Assessing preventability for obstetric hemorrhage.

Area of Science:

• Obstetrics and Gynecology
• Patient Safety
• Healthcare Quality Improvement

Background:

• Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality.
• Identifying preventable factors is crucial for improving patient outcomes and healthcare quality.

Purpose of the Study:

• To determine the preventability of obstetric hemorrhage cases.
• To identify specific preventable factors contributing to these events.
• To compare preventability and contributing factors across different hospital levels of care.

Main Methods:

• Retrospective review of a 1-year cohort of severe and near-miss obstetric hemorrhage cases within an urban perinatal network.
• Utilized a validated preventability model assessed by an expert panel for case review.
• Compared preventability rates and the distribution of contributing factors between hospital levels.

Main Results:

• Fifty-four percent of 63 identified severe and near-miss obstetric hemorrhage cases were deemed potentially preventable.
• Provider-related factors accounted for 88% of all preventable cases.
• Treatment-related preventability factors were significantly less common in level III hospitals compared to other levels (p < 0.01).

Conclusions:

• The majority of severe obstetric hemorrhage cases are preventable.
• Provider treatment errors are the most common preventable factor, occurring more frequently in level II hospitals.
• Interventions should focus on reducing provider treatment errors to enhance obstetric patient safety.