Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Reducing cesarean birth rates with data-driven quality improvement activities

E K Main1

  • 1Department of Obstetrics and Gynecology, California Pacific Medical Center, San Francisco, California 94118, USA.

Pediatrics
|January 26, 1999
PubMed
Summary

Intensive feedback on cesarean section rates, using a computerized system and open-label data, significantly reduced surgical births. This physician behavior change, not just education, proved effective in lowering cesarean section rates.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study.

BJOG : an international journal of obstetrics and gynaecology·2016
Same author

The impact of change in pregnancy body mass index on the development of gestational hypertensive disorders.

Journal of perinatology : official journal of the California Perinatal Association·2014
Same author

The relationship between maternal age and uterine dysfunction: a continuous effect throughout reproductive life.

American journal of obstetrics and gynecology·2000
Same author

Prevention of early-onset invasive neonatal group B streptococcal disease in a private hospital setting: the superiority of culture-based protocols.

American journal of obstetrics and gynecology·2000
Same author

Prematurity--steroids for all.

The Western journal of medicine·1996
Same author

The use of intravenous immunoglobulin in recurrent pregnancy loss associated with combined alloimmune and autoimmune abnormalities.

American journal of reproductive immunology (New York, N.Y. : 1989)·1996

Area of Science:

  • Obstetrics and Gynecology
  • Health Services Research
  • Medical Informatics

Background:

  • Reducing cesarean section rates is a persistent challenge in obstetrics.
  • Institutional guidelines alone have often proven insufficient for significant change.
  • Physician behavior modification is key to altering cesarean birth rates.

Purpose of the Study:

  • To analyze the impact of intensive outcomes feedback on cesarean section rates.
  • To evaluate the effectiveness of a computerized information system for obstetric outcomes.
  • To assess the influence of 'open label' feedback on physician practice patterns.

Main Methods:

  • A comparative study of two private obstetric services in San Francisco.
  • Implementation of The Perinatal Data Center for intensive outcomes feedback at one hospital.

Related Experiment Videos

  • Introduction of the system to the control hospital and subsequent 'open label' feedback post-merger.

    • Main Results:

    • Cesarean birth rates remained stable (24-25%) before intervention.
    • Introduction of the outcomes system led to a decrease to 21% in the first hospital.
    • Subsequent system introduction and 'open label' feedback further reduced rates to 18.5%.

    Conclusions:

    • Intensive use of comparative outcome data can alter physician practice and lower cesarean birth rates.
    • Strong physician leadership is crucial for implementing practice pattern changes.
    • Nonblinded, intradepartmental distribution of outcomes is a highly effective tool for change.