Protect Mothers and Babies from Unnecessary Harm

Virginia Business Coalition on Health joins The Leapfrog Group in announcing a call to action.

Washington, D.C., January 26, 2011—Virginia Business Coalition on Health joins the employer-driven hospital quality watchdog, The Leapfrog Group, in issuing a Call to Action in response to new data finding that thousands of babies are electively scheduled for delivery too early, resulting in a higher likelihood of death, being admitted to a Neonatal Intensive Care Unit (NICU), and life-long health problems.
Despite the importance of this issue to women and babies, Leapfrog is the first national organization to make this information public by hospital. The findings from 773 hospitals in Leapfrog’s 2010 annual hospital survey reveal significant variation among hospitals in their rates of early elective cesarean section and elective inductions, with some hospitals having 10 times the rate of others.

Eileen Ciccotelli, vice president of the Virginia Business Coalition on Health, and Virginia leader for The Leapfrog Group, notes that only Leapfrog reporting hospitals are providing voluntary rates of early elective deliveries at this time. Every hospital should report on this. Experts, including those from the American College of Obstetricians and Gynecologists (ACOG), Childbirth Connection, and the March of Dimes, caution that the amount of time a baby needs to develop fully, which includes having a fully developed brain and other organs, is at least 39 completed weeks. Sometimes there is a medical reason to schedule a newborn delivery before the 39th week—for example, if woman has high blood pressure at the end of pregnancy or broken membranes before labor begins. However, Leapfrog finds that newborns are being “electively” scheduled – meaning without a medical reason – for delivery before the 39th week at alarming rates.

Virginia Business Coalition on Health, Leapfrog, Childbirth Connection, and the March of Dimes are working together to share information about the importance of every week of pregnancy with women, local employers, and others. As a Leapfrog member, Virginia Business Coalition on Health will promote Leapfrog’s new webpage that lists hospital rates of early elective deliveries and share educational resources from Childbirth Connection and the March of Dimes with their employee populations.

The new data on early elective deliveries come from Leapfrog’s 2010 annual hospital survey, where hospitals are asked to report the percentage of non-medically indicated births between 37 and 39 weeks gestation that were delivered electively by cesarean section or induction. The Joint Commission has begun monitoring hospital performance on this quality measure as well. In April 2010, the group added the elective deliveries measure to its perinatal core measure set.

The survey measure is endorsed by the National Quality Forum, an organization tasked with bringing together experts and stakeholders to come to consensus on national measures of hospital quality and safety. Hospital rates of elective deliveries scheduled too early are now available for easier viewing on a special website: www.leapfroggroup.org/tooearlydeliveries.

According to Leapfrog, hospital rates of early elective deliveries range from less than 5% to more than 40%. Among the 773 hospitals nationwide that voluntarily provided Leapfrog with information on this measure, 13 hospitals in Virginia fared “Better Than Target”. The variation in hospital rates has long been talked about in the health care community. Yet Leapfrog’s release of 2010 data is the first real evidence that the practice of scheduling newborn deliveries before 39 weeks without a medical reason is common and varies among hospitals even in the same state or community.

In 2010, Leapfrog’s target for hospitals was a cesarean section and/or induction rate of less than 12% of the total number of non-medically indicated deliveries occurring between the 37th and 39th week of gestation. In 2011, Leapfrog will lower the target to 5%. This change was made in part because 50% of reporting hospitals were able to meet Leapfrog’s 12% target in 2010 and 29% of reporting hospitals exceeded Leapfrog’s target by reporting rates of 5% or less.

About VBCH
The Virginia Business Coalition on Health (VBCH) (www.myVBCH.org ) is a non-profit, 501(c)(3), catalyst-coalition founded in 1983 under the name of the Hampton Roads Health Coalition and expanded Virginia-wide in 2006. VBCH is a member of the National Business Coalition on Health, the National Quality Forum, The Leapfrog Group and others. VBCH unites employers through adoption of value-based benefits-design to improve worksite wellness to include disease management, health plan quality, and hospital patient safety and quality. Programs include the Wellness in the Workplace Awards, eValue8 Health Plan RFI Evaluation, the Leapfrog Hospital Survey, Heart Disease and Stroke Prevention ToolKit for Employers, P3 Diabetes Pharmacist Diabetes Coaching model, Diabetes Resources Directory, education such as their annual Health Summit and regular business roundtables, and communications to promote best practices. VBCH is a mixed-model member coalition of stakeholder purchasers (employers) and providers, representing 300,000 employees and their dependents.

About The Leapfrog Group
The Leapfrog Group (www.leapfroggroup.org) is a coalition of public and private purchasers of employee health benefits founded a decade ago to work for improvements in health care safety, quality, and affordability. Maternal/Child care represents a major component of health benefits programs, and Leapfrog’s purchaser members share concerns about the quality of obstetrics and neonatal intensive care. Early elective deliveries represent a significant cost in health care, with one study estimating that nearly $1 billion dollars could be saved annually in the U.S. if the rate of early elective deliveries were reduced to 1.7%.

The Leapfrog Hospital Survey focuses on three critical areas of patient safety and quality: how patients fare, which includes issues like mortality for common high-risk surgeries and procedures; resources used to care for patients measured by length of stay and readmission rates; and management practices that promote safety and quality, such as adopting computerized physician order entry to reduce medication errors. 2010 Leapfrog Hospital Survey Results for over 1200 hospitals can be found at www.leapfroggroup.org/cp.