To evaluate the effectiveness of an existing quality improvement (QI) training program known as TeamBirth, using a randomized stepped-wedge hybrid type II study design, to (a) decrease nulliparous term singleton vertex (NTSV) cesarean birth (CB) across all birthing people, and specifically for Black birthing people, and (b) increase shared decision-making (SDM), (c) improve patient experience of respectful care. TeamBirth uses a train-the-trainer model to implement patient-participatory shared decision-making on Labor and Delivery (L\&D) units, with the goal of decreasing unwanted and unnecessary interventions and improving patient experiences and outcomes for labor and birth.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
2,200
TeamBirth
Endeavor Health Northwest Community Hospital
Arlington Heights, Illinois, United States
RECRUITINGRush Copley Medical Center
Aurora, Illinois, United States
RECRUITINGLoyola MacNeal Hospital
Berwyn, Illinois, United States
RECRUITINGMemorial Hospital of Carbondale
Carbondale, Illinois, United States
RECRUITINGMount Sinai Hospital
Chicago, Illinois, United States
RECRUITINGNorthwestern Memorial Hospital
Chicago, Illinois, United States
RECRUITINGJohn H Stroger Memorial Hospital
Chicago, Illinois, United States
RECRUITINGRush University Medical Center
Chicago, Illinois, United States
RECRUITINGUI Health
Chicago, Illinois, United States
RECRUITINGSaint Mary of Nazareth Hospital
Chicago, Illinois, United States
RECRUITING...and 12 more locations
Nulliparous Term Singleton Vertex (NTSV) Cesarean Birth (CB)
NTSV CB Rate for all birthing people in participating hospitals
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Shared Decision Making (SDM)
Childbirth Options, Information, and Person-Centered Explanation (CHOICEs) scale, scores range from 14 to 90, high scores indicate higher levels of shared decision making
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
NTSV CB in Black birthing people
NTSV CB Rate Black birthing people in participating hospitals
Time frame: 6 months prior to TeamBirth , 3 months post TeamBirth implementation
SDM in Black birthing people
Childbirth Options, Information, and Person-Centered Explanation (CHOICEs) scale, scores range from 14 to 90, high scores indicate higher levels of shared decision making
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Patient Experience
Illinois Perinatal Quality Collaborative (ILPQC) Patient-Reported Experience Measure (PREM), there is no numerical value assigned to the ILPQC PREM
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Patient Experience
Mother's Autonomy in Decision Making (MADM), scores range from 7 to 42, higher scores indicate the women had greater agency and autonomy when engaging in a shared decision making process with a maternity care provider
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Patient Experience
Person-Centered Maternity Care Scale for use in the United States (PCMC-US), scores range from 0 to 100, higher scores indicate more person-centered maternity care
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Patient Experience
CollaboRATE, scores range from 0 to 100, a higher score means the number of core dimensions of shared decision making are met
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
Patient Experience
Acceptability of Intervention Measure (AIM), scores range from 3 to 15, the lower the score, the more satisfied the patient was with their care
Time frame: 6 months prior to TeamBirth, 3 months post TeamBirth implementation
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