This proposal will determine if a Disparities in Labor Outcomes dashboard can be used as an implementation strategy to increase compliance to an evidence-based set of interventions for labor induction in a two-site difference-in-differences study design.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
2,300
This Dashboard, a method of audit and feedback, will detail use of evidence-based practices and clinical outcomes on labor and delivery as attributed to individual clinicians on labor and delivery, stratified by race and ethnicity.
Hospital of the University of Pennsylvania; Pennsylvania Hospital
Philadelphia, Pennsylvania, United States
Fidelity to a labor induction protocol recommendation to perform all cervical exams performed in latent labor were performed less than or equal to 4.5 hours apart
Reported as binary - compliant or noncompliant; Time between cervical exams from first exam at admission for labor induction to reaching 6cm dilation will be calculated. If any time between exams is \>=4.5 hours, the outcome will be considered "non-compliant". If all are \<4.5 hours, the outcome will be "compliant."
Time frame: from first cervical exam after admission for labor induction until the patient's cervical exam reaches 6cm dilation
Cesarean delivery
Reported as binary (yes cesarean or no cesarean); mode of delivery (cesarean or vaginal) will be determined at the time of delivery
Time frame: single time point, at the time of delivery
Maternal morbidity
greater than or equal to 1 of the following: endometritis, postpartum hemorrhage, blood transfusion, wound infection, venous thromboembolism, hysterectomy, intensive care unit admission, readmission within 30 days, and death
Time frame: from delivery until 30 days postpartum
Time to delivery
Time frame: as time from start of induction to delivery in hours
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