HIC Hospitals Empower Nurses to Take Initiative in Safety of OB Patients


Building on the success of the program’s multiyear obstetric safety initiative, HIC hospitals continue to lead the way in improving quality of care for obstetric patients. The latest initiative, led by the OB Nursing Best Practices Committee, encourages nurses to take action on behalf of their patients.

A group of patient safety leaders from participating hospitals meets each month to discuss ways to improve the quality of obstetric care. Over the past year, committee leaders have worked together to develop best practices for obstetric triage and for the treatment of antepartum patients. These guidelines are built on lessons learned and provide a framework to empower nurses to take action. Empowering nurses is a core principle of the committee’s work, as well as a critical step in enhancing patient safety.

“Nurses spend the most time with patients and are often the first to recognize changes in patient status.  Since Obstetrical Services includes both mother and baby, having nurses empowered to take immediate action which often includes a rapid transfer of the patient to a higher level of care, contributes to a better outcome for all,” said Carol Torchen, Vice President for Women and Children’s Services for the Mount Sinai Health System.

The OB Nursing Best Practices Committee was formed in 2013 by HIC Chief Nursing Officer Pat Kischak. The group brings together nursing leaders from Bronx-Lebanon Hospital Center, Maimonides Medical Center, Montefiore Medical Center, and Mount Sinai Health System (including Mount Sinai Beth Israel, Mount Sinai Hospital, and Mount Sinai Roosevelt).

“Our hospitals understand the important role that nurses play in improving patient safety, and they consistently look for ways to encourage nurses to speak up as advocates for their patients,” said Kischak.

Recent topics discussed by the committee include industry-wide concerns about patient falls in the OB unit. Other issues include preventing infant abduction, bar-coding breast milk, and treatment of postpartum patients with unplanned returns to the hospital.

The group has served as a model for other committees in bringing together physicians and nurses in a joint effort.

“One of the key takeaways from our meetings is a simple lesson—listen to nurses,” said Dr. David Feldman, HIC’s Chief Medical Officer. “If we’re seriously committed to enhancing safety, we have to break down the traditional walls that separate clinicians. As physicians, that means affirming the value of nurses’ professional judgment and making sure they feel comfortable speaking up.”

HIC hospitals have demonstrated extraordinary success in improving OB safety. A report released last year showed a 42 percent drop in the number of complications during labor and delivery among member institutions. The findings were remarkable, given that close to 15 percent of all deliveries in New York State occur in HIC member hospitals. The sharp decrease came as a result of a multiyear initiative in which the hospitals worked in collaboration to develop best practices and enhanced training programs.

About Hospitals Insurance Company
Hospitals Insurance Company (HIC) is a premier provider of medical professional liability insurance to physicians and hospitals in New York. HIC works closely with member hospitals to lead initiatives to improve patient safety and quality of care. The HIC program grew out of a partnership established in the mid-1970s when four large New York hospitals created a shared professional liability program, HIC, with their own risk management advisors, FOJP Service Corporation. The central mission of HIC and FOJP—unlike those of most private insurers—is to improve patient safety and quality of care within member hospitals. HIC does not have traditional shareholders and is not driven to recruit members or build profit margins. Instead, HIC focuses resources to reduce patient injury and improve clinical outcomes.

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