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Code Crimson: A Postpartum Hemorrhage Bundled Intervention Quality Improvement Project
Stefanie Modri1, Mehar Sharma, Elizabeth Quigley
1Author Affiliations: Family and Community Health Department (Mrs. Modri), University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Pre-Health Post-Baccalaureate Program (Ms Sharma), University of Pennsylvania, Philadelphia, Pennsylvania Nursing Department (Mrs. Quigley), Labor and Delivery Unit (Mrs. Anca and Mrs. O'Hanlon), Mother-Baby Unit (Miss. Pyle and Mrs. Hussey), Women's Services Department (Dr. Hamm), Pennsylvania Hospital, Philadelphia, Pennsylvania University of Michigan Medical School (Ms Mohika), Ann Arbor, Michigan, Nursing Department (Dr Trout), Villanova University M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania.
Background:
Postpartum hemorrhage (PPH) is a leading cause of maternity mortality in the United States. The Code Crimson project aimed to enhance PPH management by implementing a standardized intervention bundle to mitigate morbidity and mortality associated with PPH.
Local Problem:
At a large Philadelphia tertiary hospital, health disparities existed for severe maternal morbidity and mortality, and PPH was a significant factor.
Methods:
A quality improvement design, using Plan-Do-Study-Act cycles and interrupted time series analysis, was undertaken.
Interventions:
The Code Crimson project implemented a standardized bundle to manage PPH, including blood product administration and massive transfusion protocol activation.
Results:
After implementing the Code Crimson bundle, there was a significant decrease in blood product use ( P < .001), with minor reductions in packed red blood cell administration over 4 units and mean blood loss.
Conclusions:
The Code Crimson bundle effectively reduced blood product utilization for PPH treatment.
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