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New project will help nurses use data to improve childbirth safety

Ariadne Labs and Boston College School of Nursing will launch a new project to help nurses use data to understand how their practices influence childbirth outcomes. The new work is made possible by a grant from the Rita & Alex Hillman Foundation’s Hillman Innovations in Care program, launched in 2014 to support bold, evidence-based interventions that improve the health and health care of vulnerable populations. The grant will provide $600,000 of support over a three year period beginning in 2020.

“We are so excited to be partnering with Dr. Joyce Edmonds at Boston College to give nurses more credit for the incredible influence they have on childbirth outcomes. We’re honored by the Hillman Foundation’s support of this project,” said Dr. Neel Shah, Director of the Delivery Decisions Initiative at Ariadne Labs.

For American women, childbirth has become more dangerous despite increasing rates of intervention with cesarean sections. Women today are 50% more likely than their own mothers were to die in childbirth, and black women’s risk of dying in childbirth is three to four times greater than that of their white counterparts. The rate of delivery by cesarean section — a key indicator of the quality of labor management — has skyrocketed, but most cesareans performed in the US are avoidable. 

Research indicates a significant relationship between nursing care and the odds of cesarean, yet few hospitals are currently able to measure important differences in nursing care, let alone estimate their effect on birth outcomes, and most nurse managers have limited insight into variations in nursing practice on their own units. 

With support from the Hillman Innovations in Care program, Ariadne Labs and Boston College School of Nursing will partner with hospitals and the Obstetrical Care Outcomes Assessment Program  to help nurses use data on the care they are providing to increase their understanding of the effects their care practices have on childbirth outcomes. This grant will help gather the data through a well-established “audit and feedback” intervention, giving nurse-led audit committees insight into nurse-specific cesarean rates. The project will test whether this information can help nurse managers improve safety and how audit committees use this data to strengthen nursing practice. 

Leading the project are Joyce K. Edmonds, PhD, MPH, RN, Associate Professor at Boston College Connell School of Nursing, and Neel Shah, MD, MPP, Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and director of the Delivery Decisions Initiative at Ariadne Labs.