New hospital safety standards target maternal mortality rate for postpartum hemorrhage, preeclampsia

Kits stocked with supplies to stop severe bleeding from childbirth and training drills for doctors and nurses to practice responding to a hemorrhage crisis will be required at U.S. hospital maternity units next year to prevent deliveries from turning deadly.

About four out of five babies nationally are delivered at the hospitals that must adopt new safety standards in a call for action this week by the nation’s largest hospital accreditation group. Failure to do so by July 1 puts their Joint Commission accreditation at risk.

David Baker, the commission’s executive vice president for health care quality evaluation, credited a USA TODAY investigation with pushing the safety standards forward, saying the two-year Deadly Deliveries series “helped to open up all of our eyes to the magnitude of the problem.”

The standards call for maternity units to keep life-saving medications immediately accessible. Hospitals also must plan for the rapid release of blood supplies for transfusions.

“Minutes matter in these really life-threatening emergencies,” said Baker of the Joint Commission, which provides oversight to about 70 percent of U.S. hospitals by ensuring that they have voluntarily met quality standards.

USA TODAY exposed how hospitals across the nation fail to follow nationally promoted best practices to prevent harm. Each year in the United States, about 700 women die and 50,000 suffer serious injuries — many preventable — from childbirth complications. Hemorrhage is the leading preventable cause of severe maternal injury and death.

The detailed standards also call for birthing hospitals to assess every patient’s risk, seeking to address racial disparities in childbirth. Black mothers are three times as likely as white mothers to die, the Joint Commission’s guidance to hospitals notes.

A USA TODAY analysis of billing data from 7 million births found that one in eight hospitals in 13 states have complication rates of at least double the norm. The results called into question how hospitals have long blamed societal problems, such as poverty and pre-existing medical conditions, for the nation’s rising rates of maternal death and injuries.

The Joint Commission also has issued specific actions to address dangerously high blood pressure, another top cause of preventable maternal death and injury. The group plans to help hospitals struggling to meet its deadline.

USA TODAY’s investigation also has helped spur political action in Washington:

Congresswoman Anna Eshoo quoted USA TODAY’s finding that “the United States is the most dangerous place in the developed world to deliver a baby” during a September hearing in the U.S. House of Representatives on maternal health.

The House Committee on Ways and Means last year asked the operators of major hospitals nationally to answer sweeping questions about their actions to reduce maternal death and harm. Thousands of pages of feedback were submitted, and the Republicans who launched the investigation are working with the current Democratic leadership to review federal programs.

A U.S. law was enacted to help states to determine why woman are dying from pregnancy and childbirth, bolstering efforts to confidentially collect and analyze standardized data on every mother’s death.

Most mothers soon will also be delivering at hospitals newly required to adopt established best practices to prevent harm, building on efforts that have been credited with reducing maternal injuries and deaths in California.

“These are the roadmaps for safe care in hospitals,” said Elliott Main, medical director of the California Maternal Quality Care Collaborative.

Main called the Joint Commission’s mandate a major advance toward improving care for mothers, adding that “hospitals don’t change for the fun of it.”

Read more at usatoday.com.