Physician-Driven Initiative to Reduce Hospital Episiotomy Rates

Although episiotomy was once considered a routine part of childbirth, in recent years, there has been a shift away from this practice. Episiotomies have been linked to perinatal injury, loss of bladder or bowel control and other complications that can increase costs and endanger the mother's health. Spurred by the hospital's 2014 Leapfrog score, physicians in the obstetrics department collaborated with staff in the nursing and quality departments and their peers to reduce episiotomy rates in the hospital.

By implementing processes for improved documentation, clearer communication between teams and healthy, transparent reporting on individual physicians' rates, they reduced the rate from 26.2 percent in calendar year 2013 to 10.5 percent for January through April 2015, which is below the 12 percent target rate set by Leapfrog in 2014.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations 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—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/