Code Crimson: A Postpartum Hemorrhage Bundled Intervention Quality Improvement Project

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Quality Improvement in Healthcare

Background:

• Postpartum hemorrhage (PPH) is a primary cause of maternal mortality in the U.S.
• Health disparities in severe maternal morbidity and mortality were identified at a Philadelphia tertiary hospital, with PPH as a key contributor.
• The Code Crimson project was initiated to address these disparities by improving PPH management.

Purpose of the Study:

• To implement and evaluate a standardized intervention bundle for managing postpartum hemorrhage (PPH).
• To reduce morbidity and mortality associated with PPH through enhanced management protocols.
• To address existing health disparities in severe maternal outcomes by targeting PPH.

Main Methods:

• A quality improvement methodology utilizing Plan-Do-Study-Act (PDSA) cycles.
• Interrupted time series analysis was employed to assess the impact of the intervention.
• Implementation of the Code Crimson bundle, including standardized blood product administration and massive transfusion protocol activation.

Main Results:

• Significant reduction in overall blood product utilization for PPH treatment (P < .001).
• A decrease in the administration of packed red blood cells exceeding 4 units.
• Observed minor reductions in mean blood loss among patients experiencing PPH.

Conclusions:

• The Code Crimson standardized bundle effectively reduced blood product utilization in the treatment of postpartum hemorrhage.
• The intervention demonstrates a successful approach to mitigating complications associated with PPH.
• The project highlights the potential of standardized protocols in improving maternal outcomes and addressing health disparities.