From left are RMC Board Chairman James Amaker and RMC Director of Quality Improvement Indun Whetsell with Innovative Storyboard Award and award-winning storyboard.

During the S.C. Hospital Association’s (SCHA) Trustee Administrator Physician (TAP) Conference, held recently, the Regional Medical Center was presented the 2009 Storyboard Scholarship Award for “Most Innovative Q.I. Initiative” from the S.C. Every Patient Counts Campaign.

Each year, hospitals are invited to submit an application to display their storyboard, an illustrated presentation of a quality improvement initiative, at the SCHA TAP Conference and at the Institute of Health Improvement’s annual national quality forum.

RMC’s Quality Team of healthcare professionals includes physicians, nurse midwives and nurses from the specialty areas of quality, labor and delivery, and newborn nursery. Their award-winning storyboard, entitled, “It’s Worth the Wait -- Elective Pitocin Induction Bundle,” charted the team’s research, findings and progress in establishing and implementing guidelines to enhance the safety of electively starting the childbirth process.

“The goal of our initiative was to develop and implement an elective bundle, a set of guidelines, for childbirth induction,” noted Dr. Rick Williamson, a member of the RMC Quality Team. “This concept is being evaluated on a national level, and our RMC Quality Team is on the forefront of recognizing the importance of the national trend and taking a proactive role in our region to bring awareness to and implement safe elective induction guidelines. We want to make planned induction practices safe as possible for mothers and fetuses,” he explained. The Quality Team’s research indicated that the biggest risks of elective induction are complications of a premature infant and a higher C-section rate.

The bundle concept is an all-inclusive initiative. “All of the bundle guidelines must be met for a patient to be electively induced; this includes the fetus must be a full 39 weeks, and the mother’s body must be making the changes needed in preparation for childbirth (cervix must be dilating and softening for labor). Additionally, we must monitor the fetal heart rate for reassurance, while evaluating the labor for evidence of being too strong or too forceful to ensure the fetus is tolerating the process,” Dr. Williamson explained.

Members of RMC’s winning Quality Team are from left, front row: Johnnie Padgett, RN, and Shawana Burnette, RN. Back row: Indun Whetsell, RN, Charlotte Wofford, RN, Dr. Richard Richardson, Patti Smith, Certified Midwife; Dr. Rick Williamson and Micki Schurlknight, RN. (Absent from photo was Peggy Callahan, RN.)

“Years ago, mothers waited for labor to begin naturally, but gradually more patients have requested elective induction. This trend has increased steadily, especially in the last 10 years,” he noted. “There are several key reasons why patients prefer to be induced, including the discomfort of pregnancy and the convenience for the patient in choosing a delivery time that fits both the patient’s and spouse’s or other family members’ schedules – like grandparents who live out of state. Since doctors cannot be on call 24 hours every day, sometimes a patient wants to ensure that her doctor delivers her baby so she will ask to schedule the delivery during a time her doctor will be available in lieu of the potential of going into labor when another physician is on call.”

RMC’s Quality Team received an engraved plaque and a $2,000 scholarship to attend the Institute of Health Improvement’s 21st annual National Forum on Quality Improvement in Healthcare Conference to be held in Orlando, Fla., this December. The IHI conference, which provides another opportunity for organizations committed to the mission of improving healthcare to showcase storyboards and quality improvement strategies, draws nearly 6,000 healthcare professionals from around the world as well as thousands of others via satellite broadcast.