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Use of Maternal Early Warning Trigger tool reduces maternal morbidity
Laurence E Shields1, Suzanne Wiesner2, Catherine Klein2
1Maternal Fetal Medicine, Marian Regional Medical Center, Santa Maria, CA; Department of Patient Safety, Dignity Health, San Francisco, CA.
American Journal of Obstetrics and Gynecology
|March 1, 2016
Summary
Implementing a Maternal Early Warning Trigger (MEWT) tool significantly reduced severe maternal morbidity and composite morbidity in a pilot study. This clinical assessment tool shows promise for widespread use in US maternity centers.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Clinical Quality Improvement
Background:
- Maternal mortality and morbidity are increasing in the United States.
- National and state organizations recommend maternal early warning tools.
- Limited data exist on the effectiveness of these tools in reducing morbidity.
Purpose of the Study:
- To determine if a clinical pathway-specific Maternal Early Warning Trigger (MEWT) tool could reduce maternal morbidity.
- To assess the impact of the MEWT tool on severe maternal morbidity, composite morbidity, and ICU admissions.
Main Methods:
- Prospective pilot implementation of an internally developed MEWT tool in 6 hospitals.
- The MEWT tool addressed sepsis, cardiopulmonary dysfunction, preeclampsia-hypertension, and hemorrhage.
- Compared outcomes during a 24-month baseline and a 13-month study period, with a control group from non-pilot sites.
Main Results:
- Significant reductions in CDC-defined severe maternal morbidity (P < 0.01) and composite morbidity (P < 0.01) were observed with MEWT tool use.
- Intensive care unit (ICU) admissions remained unchanged.
- No significant changes in morbidity or ICU admissions were noted at non-pilot control sites.
Conclusions:
- The MEWT tool significantly improved maternal morbidity by addressing common causes and providing management recommendations.
- The tool's adaptability suggests suitability for most US maternity centers.
- Early warning tools are effective in improving maternal health outcomes.
