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Related Experiment Videos

The perinatal quality collaborative of North Carolina's 39 weeks project: a quality improvement program to decrease

Kate Berrien1, James Devente2, Amanda French3

  • 1Perinatal Quality Collaborative of North Carolina, Chapel Hill, NC, USA; Community Care of North Carolina, Raleigh, NC, USA.

North Carolina Medical Journal
|May 17, 2014
PubMed
Summary

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The 39 Weeks Project successfully reduced early elective deliveries by 45% in North Carolina hospitals. This initiative aimed to improve infant outcomes by adhering to guidelines for full-term gestation.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Healthcare Quality Improvement

Background:

  • Elective deliveries before 39 weeks gestation are associated with poorer infant outcomes.
  • Despite guidelines, nearly one-third of US births in weeks 36-38 are elective.
  • The Perinatal Quality Collaborative of North Carolina (PQCNC) initiated the 39 Weeks Project to address this issue.

Purpose of the Study:

  • To decrease the incidence of early-term elective deliveries in North Carolina hospitals.
  • To promote adherence to obstetric guidelines regarding gestational age at delivery.
  • To improve perinatal outcomes through quality improvement initiatives.

Main Methods:

  • 33 hospitals participated, implementing new or revised policies to reduce elective early-term deliveries.

Related Experiment Videos

  • A multi-faceted approach included learning sessions, webinars, newsletters, and a shared online platform.
  • Hospitals submitted monthly data for ongoing training and analysis by PQCNC.

    • Main Results:

    • Elective deliveries before 39 weeks decreased by 45% (from 2% to 1.1% of all deliveries).
    • The proportion of elective deliveries among scheduled early-term births fell from 23.63% to 16.19%.
    • Documented medical indications for early delivery increased significantly, from 62.4% to 88.2%.

    Conclusions:

    • The PQCNC's 39 Weeks Project effectively reduced early-term elective deliveries in participating hospitals.
    • The project demonstrated the success of collaborative quality improvement efforts in obstetric care.
    • Further data collection is needed to assess changes in patient outcomes.