PQCNC SIVB LS1 Aggregate Baseline Data

8/7/2019 PQCNC SIVB LS1 Aggregate Baseline Data

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PQCNC Support for Birth InitiativeAggregate baseline data


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JCAHO rate = C/S rate for all NTSV admissions (includes scheduled C/S)


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FacilityJoint CommissionRate

110 27.03%120 25.00%200 10.53%210 18.42%270 28.21%300 19.51%320 37.14%330 14.29%350 24.00%380 54.55%390 23.08%392 34.78%

FacilityJoint CommissionRate

400 16.00%420 34.51%430 33.75%500 24.00%510 21.43%530 30.23%540 34.21%550 6.25%640 21.74%650 35.90%660 24.68%680 39.39%

All Facilities November 2010 "Joint Commission" Rate


4/17

NTSV vaginal birth rateAggregate: 75.23% overall, 80.23% no risk factors, 61.69% with risk

Facility VBRoverall

VBR noriskfactors

1+ riskfactors

110 79.22% 80.60% 70.00%

200 81.82% 82.50% 80.00%

210 77.50% 73.30% 80.00%270 76.92% 83.08% 46.15%

300 68.24% 79.03% 39.13%

320 73.08% 81.82% 45.16%

330 86.71% 91.67% 50.00%

350 66.67% 72.09% 50.00%

390 82.00% 87.18% 63.64%

391 80.00% 85.00% 70.00%

392 74.07% 78.18% 56.00%

400 75.56% 81.08% 50.00%

Facility VBRoverall

VBR noriskfactors

1+ riskfactors

420 74.23% 80.45% 60.66%

430 73.29% 78.95% 53.13%

490 91.30% 94.12% 83.33%500 80.95% 78.82% 90.00%

510 86.36% 88.24% 80.00%

530 74.39% 80.65% 55.00%

540 69.62% 70.83% 67.74%

550 93.75% 93.33% 100%

640 70.83% 71.05% 70.00%

650 73.42% 80.70% 54.55%

660 78.23% 85.53% 66.67%

680 76.81% 81.63% 65.00%


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Frequency of maternal risk factors

Diabetes IUGR Maternalage >35

Hypertensivedisease

Macrosomia(EFW >4000g)

Obesity

100 46 74 231 18 184

5.0% 2.3% 3.7% 11.6% 0.9% 9.2%

n=1998


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Baseline Data: Vaginal Birth Rate by Cervical Dilation andLabor Status at Admission

Type of Labor

Numberof

patientswith nocervical

exam atadmissionprovided

Percentwho

delivered

vaginally

Numberof

patientsadmitted

with a

cervicaldilation of

0-3cm

Percentwho

delivered

vaginally

Numberof

patientsadmitted

with a

cervicaldilation of

4+cm

Percentwho

delivered

vaginally

Totalnumber of

patients

Total whodeliveredvaginally

Induction

of labor7 42.86% 927 64.83% 47 70.21% 981 64.93%

Spontaneous labor

1 100.00% 469 82.73% 487 88.71% 957 85.79%


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Labor patientsDilation at admission 0cm 1cm 2cm 3cm

Number 14 88 140 231

Percent of laborpatients

1.5% 9.2% 14.6% 24.0%

Aggregate Frequency of Cervical Dilation< 4cm among Patients in laborat Admission

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

1

%age of pts in labor at 0cm

%age of pts in labor at 1cm

%age of pts in labor at 2cm%age of pts in labor at 3cm


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Aggregate frequency of cervical dilations admittedNOT in labor and with intact membranes

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Of pts not in labor, notruptured, number and

percent that were 0-1cm





Cesarean Deliveries

Vaginal Deliveries

# pts not in labor with intactmembranes at admission

Not in labor, intactmembranes, cervicaldilation at admission

0-1cm


2-3cm


4-5cm

766 491 233 37

64.1% 30.4% 4.8%


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Aggregate Mode of Delivery By Use of Cervical Ripening Among Patients Admitted for Induction of Labor01/01/2010 - 12/31/2010

Cervical Ripening TotalCesarean Section

CountCesarean Section

RateVaginal Delivery

CountVaginal Delivery

Rate

Cervical Ripening

Not Used551 171 31.03% 380 68.97%

Cervical RipeningUsed

430 173 40.23% 257 59.77%


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Aggregate Mode of Delivery by Top 5 Cervical Ripening Methods01/01/2010 - 12/31/2010

Method Cesarean Section Vaginal DeliveryFrequency of

UsageVaginal Birth Rate for this

Method

Cervidil 16.52% 26.02% 42.53% 61.17%

Cytotec 9.95% 15.16% 25.11% 60.36%

Foley Bulb 7.47% 9.95% 17.42% 57.14%

Foley Bulb+Cervidil 0.68% 1.81% 2.49% 72.73%

Foley Bulb+Cytotec 1.81% 3.17% 4.98% 63.64%


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12/17

Aggregate Primary Indication for C-section01/01/2010 - 12/31/2010

Indication

Chorioamnionitis 0.42%

Malpresentation 1.04%

(No indication) 1.67%Failed operative vaginal delivery 1.67%

Presumed cephalopelvic disproportion 4.38%

Other 5.00%

Failure to descend (2nd stage C/S) 14.38%

Nonreassuring fetal status 31.46%

Failure to progress (1st stage C/S) 40.00%


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Aggregate IUPC Use Among Failure to Progress Cesareans01/01/2010 - 12/31/2010

IUPC Used IUPC Count IUPC Rate

(No answer) 10 5.21%

No 68 35.42%

Yes 114 59.38%


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Aggregate Frequency of Adequate Uterine ContractionsPrior to FTP C-section (primary indication)

# MVUs reached 2002hrs

# MVUs DID NOT reach 2002hrs

No answer

42 64 936.5% 55.7% 7.8%

# MVUs reached200 2hrs

# MVUs DID NOTreach 200 2hrsNo answer


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16/17

How many women in NC go into spontaneous labor?Data from PQCNC 39 Weeks Project

Hospital Induction rateJune 2010

Scheduled C/S rateJune 2010

Total ScheduledJune 2010

A* 22.2% 12.1% 34.2%

B 45.5% 27.3% 72.8%

C 30.2% 13.9% 44.1%D 21.3% 16.9% 38.2%

E 29.9% 22.4% 52.3%

F 54.5% 9.1% 63.6%

G 22.7% 16.5% 39.2%

H* 12.6% 21.2% 33.8%

I 35.5% 34.0% 69.5%

J* 18.0% 10.3% 28.3%


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Understanding your data

If something doesnt look right, consideryour sample size was it too small?

Sample should be a minimum of 40 NTSVpatients admitted for intended vaginal birth

Sample should be consecutive patients

Documents

PQCNC SIVB LS1 Aggregate Baseline Data