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Development and implementation of a quality improvement toolkit, iron deficiency in pregnancy with maternal iron optimization (IRON MOM): A before-and-after study

PLoS Medicine Sep 10, 2019

Abdulrehman J, Lausman A, Tang GH, et al. - A toolkit comprising treatment algorithms, educational information for doctors and patients, modified blood work requisitions, and standardized iron prescriptions was made in order to assist obstetricians to discover and treat iron deficiency. Laboratory data of all women observed in both the obstetrics clinic and the inpatient delivery ward settings from the electronic patient record (EPR) was retrospectively obtained. A total of 1,292 and 2,400 ferritin tests and 16,603 and 3,282 antenatal hemoglobin results were derived pre- and postintervention, respectively, from the EPR. Following the implementation of the toolkit, there was a rise in testing for iron deficiency, a reduction in maternal anemia, and a drop in maternal blood transfusions during and subsequent to the pregnancy. Among women presenting for delivery, the introduction of a standardized toolkit comprising diagnostic and management pathways as well as other helps in raising ferritin testing and reduced the incidence of anemia. This approach also led to decreased proportions of women receiving RBC transfusion during pregnancy and in the first 8 weeks postpartum. Moreover, the IRON MOM toolkit is a low-tech approach that could be efficiently scaled to other settings.
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