Initiative
Obstetric Hemorrhage
Obstetric hemorrhage (OBH) is among the leading causes of preventable, pregnancy-related complications and death in Alabama, representing approximately 17% of pregnancy-related deaths between 2017-2019. Due to the physical trauma that a birthing person’s body endures during childbirth, hemorrhages can occur in patients without risk factors and is frequently not recognized until massive blood loss has occurred. Unfortunately, early recognition and intervention of OBH does not occur consistently across ER, L&D, and postpartum units.
Project Aim
Beginning January 2024, ALPQC will work in collaboration with hospitals and providers throughout Alabama to reduce the rate of SMM by 20% among pregnant and postpartum patients who experience an obstetric hemorrhage. Our key goals will be to increase the percentage of patients who receive a hemorrhage risk assessment, increase the use of quantification of blood loss, ensure patients that experience an obstetric hemorrhage receive a trauma-informed briefing of the event prior to discharge, and to narrow the black/white inequities in SMM among patients that experience an obstetric hemorrhage.
In efforts to achieve the ALPQC’s project aim for OBH, the Alliance for Innovation on Maternal Health (AIM) obstetric hemorrhage bundle will be used and tailored to the specific needs of the collaborative. AIM provides structured patient safety bundles with actionable steps to improve patient outcomes and data collection.
Increase the percentage of patients who receive a hemorrhage risk assessment.
Increase the use of quantification of blood loss
Ensure patients receive trauma-informed briefing prior to discharge
Narrow the black and white inequities in SMM among patients that experience obstetric hemorrhage.
Key Documents
Clinical Documents
- OBH Patient Debriefing Tool – Spanish
- OBH Patient Debriefing Tool
- AIM OBH Element Implementation Details
- ACOG OBH Risk Assessment Table
- ACOG Patients Who Decline Blood Products (Guidance Example)
- Checklist for Patients Who Decline Blood Products Example (CMQCC)
- Maternal Compensatory Diagram
- Medications for Postpartum Hemorrhage (CMQCC)
- Obstetric Hemorrhage Stages Algorithm (Example) -updated 02/20/2024
- Team Debreifing Form (Example)
- ACOG Hemorrhage Checklist/Protocol (Example)
Quality Improvement Tools
- SMART Aim Worksheet
- Driver Diagram How-To & Worksheet (IHI)
- 30-60-90 Day Plan Worksheet
- 30-60-90 Day Plan Sample
- PDSA How-To & Worksheet (IHI)
- OBH PDSA Worksheet
- OBH PDSA Sample
OBH Bootcamp Series
Data Resources
- OBH Outcome Measures Codes (Excel)
- OBH Data Measures Form (PDF) – updated 04/15/2024
- How to Use Random Number Generator (PDF)
- OBH Outcome Baseline Data Collection Worksheet (Excel)
- OBH Baseline Data Measures Form (PDF)
- ALPQC OBH FAQs
- AIM OBH Data Collection Plan (PDF)