Interprofessional Collaborative Approach to Improving Postpartum Hemorrhage Rates

Purpose:
Through data review, we determined that our postpartum hemorrhage (PPH) rate was above the national average. A multidisciplinary team was assembled to design strategies for improvement. The team was led by nursing, and included MDs, RNs, midwives, pharmacists, IT support and leadership.

Significance:
Development of the interprofessional collaborative team was essential for ensuring that all stakeholders had adequate representation throughout the improvement process. Effective team collaboration and communication resulted in meaningful analysis of the issue and productive solution planning.

Strategy and Implementation:
The complexity of the issue warranted a complex solution. The group members represented every possible clinical contact that the patient could have. Each team member brought unique perspective and knowledge to the table, and was valued for his or her contribution. Hierarchy between professions was minimized, as all team members were respected as equal participants in the process. The interprofessional collaborative team worked as a task force to review systems and processes to identify contributing factors for PPH. Review of the literature resulted in implementation of a risk stratification tool, order set bundles, nursing practice and policy revision, and changes to medication administration practices. Simultaneous efforts around simulation training for responding to PPH also contributed to the change process. The combination of evidence-based practice and interprofessional collaboration fostered successful teamwork.

Evaluation:
The combined efforts have resulted in a decrease in the PPH rate. Additional benefits of the collaborative efforts include a heightened awareness around PPH, increased confidence among staff responding to PPH, fewer unanticipated transfusions and decreased admissions to the ICU related to PPH.

Implications for Practice:
While the focus of this interprofessional collaborative team was specific to reducing PPH, the success translates to other disciplines. The model for team member appreciation, respect, and value can be applied to many disciplines throughout healthcare.