Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

When push comes to shove: implementing VBAC practice guidelines.

C H Coulter1, R Lehrfeld

  • 1UltraLink, Inc., Costa Mesa, CA, USA.

Physician Executive
|May 8, 1995
PubMed
Summary

Vaginal birth after cesarean-section (VBAC) guidelines aim to reduce C-sections, but implementation is inconsistent. Healthcare organizations show reluctance in accountability for VBAC decisions, impacting quality and costs.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Health benefits: employer liability and the need for change.

Employee benefits journal·2001
Same author

The consumer choice model: a humane reconstruction of the U.S. health care system.

Physician executive·2000
Same author

Direct provider contracting: one employer's experience.

Benefits quarterly·1999
Same author

Assessing HMO centers of excellence programs: one employer's experience.

Managed care quarterly·1998
Same author

Purchasers and the impact of managed care on physicians.

Physician executive·1997
Same author

Physician organizations.

Postgraduate medicine·1997

Area of Science:

  • Obstetrics and Gynecology
  • Health Services Research
  • Public Health Policy

Background:

  • Cesarean sections in the U.S. have risen dramatically, with repeat C-sections being a major driver.
  • Clinical guidelines now recommend vaginal birth after cesarean-section (VBAC) to address this trend.

Purpose of the Study:

  • To examine the implementation of VBAC guidelines by healthcare organizations.
  • To assess policies, practices, and attitudes of healthcare executives toward VBAC.

Main Methods:

  • A survey was conducted among 156 members of the American College of Physician Executives.
  • Respondents were medical directors in various healthcare settings (HMOs, hospitals).

Main Results:

  • Healthcare organizations have not consistently implemented VBAC guidelines.
  • Physician executives reported reluctance to hold physicians, patients, or hospitals accountable for VBAC decisions.
  • This lack of accountability affects financial, utilization, and quality outcomes.

Conclusions:

  • Widely accepted clinical practice guidelines may not effectively reduce costs or improve quality if not consistently implemented.
  • Barriers to VBAC implementation include patient acceptance and provider payment issues.

Related Experiment Videos