Every Week Counts ended in 2014, but the effort to eliminate early elective deliveries continues. As an annual update, the Office of Perinatal Quality Improvement created a report sent to hospitals that includes individual hospital data from Hospital Compare and updated Oklahoma birth certificate data. Individual hospital data is reported on CMS’s Hospital Compare website (publicly available at https://www.medicare.gov/hospitalcompare/). Hospitals submit data to CMS utilizing the Joint Commission’s National Quality Core Measure in Perinatal Care, Elective Delivery (PC-01). This measure is periodically updated, and the current version of the measure can be found at manual.jointcommission.org. PC-01 is based on ICD-10 coding. The tables listing the codes used in each measure (including Table 11.07) are located in Appendix A of the manual.
The data from Hospital Compare (reported as rolling averages) show that the Oklahoma PC-01 rate decreased to match the national average of 2% for the periods of Q3 2015 through Q3 2016. For the period reported from Q1 2016 – Q4 2016, the Oklahoma rate (1%) dropped below the national average (2%) and, in the next report for Q2 2016 – Q1 2017, Oklahoma again equaled the national average at 2%.
However, more current data from Oklahoma birth certificates show a concerning trend. In Q4 2016, the rate of births at 39-41 weeks decreased and births at 36-38 weeks increased—a reversal of a trend we saw with EWC. This reversal continued in 2017. Know the early elective delivery rates at your hospital (contact firstname.lastname@example.org for more information). And, more importantly, investigate whether hard stop policies to eliminate EEDs are still working effectively in your hospital. Let’s not undo the great work that was done during EWC!