MOREOB Case Studies

Bonnyville Health Centre, Alberta

"We needed to redesign the way prenatal care was being provided to the First Nations’ women."
10 day reductionin ICU stays
The average admissions and length of stay in the Neonatal Intensive Care Unit for infants requiring transfer for further care was reduced to 9 days from 19

Pizza in Rural Canada: The Great Leveler

In a small rural community in Northern Alberta, Canada, where a small group of family physicians provide care to the 20,000 members of the mostly aboriginal community, there were a lot of knowledge gaps in obstetric care. The first objective of the MOREOB team was to get people from all over the health centre – from physicians to nurses to environmental services personnel – to sit down and talk about the challenges of the hospital. This led to the creation of “Pizza Fridays” where a physician would bring in pizza and everyone would share their experiences. Working with the community, the MOREOB team used “outside the (pizza) box” thinking to redesign prenatal care for an aboriginal population.
Bonnyville Health Centre, Alberta


Markham Stouffville Hospital

“We all continue to work daily on improving care for women and holding each other accountable for high quality evidence-based practice.”
5.9% reduction in C-sections
C-sections were reduced to 23.7% from 29.6% during the five years starting 2009/10 and ending 2013/14.

Upsetting the Apple Cart in a City in Southern Ontario: Changing the Status Quo Hierarchy and Higher Cesarean Rates

Markham Stouffville Hospital (MSH) serves the fastest growing region in Ontario, Canada, with a 22% increase in population size between 2001 and 2006. In the period that followed that rapid growth, MSH experienced a rise in C-sections from 25% in 2005 to 29.6% in 2010 and the induction rate increased from 16% in 2002/03 to 24% in 2009/10. The MSH MOREOB team identified three kinds of interventions that would be necessary to reverse those trends: interventions aimed at pregnant women planning to deliver at MSH, interventions aimed at MSH providers, and interventions that would affect hospital policies. While only 15% of women attempted VBAC in 2009-2010, this rate rose steadily to 33.6% of women in 12/14 with about 80% of those having vaginal births, and MSH surpassed its original goal of reducing the CS rate to 25%.
Markham Stouffville Hospital
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More than OB

We can apply a similar approach to communication and teamwork that we bring to OB to adjacent maternal/infant care departments and even other hospital units such as emergency, ICU, cardiology, and other risk management areas.