Two Widely Used Quality Measures For Obstetric Care Not Associated With Severe Complications In Mothers And Babies



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INTRO: Each year in the United States about 60 thousand women and one out of every ten low-risk babies experience severe complications during and after childbirth. There are existing quality measures used to assess these complication rates in order to help hospitals provide better care. A new study evaluated two of these measures to determine if they were associated with severe complications in both mothers and their babies. Catherine Dolf explains in this week’s JAMA Report. B-ROLL Margaret holding her baby, cu of baby NEW MOM MARGARET STEVENS IS HOLDING HER FIRST CHILD, JOHN RANDALL O’KEEFFE. SOT/FULL Margaret Stevens - New Mother Super@:04 Runs:08 “When we got through the labor and delivery and there were no complications it was just a huge feeling of relief.” B-ROLL Margaret and her baby HOWEVER, NOT ALL DELIVERIES ARE THAT SMOOTH. SOT/FULL Elizabeth A. Howell, M.D., M.P.P., - Icahn School of Medicine at Mt. Sinai Super@:15 Runs:08 “There’s significant variation in how well hospitals perform in the care they deliver to women during their delivery hospitalization.” B-ROLL Dr. Howell walking in hospital, talking with colleague Graphic over video, various shots of hospital nursery, cu of babies hand DR. ELIZABETH HOWELL FROM THE ICAHN SCHOOL OF MEDICINE AT MT. SINAI AND CO-AUTHORS EXAMINED TWO WIDELY USED QUALITY MEASURES, ELECTIVE DELIVERIES PERFORMED PRIOR TO 39 WEEKS OF GESTATION AND CESAREAN DELIVERIES IN LOW-RISK WOMEN, LOOKING TO SEE WHETHER THESE WERE ASSOCIATED WITH SEVERE COMPLICATIONS IN MOTHERS AND THEIR BABIES. THEY EXAMINED 116 THOUSAND DELIVERIES THAT TOOK PLACE AT 41 NEW YORK CITY HOSPITALS DURING 2010. SOT/FULL Elizabeth A. Howell, M.D., M.P.P., - Icahn School of Medicine at Mt. Sinai Super@:47 Runs:10 “Hospitals that performed well on these quality measures didn’t necessarily have low rates of severe complications in moms or babies.” B-ROLL Graphic over video SEVERE COMPLICATIONS FOR MOTHERS INCLUDE, KIDNEY FAILURE, RESPIRATORY FAILURE, AND THE NEED FOR BLOOD TRANSFUSIONS. FOR BABIES, NERVE DAMAGE, HYPOXIA OR NOT HAVING ENOUGH OXYGEN, SHOCK AND INFECTION. SOT/FULL Elizabeth A. Howell, M.D., M.P.P., - Icahn School of Medicine at Mt. Sinai Super@1:08 Runs:09 (Video covering middle of bite: mother walking with baby) “About one in every 42 women had one of these severe maternal complications. One in about 13 babies had a complication.” GXF FULL JAMA COVER THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. SOT/FULL Elizabeth A. Howell, M.D., M.P.P., - Icahn School of Medicine at Mt. Sinai Super@1:21 Runs:20 (Video covering middle of bite: Dr. Howell looking at chart, nurse attending to a baby) “Some hospitals had rates that were three to four times higher than other hospitals. The current measures are not sufficient, they’re good but we need more, and unless we measure the right things we don’t know where to improve. We want a robust set of quality measures that capture the outcomes that are important to women.” B-ROLL Margaret and her baby ALTHOUGH MARGARET IS TIRED, SHE IS ENJOYING BEING A MOM. SOT/FULL Margaret Stevens - New Mother Super@1:44 Runs:11 (Video covering 2nd half of bite: Margaret and her baby) “I’ve only had two hours of sleep, so motherhood has been sleepy but filled with an indescribable feeling of joy and relief.” B-ROLL Margaret and her baby on the bed CATHERINE DOLF, THE JAMA REPORT. TAG: ON AVERAGE, A HOSPITAL WITH HIGHER COMPLICATIONS IN MOTHERS ALSO HAD HIGHER COMPLICATIONS IN BABIES. Please see the complete study for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. TO CONTACT: Dr. Elizabeth Howell call: Sid Dinsay at (212) 241-2965 doi.10.1001/jama.2014.13381 ADDITIONAL SOUNDBITES: Elizabeth A. Howell, M.D., M.P.P., - Icahn School of Medicine at Mt. Sinai QUOTE 1 Runs :21 “A number of severe maternal complications occur every year in this country. In fact, about 60 thousand women have a severe complication during their delivery hospitalization. We also know that complications occur in low-risk babies about one in ten. And we also know that a significant portion of these complications are preventable making quality of care really important.”
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