TY - JOUR AU - Kominiarek, Michelle A.; Scott, Shirley; Koch, Abigail R.; Zeschke, Maripat; Cordova, Yvette; Ravangard, Samadh F.; Schy, Deborah; Geller, Stacie E. TI - Preventing Maternal Morbidity from Obstetric Hemorrhage: Implications of a Provider Training Initiative SN - 0735-1631 SN - 1098-8785 PY - 2017 JO - Am J Perinatol JF - American Journal of Perinatology LA - EN VL - 34 IS - 01 SP - 74 EP - 79 ET - 2016/05/30 DA - 2016/12/23 KW - hemorrhage KW - maternal morbidity KW - provider training KW - provider education AB - Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage.Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related.Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010.Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative. PB - Thieme Medical Publishers DO - 10.1055/s-0036-1584274 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0036-1584274 ER -