Strong science exists for much of ‘what‘ we do in perinatal care. The track record of safety is strong when you consider the actual number of poor outcomes. However, our execution (‘how‘ we do our work) of the best science varies quite a lot from clinician to clinician for both nurses and physicians. We know this from both chart reviews and malpractice claims.

In order to improve the safety and reliability of our care and outcomes, we have to agree on both the ‘what’ and the ‘how’ of the care for our patients. 

We need and want a care system that can deliver the best care at a high level of reliability. The current system of care cannot get us to that level of reliability without redesign of the care system and improving the reliability of our processes of care (induction, augmentation, fetal monitoring, determining and honoring patient preferences, etc.).

IHI is working with teams as part of the Improving Perinatal Care Collaborative to test new ideas that address these issues.

Applying the principles of reliability science as developed by IHI, teams are testing the implementation of two bundles: the Elective Induction Bundle and the Augmentation Bundle.

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Perinatal Trigger Tool

The Perinatal Trigger Tool provides instructions for conducting a retrospective review of patient records using triggers to identify possible adverse events causing any physical harm to the infant or mother.

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Idealized Design of Perinatal Care

IHI Innovation Series White Paper

Reviews of perinatal care have consistently pointed to failures in communication among the care team and documentation of care as common factors in adverse events that occur in labor and delivery. This white paper provides detail about IHI's Idealized Design process and examines some of the initial work of the Idealized Design of Perinatal Care innovation project.

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