{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:48:10Z","timestamp":1763686090530},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVE:<\/jats:title>\n            <jats:p>To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities. The association between institutional characteristics and adoption of evidence-supported practices (ie, those supported by prior literature or recommended by professional organizations as beneficial for improving birth outcome or patient safety) was examined using bivariate analysis and appropriate statistical tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Most hospitals regularly audited adherence to written protocols regarding critical areas of care; however, 77.7% and 16.8% reported not having written guidelines on diagnosis of labor arrest and management of abnormal fetal heart rate, respectively. Private nonprofit hospitals were more likely to have a written protocol for management of abnormal fetal heart rate (<jats:italic toggle=\"yes\">P<\/jats:italic>=.002). One in 10 hospitals (9.7%) did not regularly review cases with significant morbidity or mortality, and only 69.0% regularly tracked indications for cesarean delivery. Moreover, 26.3%, 14.3%, and 8.7% of the hospitals reported never performing interprofessional simulations for eclampsia, shoulder dystocia, or postpartum hemorrhage, respectively. Teaching status was associated with more frequent simulations in these three areas (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2264.04 for all), while larger volume was associated with more frequent simulations for eclampsia (<jats:italic toggle=\"yes\">P<\/jats:italic>=.04).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>Hospitals in California engage in a wide range of practices to assure or improve quality of obstetric care, but substantial variation in practice exists among hospitals. There is opportunity for improvement in adoption of evidence-supported practices.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/aog.0000000000002437","type":"journal-article","created":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T20:57:17Z","timestamp":1515704237000},"page":"214-223","source":"Crossref","is-referenced-by-count":11,"title":["Quality Assurance Practices in Obstetric Care"],"prefix":"10.1097","volume":"131","author":[{"given":"Lisbet S.","family":"Lundsberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry C.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace Villarin","family":"Due\u00f1as","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly D.","family":"Gregory","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly K.","family":"Grossetta Nardini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian M.","family":"Pettker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L.","family":"Illuzzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230711","first-page":"1","article-title":"Births: final data for 2015","volume":"66","author":"Martin","year":"2017","journal-title":"Natl Vital Stat Rep"},{"key":"R2-20230711","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1097\/AOG.0b013e31826d60c5","article-title":"Severe maternal morbidity among delivery and postpartum hospitalizations in the United States","volume":"120","author":"Callaghan","year":"2012","journal-title":"Obstet Gynecol"},{"key":"R5-20230711","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1097\/AOG.0000000000000219","article-title":"The National Partnership for Maternal Safety","volume":"123","author":"D'Alton","year":"2014","journal-title":"Obstet Gynecol"},{"key":"R6-20230711","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/AOG.0000000000000793","article-title":"Transforming communication and safety culture in intrapartum care: a multi-organization blueprint","volume":"125","author":"Lyndon","year":"2015","journal-title":"Obstet Gynecol"},{"key":"R7-20230711","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1213\/ANE.0000000000000399","article-title":"The use of postpartum hemorrhage protocols in United States academic obstetric anesthesia units","volume":"119","author":"Kacmar","year":"2014","journal-title":"Anesth Analg"},{"key":"R8-20230711","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/GRF.0000000000000238","article-title":"Simulation and shoulder dystocia","volume":"59","author":"Shaddeau","year":"2016","journal-title":"Clin Obstet Gynecol"},{"key":"R9-20230711","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1097\/AOG.0b013e3181d9f4cd","article-title":"Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review","volume":"115","author":"Meri\u00e9n","year":"2010","journal-title":"Obstet Gynecol"},{"key":"R10-20230711","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1471-2393-13-83","article-title":"A survey of access to trial of labor in California hospitals in 2012","volume":"13","author":"Barger","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"key":"R11-20230711","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1046\/j.1523-536X.2003.00241.x","article-title":"Labor induction rate variation in upstate New York: what is the difference?","volume":"30","author":"Glantz","year":"2003","journal-title":"Birth"},{"key":"R12-20230711","doi-asserted-by":"crossref","first-page":"523.e1","DOI":"10.1016\/j.ajog.2015.08.013","article-title":"Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals","volume":"213","author":"Korst","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"R16-20230711","first-page":"693","article-title":"Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists","volume":"123","year":"2014","journal-title":"Obstet Gynecol"},{"key":"R17-20230711","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/AOG.0b013e31817bbc61","article-title":"Improving neonatal outcome through practical shoulder dystocia training","volume":"112","author":"Draycott","year":"2008","journal-title":"Obstet Gynecol"},{"key":"R18-20230711","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.ajog.2011.05.002","article-title":"Outcomes associated with introduction of a shoulder dystocia protocol","volume":"205","author":"Grobman","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"R19-20230711","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.ajog.2014.07.012","article-title":"Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety","volume":"212","author":"Shields","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"R20-20230711","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.1097\/AOG.0000000000001642","article-title":"Obstetric Care Consensus No. 5: severe maternal morbidity: screening and review","volume":"128","year":"2016","journal-title":"Obstet Gynecol"},{"key":"R23-20230711","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1177\/1077558708318285","article-title":"A survey of hospital quality improvement activities","volume":"65","author":"Cohen","year":"2008","journal-title":"Med Care Res Rev"},{"key":"R24-20230711","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/1077558705283122","article-title":"Quality improvement implementation and hospital performance on patient safety indicators","volume":"63","author":"Weiner","year":"2006","journal-title":"Med Care Res Rev"},{"key":"R26-20230711","doi-asserted-by":"crossref","DOI":"10.1136\/bmjquality.u217936.w7106","article-title":"Reducing the incidence of obstetric sphincter injuries using a hands-on technique: an interventional quality improvement project","volume":"5","author":"Rasmussen","year":"2016","journal-title":"BMJ Qual Improv Rep"},{"key":"R27-20230711","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0b013e31821e5f65","article-title":"Indications contributing to the increasing cesarean delivery rate","volume":"118","author":"Barber","year":"2011","journal-title":"Obstet Gynecol"},{"key":"R29-20230711","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1001\/jama.2017.11525","article-title":"Measuring the cost of quality measurement: a missing link in quality strategy","volume":"318","author":"Schuster","year":"2017","journal-title":"JAMA"}],"container-title":["Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006250-201802000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T18:17:23Z","timestamp":1689099443000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006250-201802000-00004"}},"subtitle":["A Survey of Hospitals in California"],"short-title":[],"issued":{"date-parts":[[2018,2]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0000000000002437","relation":{},"ISSN":["0029-7844"],"issn-type":[{"value":"0029-7844","type":"print"}],"subject":[],"published":{"date-parts":[[2018,2]]}}}