Increased Cesarean Efficiency with Improvement Program

Cesarean delivery efficiency increased after implementation of a quality improvement program
By Lisa Cockrell, PhD
HealthDay Reporter

MONDAY, Feb. 23 (HealthDay News) -- Cesarean delivery efficiency, measured by the time from decision to incision, significantly improved over two years with the implementation of a quality improvement program, according to research published in the March issue of Obstetrics & Gynecology.

Roberta Haynes de Regt, M.D., of the Evergreen Hospital Medical Center in Kirkland, Wash., and colleagues assessed the decision-to-incision time for unscheduled cesarean delivery procedures, which were ordered for various indications. Those procedures that were initiated within 30 minutes of the decision to proceed were considered efficient. The investigators compared delivery efficiency between 2004 and 2006, after a quality improvement program was initiated in 2004 at a community hospital.

The efficiency rate of unscheduled cesarean deliveries significantly improved during the study period (from 36 percent to 59 percent), the researchers report. Unscheduled deliveries classified as an emergency procedure improved (67 percent to 84 percent), as did those for patients with an indication of failure to progress (33 percent to 54 percent), the investigators found. Cesareans occurring for an indication classified as "other" (including breech, placental abruption and multiple gestation) were among the most improved (18 percent to 49 percent), the report indicates.

"Cesarean delivery efficiency varied by indication, but a data-driven hospital-based initiative successfully improved efficiency over time," the authors conclude. "Indication-based standards that address an institution's staff and structural capacity are needed to evaluate time from decision to incision."

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