Early Elective Delivery: Decreasing Incidence of 37 to 39 Week Inductions and Cesarean Sections Without Medical Justification

In the 2010 reporting period (July 2009-June 2010), the medical center's incidence of early elective deliveries without medical justification per Leapfrog definitions was 33.5 percent. A gap was identified between their internal data and Leapfrog reported data.

The department of obstetrics and gynecology was educated on Leapfrog's definition, rationale and data and they decided to align their internal definition and measurement with Leapfrog. Education on the risks of early elective deliveries was provided to practitioners and patients.

In October 2011, the medical center implemented a policy and process to reduce early elective deliveries. By the end of 2011, their early elective delivery rate decreased to 7.7 percent. The current rate is 2 percent, better than the Leapfrog 2012 goal.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)