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Alexian Brothers Hospital Network
3040 Salt Creek Lane
Arlington Heights,
Illinois 60005
847-818-5100 Phone
847-981-5561 Fax
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Alexian Brothers History
For more than 700 years, the Alexian Brothers have cared for the sick, the aged, the poor and the dying. The basic Judeo-Christian beliefs that inspired the founders of this Catholic religious congregation sustain its ministry today. This heritage is espoused by the governance, management and entire health-care team throughout Alexian Brothers Health System in their mutual commitment to promote the physical, mental, spiritual and social well-being of all individuals served through the health-care ministry.
Alexian Brothers Mission
Alexian Brothers Health System carries out the healing mission of the Catholic Church through the Alexian Brothers ministries by identifying and developing effective responses to the health and housing needs of those we are called to serve.
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Vol.
2, Issue
3 •
June 2009
ABMC Women and Infant Services
Linda Fournier
For over two and a half years, Alexian Brothers Medical Center Women and Infant Services, has been participating in a program that has brought subtle, yet profound change in the way we provide maternity services. It's almost imperceptible.
Milestones were reached at various times along this journey, through the tireless efforts of our dedicated Labor and Delivery staff. They made this culture change happen and need to be applauded for all their hard work in keeping these changes alive every day. But how did we get there...
Back in 2006, our tradition, like most maternity units, was to induce mothers when the fetus reached term gestation which was 37-40 weeks gestation. The medication, oxytocin (Pitocin), was administered to high dose levels to affect delivery. At times, the over-zealous use of oxytocin led to uterine hyperstimulation (terminology changed in September, 2008 to tachysystole), where the contractions were occurring too close together to allow the fetus sufficient time to recover before the next contraction would begin. The notion of “Pit to distress” was commonplace back then.
In June, 2006 Women & Infant Services, was introduced to the Perinatal Innovation Community work initiated by the Institute for Healthcare Improvement. IHI’s focus was to reduce harm to both mothers and babies by redesigning maternity care using a cutting edge approach.
Women & Infant Services, as a participating member of their perinatal community, was introduced to care “bundles” composed of several elements, which when adopted, would lead to better patient outcomes, than if each element was used alone. (See attached, “Oxytocin Innovation Bundles”). These bundles were scientifically grounded. In addition, a main feature of their work was for units to improve care by enhancing reliability (every patient, every time) and reducing variation in care processes.
Central to implementing and sustaining change was the ongoing data collection for compliance with the bundles and tracking perinatal harm. Periodically, IHI also wanted more detailed information regarding oxytocin administration—looking at structural elements, process of care and outcome measures. Approximately every six months from March 2008 through March, 2009, our unit took the “deep dive.” The results were tallied and comparisons were made against the previous time period(s). Looking back over these three periods, changes in our practice, as well as, our culture, became apparent.
Our outcomes remained consistently good—reduced harm to moms and their newborns. We have moved away from seeing hyperstimulation (which is now being called tachysystole) with oxytocin administration. Our Labor and Delivery staff is monitoring for it, and adjusting their care quickly to manage it. Likewise, we are noting greater frequency in the number of ways staff quickly intervene to troublesome fetal heart rate tracings. Although not captured by our “hard data,” when you walk through our unit, there is heightened awareness and communication among Labor and Delivery staff to pick up on tachysystole or fetal heart rate changes to keep our moms and babies safe from harm.
When you practice daily, you may not see how you moved from point A to point B. Working with IHI to implement their perinatal care measures and collect data on these measures, provided the means to have our department look back and reflect upon where we were and where we are now.
Are we there yet? Oh, yes, we are there!
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