Inpatient obstetric care results in more than 50% of obstetrics and gynecology claims ( White, Pichert, Bledsoe, Irwin, & Entman, 2005). Data include the Joint Commission (TJC) sentinel event alerts Preventing Infant Death and Injury During Delivery ( Joint Commission on Accreditation of Healthcare Organizations, 2004) and Preventing Maternal Death ( TJC, 2010), Summary Data of Sentinel Events Reviewed by the Joint Commission ( TJC, 2011b), the American College of Obstetricians and Gynecologists’ ( ACOG, 2009a) 2009 ACOG Survey on Professional Liability, the Jury Verdict Research (2009) report Current Award Trends in Personal Injury, reports from reviews of professional liability insurance company claims ( Clark, Belfort, Dildy, & Meyers, 2008 Crico Strategies, 2010 Greenwald & Mondor, 2003), and experience working with hospitals and healthcare systems to reduce risk of perinatal patient harm and to promote patient safety. ![]() The recommendations are based on data concerning the most common causes of preventable injuries to mothers and babies during labor and birth. ![]() Suggestions to minimize risk of professional liability are also provided. This chapter offers recommendations for creating conditions that provide the safest care possible for mothers and babies using a framework for perinatal high reliability that includes each of these essential criteria. Ideally, there are established criteria for ongoing monitoring of quality of care that include structure, process, and outcome measures. ![]() When unit operations and clinical care are based on “What is best (safest) for the mother and baby?”, quality is a natural outcome. CREATING a safe clinical environment during labor and birth requires effective leadership, a shared philosophy, interdisciplinary collaboration, professional behavior, and excellence in key clinical practices.
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