Grady General Hospital Protocol Named National Blueprint for Care

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Archbold’s Grady General Hospital is known throughout the state for their award-winning quality healthcare.

But recently, GGH was recognized on a national level by VHA Inc., a national healthcare network that works to improve performance and efficiency in clinical, financial and operational management.

This summer, VHA named GGH’s initiative to eliminate early elective deliveries (EEDs) as a Leading Practice Blueprint, an endorsed model which hospital’s across the country should adopt.

According to the March of Dimes, births across the country are being scheduled early for non-medical reasons, creating significant risks for babies and providing no medical benefit to mothers. Even babies born just a few weeks too soon can face serious health challenges and are at risk for lifelong disabilities such as cerebral palsy, lung problems and vision and hearing loss.

In 2012, Grady General Hospital decided to take steps to improve the health of the mothers and babies in the hospital’s service area. The protocols the hospital put in place took their EED rate from over 50 percent to zero, a rate that has sustained since the initiative began three years ago. 

“When we began to examine this issue, we knew our facility didn’t have a zero percent EED rate, but through the discovery process we were very surprised to learn how high our rate actually was,” said Crystal Ramm, GGH administrator. “This further influenced our decision to focus on this area.”

According to Ramm, changing culture can be difficult for any organizations and GGH was no exception.

“Though our nursing staff was quick to get on board with reducing our EED rates it took several steps to create a culture of accountability that worked for everyone,” said Ramm. “It was truly a team effort.”

“Our first step was to secure support of our senior management team and the health system risk management team in order to implement better policies on elective inductions and scheduled C-sections, which resulted in adoption of a hard stop policy,” said Vicki Jenkins, GGH OB nurse manager. “We also empowered our nurses and other front-line staff to talk with physicians if it appeared that they were perhaps moving forward with an early elective delivery.”

To help further the initiative, GGH hosted a VHA physician for a mentoring session on-site in Cairo to speak directly with physicians about the challenges they would likely face and how they could respond to patient pressure and other real-world scenarios.

“The key reason it worked was because our physicians were truly invested in the success of our hospital,” said Ramm. “When presented with data and the ‘why’ behind the hard stop policy, our entire clinical team recognized the need to reduce EEDs.”

“As physicians, we recognized performing EEDs really could lead to negative outcomes for our patients,” said GGH physician Ashley Register, MD. “What really drove physician buy-in was the education provided and the peer review process for EEDs. Quite honestly, we really just wanted to do what was best for our patients and their new babies.”

For GGH to be recognized, VHA applied industry-standard criteria in the analysis of leading practice indicators to determine if GGH met the guidelines for a leading practice.  This summer, a team of VHA experts visited Cairo to study and document the early elective deliveries prevention processes. GGH’s team collaborated with VHA’s knowledge transfer team to develop a Leading Practice Blueprint® that mapped out each step in the process.  Not only are the clinical processes showcased, but also the cultural factors and social patterns that influence performance to ensure the most success in transferring the knowledge for other hospitals to implement.

“We were absolutely thrilled with our results of having a zero percent EED rate for over two years. Our nursing staff and physicians, along with our group working with VHA, are to be commended for not only reaching but surpassing our original goal of a five percent EED rate,” said Ramm. “We truly feel we have hardwired this change into practice and are excited to know that we are providing the best and safest care to all our OB patients. It is such an honor that our team is being recognized for their efforts to make our hospital a safer place for our patients. We hope other hospitals can have the same success by adapting our process so many patients across the country can benefit.”