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Utilizing leadership to achieve high reliability in the delivery of perinatal care

Authors Parrotta C, Riley W, Meredith L

Received 13 July 2012

Accepted for publication 23 August 2012

Published 1 November 2012 Volume 2012:4 Pages 157—163

DOI https://doi.org/10.2147/JHL.S28747

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5


Carmen Parrotta,1 William Riley,1 Les Meredith2

1School of Public Health, University of Minnesota, Minneapolis, MN, 2Premier Insurance Management Services Inc, Charlotte, NC, USA

Abstract: Highly reliable care requires standardization of clinical practices and is a prerequisite for patient safety. However, standardization in complex hospital settings is extremely difficult to attain and health care leaders are challenged to create care delivery processes that ensure patient safety. Moreover, once high reliability is achieved in a hospital unit, it must be maintained to avoid process deterioration. This case study examines an intervention to implement care bundles (a collection of evidence-based practices) in four hospitals to achieve standardized care in perinatal units. The results show different patterns in the rate and magnitude of change within the hospitals to achieve high reliability. The study is part of a larger nationwide study of 16 hospitals to improve perinatal safety. Based on the findings, we discuss the role of leadership for implementing and sustaining high reliability to ensure freedom from unintended injury.

Keywords: care bundles, evidence-based practice, standardized care, process improvement

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