02/15/19

OBHG hospitalists participating in national C-section reduction pilot in Bellevue, Wash.

OBHG hospitalists at Overlake Medical Center in Bellevue, Wash. are helping to pilot a new method of reducing cesarean sections and increasing the rate of vaginal deliveries. Overlake is one of only four hospitals in the country partnering with Ariadne Labs – a joint center of Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health – on the Team Birth Project, an innovative program focused on empowering mothers and all members of the birth team to initiate communication and inspire more collaborative teamwork to achieve better outcomes for mothers and babies.

The Team Birth Project was created to empower women and couples to communicate their birth plans and to share in the decision-making process during childbirth. The project uses tools to support best practices in clinical decision-making and communication that support and empower women’s preferences using a team approach. “The hope is to see a reduction in unnecessary cesarean deliveries by improving appropriate care and avoiding overtreatment,” said Lisbeth Jordan, MD, OBHG site director of OB hospitalists at Overlake.

A key component of the 18-month initiative is a labor and birth planning board, a patient-facing whiteboard located in every labor and delivery room that serves as a shared reference for patients, families and care team members such as nurses, midwives, obstetricians, anesthesiologists, neonatologists and other specialists. In addition to serving as a central, visible place to capture a mother’s intended birth plan, the tool is meant to foster teamwork, communication, and empowerment of women and families while reducing overtreatment. Also, as part of the program “huddles” are held regularly by providers, staff and families to discuss care decisions and preferences as they align with the birth plan.

“As hospitalists, our initial involvement in the Team Birth Project involves triaging the patient in the obstetrical emergency room to prevent premature admission of laboring women,” said Dr. Jordan. “Part of the project includes an admission decision aid containing guidelines to confirm whether admission is necessary and what options can be offered to keep patients comfortable and minimize interventions if admission is deferred. From there, we are considered part of the patient’s labor team and the patient is made aware of our role as an emergency obstetrical provider."

According to Dr. Jordan, the project has been very well received. “Everything is centered around supporting and empowering patients and working together in making a positive difference in their birth experience,” said Dr. Jordan. “Not only is the program designed to make patients feel more involved in their care, but it also reinforces the team aspect of having everyone working together through the labor and delivery process.”

For more information about the Delivery Decisions Initiative and the Team Birth Project, click here.