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Upcoming important dates, next steps for the SIVB Phase II Initiative...
(The Support for Birth initiative's weekly email newsletter comes out every Tuesday.)
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| In the literature... |
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Alternative Strategy to Decrease Cesarean Section: Support by Doulas During Labor.
Guadalupe Trueba, LCCE, FACCE, CD (DONA), Midwife, Carlos Contreras MD, Maria Teresa Velazco, MD, Enrique Garci'a Lara, MD, Hugo B. Martin'nez, MD.
The Journal of Perinatal Education Vol. 9, No. 2, 2000
Objective: To evaluate efficacy of the support given by a doula during labor to reduce cesarean rate.
Results: Results confirmed that support by doulas during labor was associated with a significant reduction in cesarean birth and pitocin administration. There was a trend toward shorter labors and less use of epidurals. The results of this study showed, as in other trials measuring the impact of a doula's presence during labor and birth, that doula support during labor is associated with positive outcomes that have physical, emotional and economic implications.
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| Culture: The Road of Trials and Obstacles: |
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Change is situational. A structure is changed, new policies are introduced, a workforce enlarged or reduced, a strategy shifted or discarded. Imbedded in the American culture and its frontier heritage is the notion that you can always start over and leave the past behind. In contrast with older nations that evolved slowly over thousands of years, the U.S. is often viewed as the product of a series of intentional changes. On that historical note, it is not surprising that many leaders fail to understand the important process of managing human transition. Picasso said, "Every act of creation is first an act of destruction."
Transition is a three-phase process of psychological reorientation that people must travel through as they come to terms with change. Transition always begins with an ending, people leave the known limits of the old reality and move into the neutral zone-a state of dormancy-where old behaviors and attitudes fade and people internally prepare themselves before venturing into an unknown realm where the rules and limits are not fully known. Only after completing the first two phases can people embrace the third: beginning again with a new purpose, outlook and identity
(Kimball, 2005)
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| QI Tips: Developing a change |
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Confronted with the need for change, many people first respond by attempting more of the same (more money, more people, more inspection, more equipment, more rules, and so on). If improvement results, it is usually costly and might not last long. Another ineffective response to the need for change is to try to define the perfect change. People often become so busy developing the perfect change that nothing gets done. Changes developed should be detailed enough to test. For example, if "better communication" is suggested as a change, some detail around who, what, when, where, and how would be needed.
We have found three approaches to be effective to develop a change that results in improvement:
1. An understanding of processes and systems of work
2. Creative thinking
3. Adapting known good ideas
Langley, Gerald J.; Moen, Ronald D.; Nolan, Kevin M.; Nolan, Thomas W.; Norman, Clifford L.; Provost, Lloyd P. (2009-06-03). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (JOSSEY-BASS BUSINESS & MANAGEMENT SERIES) (Kindle Locations 951-952). Wiley Publishing. Kindle Edition.
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| SIVB November Webinar |
|  The next webinar is Tuesday, November 27th, 7:30 - 8:30 AM. Please plan to have at least one person from your team on the call so we can hear your 'voice'.
Forsyth Medical Center will share the results of their use of the C-Section Review tool. We will have a family panel to continue our discussion of home births. Please come prepared with ideas for the next PDSA cycle.
Click here for webinar information.
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Contact
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Tammy Haithcox
PQCNC Clinical Initiative Manager
Tammy.Haithcox@pqcnc.org
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