By Kim Smiley
Infant mortality rate is often used as an indication of a nation’s health and social condition. When reviewing the data for different countries, it becomes obvious that for a wealthy, developed country, the United States has a high infant mortality rate. According to the CIA World Factbook, the US infant mortality rate is 6.2 deaths per 1,000 births, which is nearly twice that of France, Italy and Spain. Additionally, the US ranked 60 for maternal deaths in a study for the Institute for Health Metrics and Evaluation.
The good news is that healthcare providers are working to improve care and help reduce preventable injuries and deaths during childbirth. Obviously, access to prenatal care, overall health of the mother and other factors play a role in birth outcomes, but some relatively simple solutions targeting labor and delivery care have proven to dramatically increase birth outcomes. A new report “Solutions in Sight” by the nonprofit Public Citizen lists some of the successes in improving birth outcomes.
One particularly impressive case is that of Ascensions Health, which reduced its neonatal fatality rate by 50% across its 43 hospitals by implementing relatively cheap, common-sense solutions. Ascension did a number of things to help improve birth outcomes such as improving training and communications. Drills were done to practice how staff should respond in a variety of emergency situations to help medical personnel identify and quickly respond to potentially dangerous scenarios. There was also focus on communication between personnel to help ensure there were no misunderstandings in high pressure situations and to encourage all staff members to speak up if they perceived a dangerous situation.
Additionally, they worked to develop “bundles” of services, which are packages of procedures that have been shown to produce the best results. Bundles are essentially guidelines for how staff should respond in a variety of situations. There was also an emphasis on reducing C-section deliveries that weren’t medically necessary because these types of births are associated with a higher rate of complications. None of these solutions were earth-shattering, but they have proven effective when consistently implemented.
In additional to the clear benefit of saving lives and reducing the number of potentially life-long injuries, improving birth outcomes has economic benefits. Better birth outcomes reduce the likelihood of expensive lawsuits. This example is a classic win-win where doing the right thing actually saves money in the long run as well.
Many of us do not spend our days delivering babies, but this example has many lessons that can be applied across industries. Learning how to provide effective, realistic training can dramatically improve performance. Empowering employees at all levels to speak up when something doesn’t look right can save lives, whether it’s in a factory or a hospital. Formally documenting and using best practices so employees can benefit from others’ experience can streamline many processes and reduce preventable errors. Sometimes the simple solutions really are the most effective.
Typically, a Cause Map is built when something has gone wrong, but it can also be used as a proactive tool to help understand why something has gone right. To view a high level Cause Map of this example, click on “Download PDF” above. Another example of a proactive, positive Cause Map is the Miracle on the Hudson, where all passengers survived a plane landing on a river.