The document discusses using checklists to improve safety during childbirth. It found that using a surgical safety checklist reduced complications, deaths, and infections. The task force will test checklists at four pause points during pregnancy, delivery, and the postpartum period. The checklists are meant to prompt essential tasks, improve communication, and catch issues. If successful, checklists could be scaled to improve outcomes for every woman and child.
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Piecing Together Safe Childbirth: Exploring Simple, Life-Saving Checks Across the Childbirth Continuum
1. PIECING TOGETHER SAFE CHILDBIRTH
Exploring Simple, Life-Saving Checks Across the Childbirth Continuum
Every Woman Every Child
Innovation Working Group
Task Force on Checklists
Interim Progress Report
April 2012
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5.
6. Surgical Checklist: Results
Results – All Sites
Baseline Checklist P value
Cases 3733 3955 -
Death 1.5% 0.8% 0.003
Any Complication 11.0% 7.0% <0.001
SSI 6.2% 3.4% <0.001
Unplanned Reoperation 2.4% 1.8% 0.047
7. EWEC IWG Checklist TF
Strategy Selection Criteria
• Potential impact
• Simplicity & user-friendliness
• Feasibility for testing
• Feasibility for scaling
• Applicability across countries
• Link to EWEC goals
10. Childbirth Checklist: Pause Points
Pause point #2
Pause point #3
Just before pushing
Soon after birth
(or before Cesarean)
Pause point #1 (within 1 hour)
On admission
Pause point #4
Delivery Before Discharge
Labor progression Postpartum
Admission to birth facility Discharge from birth facility
Labor onset
Antenatal period 28 days
Conception
42 days
Pre-conception
Time
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13. Childbirth Checklist Pilot Study
On admission At delivery
Soon after birth (within one hour) Before discharge
*P value = 0.052; all others p < 0.001
14. Checklists: Theories of Change
• Prompt at key moments in care
• Define essential tasks
• Highlight system malfunction
• Impose conceptual structure
• Increase team communication
• Facilitate essential dialogue
20. Acknowledgments
IWG Task Force on Checklists
Chairs
Scott Ratzan, Jonathan Spector
Members
Angela Lashoher, Claire Lemer, Sarah Marsh, Garrett Mehl, Marc
Mitchell, Ida Neuman, Prabhjot Singh
Advisory Group
Franklin Apfel, Gary Darmstadt, Lord Darzi of Denham, Karlee Sliver,
Bruce Gellin, Atul Gawande, Barry Bloom, Flavia Bustreo, Ian Pett,
Anayda Portela, Mario Merialdi, Patricia Mechael, Jean-Marie Okwo-
Bele, Ian Pett, Joanna Rubenstein, Sonia Ehrlich Sachs, Alexandra
Schoeb, Karlee Silver, Severin von Xylander
Support
Alice Fabiano, Grace Galvin, Amanda McKelvey, and Ade Obayemi
Editor's Notes
When BOEING makes a plane, they produce a ‘USER MANUAL’. Individual Airlines can modify slightly, but have to get permission (“NO TECHNICAL OBJECTION”) from Boeing.
