Assessing the safety and quality of Canadian obstetrics

Monday, 17 October 2016

Joint report focuses on quality and safety of childbirth, and on better protecting mothers and their babies

Some 380,000 children are born in Canada each year. Childbirth is the primary reason for hospitalizations. A comprehensive new report – the first of its kind in this country– makes a number of recommendations to improve processes surrounding labour and delivery in the hospital setting, and facilitate more positive outcomes for mothers and their children.

The report, Obstetrics Services in Canada: Advancing Quality and Strengthening Safety, examines the safety of obstetrics services in Canada between 2004 and 2015. The report is the result of a joint partnership between Accreditation Canada, the Healthcare Insurance Reciprocal of Canada (HIROC), the Canadian Medical Protective Association (CMPA) and Salus Global Corporation. The organizations that authored the report are each committed to healthcare safety and improving the performance of healthcare teams.


While the quality of obstetrical care in Canada remains high, and healthcare providers are committed to safe medical care, patient safety incidents continue to occur. The report highlights areas where the quality of care provided to expectant mothers and newborn babies can be improved. Key findings that could lead to better care in labour and delivery include:

  • Fetal heart rate monitoring, interpretation and response
  • Induction and augmentation of labour
  • Timing of the decision and resources to perform a Caesarean section
  • Management of shoulder dystocia
  • Assisted vaginal delivery – forceps and vacuum-assisted deliveries

“The stakes are high when it comes to obstetrical care and communication is key – both between providers and between providers and patients,” said Polly Stevens, Vice-President, Healthcare Risk Management at HIROC. “Leaders need to foster an environment that supports ‘speaking up,’ and healthcare providers need to ensure that monitoring and communication protocols are implemented reliably – every day for every patient.”


From a medical protection / insurance perspective, obstetrics is a higher risk area due to the costs awarded. While the frequency of harm remains low (HIROC’s obstetrical claim rate is less than 0.1 claims per 100 births), when problems arise in the delivery of a newborn child, the results can  be catastrophic – meaning they can result in death or impairments to the brain and spinal cord that result in lifelong disabilities. Between 2010 and 2014, 688 obstetrics medical-legal cases that arose in Canada were closed at CMPA.


“In a clinical setting, it is advisable for obstetricians and healthcare workers to follow best practices and openly communicate with one another so that they can anticipate problems and take corrective action before the results become detrimental to the mother or child,” said Dr. Hartley Stern, Chief Executive Officer at CMPA.


The report highlights innovative practices that are making a positive impact on obstetrics in Canada, often at minimal cost. The report is being made available to all obstetrical care providers, teams and healthcare facilities nationwide.


“High quality obstetrical care is provided by highly functioning healthcare teams,” said Malcolm Eade, Salus Global President and Chief Executive Officer. “An environment where the goals of hospital administrators and frontline staff are aligned enables quality care to grow and be sustained. Salus Global is committed to the development of high performing and highly reliable healthcare teams.”


About Accreditation Canada
Accreditation Canada is an independent, not-for-profit organization that accredits healthcare and social services organizations in Canada and around the world. Its comprehensive accreditation programs foster ongoing quality improvement through evidence-based standards and a rigorous external peer review. Accredited by the International Society for Quality in Healthcare (ISQua), Accreditation Canada has been helping organizations improve healthcare quality and patient safety for more than 55 years.


The Healthcare Insurance Reciprocal of Canada (HIROC) is a non-profit insurance reciprocal owned and governed by over 700 healthcare organizations across Canada. It was started in the 1980s when healthcare organizations were unable to find reasonably priced insurance in the commercial marketplace. The reciprocal/cooperative model allows for pooling of data across multiple similar organizations, sharing of lessons learned, and collective pressure exerted by members to implement effective risk management programs that reduce injury.


About CMPA
The Canadian Medical Protective Association (CMPA) is a not-for-profit association which provides medical-legal protection to approximately 95,000 Canadian physicians. The CMPA multidisciplinary teams collect and analyze medical-legal information to determine risk trends. This contributes to the extensive knowledge base on which the Association’s professional development programs for physicians, education materials, and policy positions are built.


About Salus Global Corporation
For more than 14 years, Salus Global Corporation has been recognized as the world leader in helping healthcare organizations achieve better clinical, economic, and operational outcomes. A specialty consulting and implementation firm, we help healthcare organizations improve performance and quality outcomes through increased interprofessional collaboration.


For more information, or media inquiries, please contact:

  • Accreditation Canada Communications / 1-800-814-7769 ext. 410 / This email address is being protected from spambots. You need JavaScript enabled to view it.
  • Ellen Gardner / HIROC / 416-730-3085; 416-414-3018 (cell)/ This email address is being protected from spambots. You need JavaScript enabled to view it.
  • Joel Baglole / CMPA / 613-725-9965 ext. 262; 613-806-5313 (cell) / This email address is being protected from spambots. You need JavaScript enabled to view it.
  • Heidi Ludwick / Salus Global / 416-704-7284 (cell) / This email address is being protected from spambots. You need JavaScript enabled to view it.

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