Becker's Clinical Quality & Infection Control

17 QUALITY IMPROVEMENT & MEASUREMENT 1 in 5 women report mistreatment during maternity care: CDC By Mariah Taylor T wenty percent of women reported experiencing mistreatment during pregnancy and delivery care, a new CDC report found. The CDC analyzed data from the Porter Novelli View Moms survey, which had 2,402 participants report on overall satisfaction with the maternity care they received. The survey was given between April 24-30. Here are five key findings: • Reported mistreatment during maternity care was highest among Black (30 percent), Hispanic (29 percent) and multiracial (27 percent) women. • Women with no insurance or public insurance reported at least 10 percentage points more mistreatment compared to women with private insurance. • The most common incidents of mistreatment reported were receiving no response to requests for help, being shouted at, not having their physical privacy protected, and made to accept unwanted treatment or being threatened with withholding treatment. • Discrimination based on age, weight and income varied by race, but about 29 percent of women reported experiencing it during maternity care. • Forty-five percent of women reported holding back questions or concerns for fear of being told what they were experiencing was normal, being embarrassed to talk about it, feeling their healthcare provider would think they were difficult, thinking their healthcare provider seemed rushed, or not feeling confident. Quality maternity care can be one way to reduce pregnancy- related deaths. The report offered three things healthcare systems and professionals can do to improve quality care: • Systems can encourage a culture of respectful maternity care, hire and keep a diverse workforce, and train all staff on unconscious bias and stigma. • Systems can promote quality improvement actions with a focus of increasing respect in maternity care. • Providers can take steps to ensure all patients feel respected, understood and valued. n authority to regulate, penalize or sanction, and yet has steadily and sustainably advanced aviation safety. ere is now a growing coalition of healthcare and other organizations calling for the establishment of a National Patient Safety Board to play a similar role in healthcare. Amrit Gil, MD. Associate Chief Safety Officer at Cleveland Clinic: Organizations such as the Agency for Healthcare Research and Quality as well as pediatric organizations like Solutions for Patient Safety have attempted to put a dollar amount on the cost of healthcare-acquired conditions (e.g., central line-associated blood stream infections, adverse drug events) that cause preventable harm. is cost when multiplied by the number of events happening in hospitals today is astronomical. Yet it pales in comparison to the impact of this harm on the real lives it affects: a life lost or significantly negatively impacted due to a preventable harm event in a setting where the expectation is healing; a family emotionally devastated and burdened with medical bills; the ripple effects on the second victims and the caregivers taking care of the patient that may have been involved in an error that caused harm to their patient. We have a moral imperative to do better, and I believe the establishment of a national patient safety board or team will point us to our north star and provide an evidence-based structure where we can all learn and improve collectively to benefit our patients and our teams. is body must demand rigorous attention to well-designed systems and processes as well as human-factor integration, health information technology, device safety, and safe transitions of care. Jason Custer, MD. Director of Patient Safety at the University of Maryland Medical Center's downtown campus: What I feel are the barriers from the hospital side is that individual hospitals need to feel accountable to something for patients. Many of them are accountable to e Joint Commission. e Joint Commission does have a voluntary safety event set no event reporting tool. When you go down a legislative route, and create something like a National Patient Safety Board and you take that voluntary reporting route, the hesitancy from organizations is that they will be singled out. And alternatively, if you bring in external consultants, then they may not understand the clinical nuance of that case. So anytime that we review a case we want to make sure that we get sort of a comprehensive, multidisciplinary look. I think hospitals would need assurances: one, that it would be anonymous and that these reports that were coming out of the board wouldn't carry a specific hospital label on it. en two, to make sure that you have some of the team members that are closest to the case [involved]. You have to sort of listen to their perspectives and opinions of the nuances of that clinical care because with putting the patient at the center of it all, it is important to understand that all patients aren't the same. n "We have a moral imperative to do better, and I believe the establishment of a national patient safety board or team will point us to our north star and provide an evidence-based structure where we can all learn and improve collectively to benefit our patients and our teams." — Amrit Gil, MD

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