Obstetric Hemorrhage Education Project (OBHEP) 2016 updates:
- New obstetric staff members, which include obstetricians; certified nurse midwives; anesthesiologists; certified registered nurse anesthetists; and nurses should complete all components of the OBHEP within their first year of service.
- All established hospital staff should be trained on the new material. By May 2017, hospitals should have implemented the following requirements:
- Incorporate the definition of Perinatal Hemorrhage into hospital documentation
- Quantification of blood loss for all deliveries
- Active management of the third stage of labor for vaginal deliveries
- Establishment of a protocol for patients who refuse blood products
- Development and implementation of a Massive Transfusion Protocol
- Continue reporting instances of four or more units of blood transfused and maternal intensive care unit admissions.
- Continue to conduct obstetric hemorrhage drills on a regular basis
- Conduct multi-disciplinary team debriefings after drills and actual hemorrhage events
During this implementation phase of the updated OBHEP, hospitals are asked to provide their Administrative Perinatal Center with quarterly documents of their progress.
For any further questions, concerns or request of supplemental documents of the OBHEP; please contact the Perinatal Nurses.
Maternal Mortality Review Committee (MMRC):
This committee is a sub-committee of the Perinatal Advisory Committee (PAC). The committee meets quarterly to review maternal deaths that have occurred during the pregnancy hospital admission. The original Obstetric Hemorrhage Education Project of 2008 was developed due to the findings of this committee. Maternal hemorrhages were occurring at an astounding rate, hence the development of the Obstetric Hemorrhage Education Project. The updates to the Obstetric Hemorrhage Education Project is also a result of the MMRC findings. After the inception of the first OBHEP in 2008, maternal hemorrhages were decreased dramatically, however, hemorrhage is starting to increase as a reason for maternal mortalities which called for the 2016 updates.
Severe Maternal Morbidity (SMM):
This review is done at the hospital level by the perinatal network administrators. This review is a part of the Every Woman Initiative, which is an initiative of the Association of Maternal & Child Health Programs (AMCHP). This will include all women who deliver and either need 4 pints of blood or have to be admitted to the intensive care unit (ICU) unexpectedly. This initiative is an effort to reduce maternal morbidity.
Maternal Mortality Review Committee- Violence (MMRC-V):
This committee is also a sub-committee of the Perinatal Advisory Committee (PAC). The committee meets twice a year to review maternal deaths that have occurred within 365 days after a pregnancy. The deaths reviewed include: Suicide; Intimate Partner Violence; and Substance Abuse. This is a new committee and the first meeting occurred March 22, 2016. The goal of this committee is to look for patterns of violence in the cases presented and then to make recommendations to the PAC for new state initiatives for improvement.