Implementing the Four Perinatal Quality Initiatives: Creating a Change in Model of Care and Culture

Family Centered Care (FCC) had been implemented in the institution in 2002 but it was obvious that FCC was not the current model of care. There is extensive literature on the benefits of FCC but it was necessary in this environment to take it a step further and focus on the quality of the patient experience.  From the time the patient walks through the door until they are discharged home it is an honor to be a part of their birth experience, one that can never be replicated again.  In an era of reimbursement changes and decreased funding, we needed to create a new culture of how we care for our patients so that we can ensure long-term organizational success. 

The overall approach to process improvement included defining the problem and understanding what needed to be accomplished, measuring for improvement, analyzing the data, defining what changes needed to be made to make the improvement and finally sustaining the improvement.  Change management theory guided our preparations for implementation of the new processes. Managing complex change effectively requires vision, skills, incentives and resources. Without each of these elements successful change is at risk from the following behaviors: confusion, anxiety, resistance and frustration. Those experiencing the change are also subject to the treadmill effect when there is no clearly defined and communicated action plan.

The successful implementation of FCC and the four quality initiatives provided for a new model of care involving the patient and her family through a patient centered approach. The model of care was efficient, effective, safe, and quality focused and ultimately changed the culture of the Women’s Service Line.