The safe motherhood initiative: The development and implementation of standardized obstetric care bundles in New York

The medical literature demonstrates that inadequate hospital protocols or the lack of consistent protocols for diagnosis, management, consultation, and/or referral can lead to confusion and unnecessary variation in patient care. Incongruities in clinical settings have been repeatedly shown to compromise quality of patient outcomes. Accordingly, the development and adoption of standardized protocols as the best practice for addressing incidence of adverse events remains a top priority in health care quality and safety initiatives. Among the 127 hospital facilities that provide inpatient obstetrical care in New York State, adoption and uptake of standardized care management plans is sporadic at best. In 2001, to target the incidence of severe maternal outcomes and enhance the state of maternal health in New York, the American Congress of Obstetricians and Gynecologists (ACOG) District II and the New York State Department of Health developed the Safe Motherhood Initiative. Today, the Initiative demonstrates that maternal care outcomes are well served through an organized culture of obstetric safety. ACOG District II assists hospitals to optimize their delivery of obstetric care via three toolkits containing standardized protocols for the diagnosis, prevention, and management of the leading causes of maternal mortality and morbidity: hemorrhage, hypertension, and pulmonary embolus.