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Promotion of Safe

Vaginal Deliveries

To promote safe vaginal delivery for ALL in the birthing population presenting with a nulliparous, term, singleton, vertex pregnancy (NTSV) and thus decrease NTSV cesarean delivery rates to <23.6% (Healthy People Goal 2030)[9] in all participating Tennessee birthing facilities by Summer 2024. This project will include a special focus on the BIPOC (Black, Indigenous, and People of Color) population which data shows has greater disparities in this outcome.

Tennessee Birthing Hospitals Work towards the Healthy People Goal of 2030 in promotion of safe vaginal deliveries

In early 2023, 35 hospitals throughout the state joined TIPQC with the goal of decreasing the cesarean rate to 23.6% in the birthing population presenting with nulliparous, term, singleton and vertex (NTSV) pregnancies to align with the Healthy People Goal of 2030.  Cesareans are one of the most popular surgeries in the United States despite being associated with increased risk of hemorrhage, infection, uterine rupture, and longer recovery time. After more than 18 months of hard work, the Promotion of Vaginal Delivery project moved into sustainment in September 2024.  

Hardin Medical Center achieved the Platinum QI rating which consisted of active project participation including huddles and coaching calls, monthly outcome and structure data capture, data driven QI work, clinical change implementation, and reaching the state goal of <23.6% NTSV cesarean delivery rate and <23.6% NTSV cesarean delivery rate after induction of labor for at least 2 of the previous 6 months.

Eight (8) hospitals received the gold achievement having reached 4 out of 6 of the above criteria, which included:

  • Baptist Memorial Hospital – Tipton
  • Greeneville Community Hospital
  • Johnson City Medical Center
  • Maury Regional Medical Center
  • Newport Medical Center
  • Regional One Health
  • Riverview Regional Medical Center
  • West Tennessee Healthcare – Volunteer

Decreasing cesarean rates takes strong leadership, coordinated PDSA cycles and collaboration. Throughout these past 18 months, teams worked relentlessly to decrease the number of unnecessary cesareans, and further improve care for Tennessee moms and babies. We are so proud of all the work all 35 teams put into this project! Congratulations to all teams!

Target Population

Nulliparous birthing patients with a term, singleton baby in a vertex presentation:

  • Nulliparous = first delivery/birth or Para Zero (Para Zero defined as no history of a previous pregnancy that reached at least 20 weeks gestation),
  • Term = ≥37 weeks gestation,
  • Singleton = no twins or beyond,
  • Vertex position = Cephalic position; no breech or transverse positions.

This population is also known as the NTSV population.

Downloadable

& Linked Resources

Resources

Resources for Team

Resources

Creating a Culture of Change

Resources

Project Aim Poster

QI Project Guidance

TIPQC PVD Key Driver Diagram

QI Project Guidance

TIPQC-PVD-Toolkit-06-25-2023

Resources

THA Memorandum

Resources

Approaches to Limit Intervention During Labor and Birth

Resources

SMFM Safe vaginal delivery

Resources

maternity safety and quality in cesarean delivery

Resources

CMQCC PVD Toolkit

Resources

IRB Protocol

Resources

State IRB Approval

Informercial

Promotion of Safe Vaginal Deliveries with Dr. Danielle Tate (download)

Infomercial

Promotion of Safe Vaginal Deliveries with Dr. Danielle Tate (streaming)

Elements of a Successful QI Project

TIPQC Keys for Success

Video

Resources

Promotion of Safe Vaginal Deliveries

Dr. Danielle Tate

If you missed the infomercial kickoff, here’s your chance to check it out and/or download for your own team’s use.

Hospital

Teams

State Project Leaders

Danielle Tate, MD, MBA and Connie Graves, MD led this project. 

Dr. Tate is a maternal fetal medicine specialist at the Baptist Memorial System.  She is an Associate Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center and the TIPQC Maternal Medical Director.

Dr. Graves has been involved with TIPQC since its inception and is a Maternal Fetal Medicine specialist.  Dr. Graves is the Medical Director, Tennessee Maternal Fetal Medicine, Director of Perinatal Services, St. Thomas Health, Co-Director of the Comprehensive Perinatal Cardiac Clinic, St. Thomas Health, Professor – University of Tennessee, Clinical Professor – Vanderbilt University, and Adjunct Professor – Meharry Medical College.  She also serves on many state and national boards and is widely published. 

Get

Involved.


TIPQC is actively recruiting devoted health care professionals, community leaders and patient and family partners to further our mission of improving health outcomes for mothers and babies in Tennessee.