Early Elective Deliveries Initiative

Reducing EED before 39 weeks gestational age is a priority focus area for the Centers for Medicare and Medicaid Services (CMS) because research has shown that by doing so mothers and babies have better health outcomes – including a reduced length of stay, reduced transfer to an intensified level of care and decreased financial costs to the system.* Elimination of EED requires the education, training and support of all perinatal health-related practitioners, advocates, policymakers and payers as well as patients and their families.

Building on the success of the FPQC’s partnership in the March of Dimes (MOD) 2011 Big 5 Project to reduce non-medically indicated deliveries <39 weeks, the FPQC has expanded this initiative to more Florida hospitals by continuing to partner with the MOD and the Florida Hospital Association (FHA). The three organizations, through the Health Research & Educational Trust (HRET) Hospital Engagement Network (HEN), continue working together to assist participating hospitals in moving towards the goal of reducing EED to 3% or less by the initiative’s conclusion in December 2013. Additionally, the FPQC is working with ACOG District XII to reach out to hospitals not yet identified as working with the MOD or the HEN to provide support and technical assistance in addressing EED. Substantial progress has been made in Florida and around the county at reducing these early deliveries. Efforts now focus on those few hospitals needing to further reduce these early births to acceptable levels.

To support hospital outreach efforts, the FPQC coordinates education and communication regarding the importance of the last weeks of pregnancy that features: a Speaker's Bureau of physician leaders available to conduct Grand Rounds and other professional presentations at maternity care institutions; publishing literature summaries of EED-related research in quarterly e-bulletins for distribution to providers across the state; supplying education packets and materials to hospitals; and, providing strategic outreach activities to monitor and improve the rates of non-medically indicated deliveries before 39 weeks in Florida's hospitals. The FPQC works in partnership with the Florida Association of Healthy Start Coalition's parallel consumer campaign on the importance of the last two weeks of pregnancy.

Through increasing awareness among providers and other stakeholders on this issue, the FPQC hopes to foster intermediate outcomes such as greater readiness to implement hospital perinatal quality improvement (QI) initiatives, policies and procedures regarding appropriate scheduling of deliveries. Recognizing the need to build the skills of Florida’s hospitals to implement this and other QI projects, the FPQC is planning a series of QI symposia throughout Florida in 2014. These events will focus on using the tools and methods of the TeamSTEPPS approach to quality improvement to enhance communication and standardize procedures between and among practitioners across the perinatal system to optimize patient safety and improve outcomes.

*A California Toolkit to Transform Maternity Care: "Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age," 2010. A collaborative project developed by the March of Dimes, the California Maternal Quality Care Collaborative, and the Maternal, Child and Adolescent Health Division; Center for Family Health California Department of Health.