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Texas Hospitals Are Adopting New Routines To Curb Maternal Deaths

The state plans to tackle hemorrhage, hypertension and opioid abuse first. All three are among the leading causes of maternal deaths in the state.

Dell Seton adopted protocols to reduce opioid overdoses among new moms.

Two-thirds of Texas hospitals offering maternity services are taking part in a statewide initiative aimed at reducing maternal mortality.

Texas health officials this week kicked off a project called “TexasAIM,” an effort to get hospitals to use a set of protocols referred to as “safety bundles.” The goal is to standardize how doctors in Texas deal with pregnant women who are at risk of common complications during pregnancy or shortly after giving birth.

The state plans to tackle hemorrhage, hypertension and opioid abuse first. All three are among the leading causes of maternal deaths in the state.

“Our goal is to have as many hospitals participate that want to participate,” says Dr. Manda Hall, the associate commissioner for community health improvement at the Texas Department of State Health Services.

So far, Hall says, 168 hospitals have joined TexasAIM – that’s out of the 242 hospitals in the state that offer maternity services.

“We know that there is an opportunity here to really make a difference here in Texas as it relates to maternal mortality and severe maternal morbidity,” she says. “So, we are very happy to see the number of hospitals that are here today and participating.”

During a meeting in Austin on Monday, hospital leaders from across the state met to discuss how they plan to implement the protocols and what it would look like in their own hospitals.

“What it looks like in one hospital may look different in another hospital and that’s OK,” Hall says.

That’s especially true because some hospitals already have been using these safety bundles.

“We didn’t wait for TexasAIM to come along,” says Dr. John Harkins, a professor at UT Austin’s Dell Medical School and physician with Seton hospitals. “We’ve had these because it is evidence-based, and being an academic teaching center, we were able to get these up and running.”

And Harkins says he’s already seeing results.

“From my own experience, these things work great,” he says. “They save lives.”

A lot of what doctors do is repetitive, Harkins says, and these safety bundles create yet another routine – but this one is backed by science.

“Physicians at times are loathe to adopt standardization,” he says. “And you hear things like that, ‘You know, well, each patient you have to treat it like an art, and they are all different’ and that kind of stuff. But in certain things, it’s not an art; it is a science.”

Harkins also says there are examples out there in the world of strict routines being safer.

“Airline pilots go through the exact same protocols and checklists every single time they land a plane,” he says. “They do the exact same thing every time because they know that that is the safest way to get things done.”

Texas health officials say there is evidence that creating protocols in hospitals has curbed maternal deaths in other states. For instance, one of the big drivers behind California’s effort to reduce maternal mortality rates was using new protocols in hospitals. In just four years, the state cut its rate by half.

 

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