There is currently not an obstetrics topic under the K-HIIN projects. The following resources are from the K-HEN and K-HEN 2.0 projects.

Electively delivering babies at less than 39 weeks, in the absence of a medical indication for mom or baby, is associated with increases in babies requiring higher-level nursery care, increased length of stay in the hospital and increased cost for the health care system.   

Change Package

• Reduce Early Elective Deliveries
• 2014 OB Change Package
• CMQCC - Toolkit to Support Vaginal Birth and Reduce Primary Cesareans

2012-2013 OB Progress Report

• HEN Project Report

Tools

• EED Data Collection Form
• Fall Prevention Tool for OB patients
• ACOG & CMQCC OB Hemorrhage Toolkit (Website)
• Hemorrhage Outcome Measures For HENs
• OB Hemorrhage Toolkit (Complete)
• CMQCC Hemorrhage and Pre–Eclampsia Measure Specifications
• Hemorrhage Protocol Checklist
• Hemorrhage Flowchart
• Hemorrhage Protocol Table Chart
• CMQCC Preeclampsia Toolkit
• Best Medical Center Scheduling Form for Inductions and Cesarean Delivery
• Sample Cesarean Section Induction Scheduling Policy
• Scheduling Form for Inductions and Cesarean Deliveries

 Resources

• Leapfrog Early Elective Deliveries Webinar Feb 2012
• IHI How to Guide: Prevent Obstetrical Adverse Events 
• OB/EED Driver Diagram
• Article: ACOG Committee Opinion: Nonmedically Indicated Early Term Deliveries
• ACOG New Guidelines for Safe Prevention of Cesarean Delivery

CMQCC, the March of Dimes, and the <39 Weeks Toolkit Development Task Force have developed a Quality Improvement Toolkit, "Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age" to decrease deliveries before 39 weeks in California and to help disseminate and determine best practices for prevention of early deliveries and to outline the most effective strategies for supporting California health care providers in implementing those practices.

Download complete March of Dimes/CMQCC Toolkit. 

The toolkit has the following sections which can be downloaded separately by clicking on the links below. Please note: the links open new windows, which will open a document from an outside website. Each linked document is a PDF. To view a PDF, please download Adobe Reader from the link provided below.

• Title Page  
   
• Table of Contents  
   
• Acknowledgements  
   
• Making the Case  
   
• Implementation Strategy  
    
• Data Collection/QI Measurement 
   
• Clinical Education  
   
• Patient Education  
   
• Appendices Listing  (summary)
  

  Appendix A: Form 3  - Induction/Cesarean Section Delivery Scheduling Form

  Appendix A: Form 4  - Scheduling Process Form

  Appendix A: Form 5  - Consent Form

  Appendix B: Case Studies 

  Appendix C: Form 6  - QI Tools - MAP-IT Worksheet

  Appendix C: Fishbone Diagram 

  Appendix C: PDSA Method 

  Appendix D: Letters of Support 

• References  

Please note: The appendices and references are downloadable in one section. The references are not repeated in other sections. Resources for the toolkit are available here.

The History of the Toolkit

The Toolkit Development Task Force, with co-chairs Brenda Chagolla, RNC, MSN, CNS, Elliott Main, MD and Bryan Oshiro, MD worked collaboratively with the March of Dimes, CMQCC and the California Department of Public Health, Maternal, Child and Adolescent Health Division to develop and disseminate this Toolkit. Academic and clinical leaders in California and across the United States contributed as writers and reviewers. The goal of the toolkit is to provide guidance and support to obstetric providers, clinical staff, hospitals, and health care organizations to develop efficient and successful quality improvement programs to eliminate elective deliveries <39 weeks gestation.