduce complications and improve patient outcomes. It is important for those having a baby to understand if their hospital is following these processes.
These measures reflect national standards of care and treatment processes for delivery and newborn care. The measures include:
- Elective delivery of the baby before the 39th completed week of gestation (induced births or those done by elective cesarean section)
- Cesarean sections for low-risk, first-time births
- Newborns exclusively fed breastmilk during the hospital stay
U.S. hospitals must report their compliance with these measures to The Joint Commission, a healthcare accreditation organization, the Centers for Medicare and Medicaid Services and other agencies.
The maternity and newborn measures are proven standards of care. They help reduce complications and improve patient outcomes.
For example, exclusive breastfeeding to newborn benefits both parent and child. Newborns who are breastfed have reduced risks of breathing problems and maintain a healthy weight. Breastfeeding can help lower the parent’s risk of high blood pressure and some cancers.
Patients and families can use these measure performances to objectively compare hospitals locally and nationally.
How Does Johns Hopkins Medicine Perform?
The Johns Hopkins Hospital
Delivery and Newborn Care - Baby electively delivered early
What does this measure mean for quality of care? The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have in place a standard requiring 39 completed weeks gestation prior to elective delivery. This measures the percentage of patients who had an early elective vaginal delivery or elective cesarean section before the recommended 39 weeks of gestation.
Delivery and Newborn Care - Performed cesarean section for a low-risk, first-time birth
What does this measure mean for quality of care? There is no data to suggest that having an elective cesarean section leads to better outcomes for the mother or newborn than having a vaginal delivery. Because cesarean sections are not typically recommended for low-risk, first-time mothers, this measures the percentage of women who had an elective cesarean section who have not previously given birth.
Delivery and Newborn Care - Exclusively fed breast milk to newborn
What does this measure mean for quality of care? Breast-feeding provides the best nutrition and health outcomes for a newborn. This measure is the overall rate of newborns exclusively fed breast milk during the entire hospital stay.
No data is available because Suburban Hospital currently does not provide labor and delivery care.
Note: District of Columbia state average not available for the cesarean section measure.
Sample Size: A hospital’s performance on some of the core measures is based on a sample of patients and may not reflect the hospital’s overall performance on the measure across the larger patient population.
Data Source: The Centers for Medicare and Medicaid Services and Johns Hopkins Medicine.
*Benchmark Source: National and state averages are the most recent calendar year numbers publicly available on the Centers for Medicare and Medicaid Services' Care Compare. National and state averages for previous years are not available.
**National Goal Benchmark Source: The United States Department of Health and Human Services' Healthy People 2020 goal.
In 2011 Johns Hopkins Medicine developed a plan to become a national leader in core measures with a goal of reaching 96 percent compliance.
Collaborating Across Hospitals
Ensuring that patients always receive the core measure recommended treatments requires a well-coordinated effort throughout hospital departments.
Peers from across Johns Hopkins Medicine hospitals developed 40 core measure work groups, each focused on improving a specific set of core measures. These teams involved partnerships between quality improvement staff, nurse and physician leads, faculty members, IT staff and others to identify barriers to improvement and develop solutions.
The core measure work groups allowed hospitals to share best practices and lessons learned and improve internal processes to increase core measure compliance. Johns Hopkins Medicine also established a reporting system to track core measure compliance on each unit.
Meta Phillips, R.N.
Stroke Compliance Specialist, Sibley Memorial Hospital
“The core measures reflect how well our hospital follows the best practices of care for stroke patients. By closely reviewing these care processes, we have the opportunity to concentrate on areas that need improvement.
In my experience, good communication is critical to meeting the core measures. Our Stroke Program team is small and communicates well. Our team shares information every day and talks about ways to address problems — both large and small.
Several years ago, our hospital was not meeting a best practice recommended by the American Heart Association. The best practice included using high levels of cholesterol-lowering medications to treat stroke patients. Our team presented these findings to our medications committee, whose support was helpful in educating our doctors on how to change their practice.
Reviewing these best practices requires a team effort. By reviewing our patients’ charts, we can immediately identify what is working and where we can improve. Our team is always trying to make our hospital’s processes better to provide the safest care for our patients.”
Patients and families should become familiar with the core measures and talk to their health care team if they have any questions or concerns. You can also ask your health care provider how you can prepare for surgery or other procedures to reduce your risk of complications.
Be sure you clearly understand how to manage your health as you prepare to leave the hospital, such as any new prescription medications you may need.
For more information
- The Joint Commission - Core Measure Sets
- The Centers for Medicare and Medicaid Services - Recommended Core Measures
The organization’s quality and safety performance may have been impacted by the COVID-19 pandemic. We would urge patients to consider more recent performance in combination with historical performance. Patients may benefit from discussing with their healthcare provider the disruptions COVID-19 may have caused on quality and safety of care.