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The 32 hospitals in the Dignity Health system that operate labor and delivery units have reduced early elective deliveries between 37 and 39 weeks of gestation and have saved an estimated $1 million in Neonatal Intensive Care Unit costs. Most Dignity Health hospitals are already at zero percent, showing that the goal of improved quality outcomes and lower costs can be achieved in tandem. St. Rose Dominican Hospitals-San Martín Campus has reduced its early elective deliveries significantly – from 5.21 percent to zero percent, while the Siena Campus has reduced its early elective deliveries from 4.52 percent to just .6 percent.
For the past two decades, the frequency of early elective deliveries has been on the rise. Expectant mothers often prefer to plan their baby’s birth date in advance and be assured of having their own doctor deliver the baby. Other factors include reducing the number of days of discomfort during late stage pregnancy and making sure that an anticipated quick delivery occurs in a hospital.
However, early elective deliveries come with risks, including increased newborn feeding problems, increased respiratory distress syndrome, and increased Neonatal Intensive Care Unit admissions, according to the California Maternal Quality Care Collaborative. Newborns admitted to the NICU typically spend five days in the hospital.
“More than 4,350 babies have been delivered at our San Martín and Siena Campuses over the past 12 months,” said Rod A. Davis, president/CEO of St. Rose Dominican Hospitals and senior vice president of operations, Dignity Health Nevada. “Of that number, just 21 were early elective deliveries. We want to give our children the best possible start in life, so our goal is to reduce that number to zero.”
“We applaud Dignity Health for their commitment to the health of moms and babies,” shares Leslie Kowalewski, Associate State Director of the March of Dimes in California. “Their efforts are showing a positive impact in the health and well being of their patients. We hope all hospital systems will take a similar stand and join the efforts of Dignity Health to make these constructive changes.”
St. Rose Dominican Hospitals is following a plan based on recommendations by the March of Dimes, which includes education and training for caregivers and patients, algorithms for scheduling deliveries, a checklist that includes medically necessary early deliveries and a policy for a hard stop for patients that do not meet certain criteria, such as hypertension or preeclampsia.
“The exciting thing about putting this plan in place,” said Debbie Pavlica, Director of Maternal Child Services for St. Rose Dominican Hospitals, “is that we are enabling families to take their newborns home healthier and more quickly following delivery.”
St. Rose also developed a mobile app – Baby Growth Tracker – to help teach new parents how to best care for their infants. The app features a variety of videos, including a video tour of the St. Rose Level III Neonatal Intensive Care Unit so parents with premature or ill infants will know what to expect. All hospitals in the system are focusing on evidence-based practices, multidisciplinary education to improve communication, investments in information technology, and partnerships with other community members. In addition, Dignity Health has introduced a new application for doctors called AirStrip OB™, a remote fetal monitoring application used in high risk pregnancies.