Markham Stouffville Hospital Caesarean-section Reduction Strategy (MSH-CARES) : MSH-CARES

After implementing the strategy between April 2010 and January 2011, an independent process evaluation of the strategy was sought by members of the original task force, to assess the impact of the strategy on care providers’ workload and their general experiences with components of the strategy. [...] Common themes that were discussed in each focus group session are presented in the following report, which is organized according to the overall findings regarding the individual elements of the strategy, positive changes resulting from the strategy, challenges related to the strategy, factors contributing to the success of the strategy, and suggestions to further reduce CS at MSH. [...] The implementation of the new induction policy went smoothly and quickly and our respondents attributed this to the simplicity of the new system. [...] Given that the majority of obstetricians saw the safety of the patient as a determining factor for their medical decision, the statistics on CS rates were not always seen as truly capturing the complexity that the needs of the patients may have on fluctuations of CS rates: Lately I’ve been doing sections non-stop. [...] Given that, ultimately, health care providers defined their medical decisions based on the safety and the needs of the patient, the audit system did not always reflect the many complexities that came into the decision to do the early induction or CS.