PIECING TOGETHER SAFE CHILDBIRTH Exploring Simple, Life-Saving Checks Across the Childbirth Continuum

Every Woman Every Child

Innovation Working Group

Task Force on Checklists

Interim Progress Report

April 2012

Results – All Sites

Baseline Checklist P value

Cases 3733 3955 -

Death 1.5% 0.8% 0.003

Any Complication 11.0% 7.0% <0.001

SSI 6.2% 3.4% <0.001

Unplanned Reoperation 2.4% 1.8% 0.047

Surgical Checklist: Results

• Prompt at key moments in care

• Define essential tasks

• Highlight system malfunction

• Impose conceptual structure

• Increase team communication

• Facilitate essential dialogue

Checklists: Theories of Change

EWEC IWG Checklist TF

Strategy Selection Criteria

• Potential impact • Simplicity & user-friendliness • Feasibility for testing • Feasibility for scaling • Applicability across countries • Link to EWEC goals

Piece 2: At the Time of Delivery

Childbirth Checklist: Pause Points

Pre-conception

Conception

Antenatal period

Labor onset

Admission to birth facility

Labor progression

Delivery

Postpartum

Discharge from birth facility

28 days

42 days

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Time

Pause point #1 On admission

Pause point #2 Just before pushing (or before Cesarean)

Pause point #3 Soon after birth (within 1 hour)

Pause point #4 Before Discharge

Safe Childbirth Checklist Program

Safe Childbirth Checklist Program

Piece 1: During Pregnancy

Piece 3: In the Postpartum/Postnatal Period

Chairs Scott Ratzan, Jonathan Spector

Members Angela Lashoher, Claire Lemer, Sarah Marsh, Garrett Mehl, Marc Mitchell, Ida Neuman, Prabhjot Singh

Advisory Group Franklin Apfel, Gary Darmstadt, Lord Darzi of Denham, Karlee Sliver, Bruce Gellin, Atul Gawande, Barry Bloom, Flavia Bustreo, Ian Pett, Anayda Portela, Mario Merialdi, Patricia Mechael, Jean-Marie Okwo-Bele, Ian Pett, Joanna Rubenstein, Sonia Ehrlich Sachs, Alexandra Schoeb, Karlee Silver, Severin von Xylander

Support Alice Fabiano, Grace Galvin, Amanda McKelvey, and Ade Obayemi

Acknowledgments

IWG Task Force on Checklists