Ob/Gyn & Women’s Health Institute Outcomes
Comprehensive Obstetrical Care
Obstetrics
Obstetric outcomes are reported for births attended by staff, private physicians and midwives at Cleveland Clinic Health System regional hospitals and main campus. In 2020, 80.8% of births in the system were attended by Cleveland Clinic staff physicians or midwives.
NTSVᵇ Cesarean Delivery Rate
2017 - 2020
Source: Joint Commission National Quality Measures Perinatal Care-02
ᵃCleveland Clinic Target: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Reduce cesarean births among low-risk (full-term, singleton, and vertex presentation) women. Healthy People 2020. Washington, DC: 2010
ᵇN is the total number of low-risk, first-birth women (ie, nulliparous, term, singleton, vertex presentation)
Successful Trial of Labor After Cesarean Delivery
2017 - 2020
ACOG = American Congress of Obstetricians and Gynecologists
ᵃCleveland Clinic target: ACOG practice bulletin. Vaginal birth after previous cesarean delivery. Number 5, July 1999. Clinical management guidelines for obstetrician-gynecologists. American College of
Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1999 Aug;66(2):197-204.
ᵇN is the patients with prior cesarean delivery who underwent trial of labor
Episiotomy Rate
2017 – 2020
ACNM = American College of Nurse-Midwives
Source: National Perinatal Information Center
ᵃAmerican College of Nurse-Midwives (ACNM) Benchmarking Project 2010: Practices with > 500 deliveries per year.
www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001539/ACNM_BenchmarkingProject_1012.pdf
ᵇN is the number of vaginal deliveries
Third- and Fourth-Degree Lacerations in Vaginal Deliveries Without Instrument Assistance
2017 – 2020
Source: Obstetric Trauma Rate — Vaginal Delivery With Instrument, Patient Safety Indicator #18, Provider-Level Indicator,
AHRQ Quality Indicators, Version 4.3, August 2011. qualityindicators.ahrq.gov/Downloads/Modules/PSI/V2018/TechSpecs/PSI_18_Obstetric_Trauma_Rate%E2%80%93Vaginal_Delivery_With_Instrument.pdf
ᵃCleveland Clinic target: derived from review of peer organization members of Vizient. Data from the Vizient Clinical Data Base/Resource Manager™ used by permission of Vizient. All rights reserved.
ᵇN is the total number of spontaneous vaginal deliveries
Early Elective Deliveries
2017 - 2020
Elective deliveries between 37 weeks and 38 weeks 6 days gestational age.
ᵃN is the total number of deliveries.
Postpartum Readmission Rates
2017 – 2020
N is the total number of deliveries.
Postpartum Depression Screening
2017 – 2020
The Ob/Gyn & Women's Health Institute screened more than 82% of postpartum patients for depression in 2020. This was accomplished by incorporating screening for postpartum depression into an electronic questionnaire that was developed within the electronic medical record for all 6 week postpartum encounters. A two-item patient health questionnaire is used to evaluate all postpartum patients. If either question is answered yes, a complete Edinburgh Postnatal Depression Scale is administered.
With this screening and provider education, patients with symptoms of depression are identified, and opportunities for treatment and intervention are maximized.
N is total number of visits.
Severe Maternal Morbidity (SMM) Rate
2017 – 2020
To identify delivery hospitalizations with SMM, the chart used the International Classification of Diseases (ICD) diagnosis codes listed in CDC’s web site at https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm
N is the total number of deliveries.
NTSV Cesarean Rates on Midwife Patients
2017 – 2020
Women considered to have midwife care saw a midwife for the majority of their OB visits.
N is the total number of Low-risk, first-birth women (ie, nulliparous, term, singleton, vertex presentation) whose prenatal care provided by midwives.
Nulliparous Preterm Birth Rates on Midwife Patients
2017 - 2020
N is the total number of midwife deliveries in the year.
Nulliparous Preterm Birth Rates by non-Midwife Providers
2017 - 2020
N is the total number of non-midwife deliveries in the year.