Bree Collaborative releases its first report – Obstetrics Care

Last month, the Robert Bree Collaborative released its report on how to improve quality and health care outcomes of obstetrics care in Washington State.  This is the first report from the Bree Collaborative, a public/private consortium established in 2011 by the Washington State House Bill 1311.  An offshoot of the Washington State Advanced Imaging Management (AIM) project, the Bree Collaborative is named in memory of Dr. Robert Bree, a pioneer in the imaging field and a key member of the AIM project.

The Bree Collaborative was created to help Washington State identify health care services with significant variation in care or utilization, which can signal waste or unnecessary tests or services, and recommend evidence-based, cost-effective strategies for improvement.  Appointed by Governor Christine Gregoire, the 24-member Collaborative includes hospital, health plan, employer, physicians and quality improvement organization representatives from across Washington State, like Harborview/University of Washington Medical Center, Wenatchee Valley Medical Center, Regence, Group Health Cooperative, Premera, Cigna, Boeing, King County, Costco, and Swedish Medical Center.

Here are two reasons this is not just another report.

1) The report pushes the envelope with one of its goals: eliminate elective deliveries before the 39th week (zero incidence) – a bold goal many local and national organizations won’t set. The standards for scheduling elective inductions and labor and delivery guidelines for C-sections recommendations are also audacious (and somewhat controversial).  Nationally, no widely accepted standards or guidelines currently exist which have been endorsed by the local or national obstetrics professional societies.

2) The report recommendations could have broad reaching ramifications. Per the Bree Collaborative legislation, the administrator of the Health Care Authority must review the strategies and recommendations and decide whether to adopt and apply recommended strategies to state purchased health care programs – Medicaid, Washington State employee health plan, Labor & Industries and the Department of Corrections.  It is unclear when the HCA will announce the outcome of its review given the recent shift in HCA leadership.

Stay tuned for the Bree Collaborative’s recommendations on other topics such as readmissions, low back pain and cardiology at the end of 2012/beginning of 2013.

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