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Code Crimson: A Postpartum Hemorrhage Bundled Intervention Quality Improvement Project.

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The Code Crimson project successfully reduced blood product use for postpartum hemorrhage (PPH) management. This standardized intervention bundle significantly decreased blood product utilization in PPH treatment.

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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.