Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety.
Clark, Steven L. MD; Belfort, Michael A. MD, PhD; Byrum, Spencer L. LCDR (ret.) USCG; Meyers, Janet A. RN; Perlin, Jonathan B. MD, PhD
[Editorial] American Journal of Obstetrics & Gynecology. 199(2):105e1-105e7, August 2008.

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: In a health care delivery system with an annual delivery rate of approximately 220,000, a comprehensive redesign of patient safety process was undertaken based on the following principles: (1) uniform processes and procedure result in an improved quality; (2) every member of the obstetric team should be required to halt any process that is deemed to be dangerous; (3) cesarean delivery is best viewed as a process alternative, not an outcome or quality endpoint; (4) malpractice loss is best avoided by reduction in adverse outcomes and the development of unambiguous practice guidelines; and (5) effective peer review is essential to quality medical practice yet may be impossible to achieve at a local level in some departments. Since the inception of this program, we have seen improvements in patient outcomes, a dramatic decline in litigation claims, and a reduction in the primary cesarean delivery rate.

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