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Assessment of compliance with a color coded protocol for non-elective cesarean section in a maternity ward in France.
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  • Oriane Vetier,
  • Marie-Alice Yanni,
  • Linda Lassel,
  • Helene Isly,
  • Alain Beuchée,
  • Maela LE LOUS
Oriane Vetier
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Marie-Alice Yanni
University Hospital of Rennes
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Linda Lassel
University Hospital of Rennes
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Helene Isly
University Hospital of Rennes
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Alain Beuchée
University Hospital of Rennes
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Maela LE LOUS
University Hospital of Rennes
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Abstract

Purpose: The aim of a color coded protocol for non-elective cesarean-sections is to improve decision-delivery interval by better organization of care in a maternity unit. We set out to assess compliance of a color coded protocol and its impact on maternal and neonatal outcomes since its implementation in our maternity ward. Materials and methods: This was a retrospective study including a sample of 200 patients per year who underwent an non-elective cesarean section delivery in Rennes University Hospital from January 1, 2015 to December 31, 2018. Patients were grouped by year and by color code (red, orange or green). The main outcome was compliance with the protocol (color code in accordance with indication for cesarean section) and compliance with the corresponding decision-delivery interval. Secondary outcomes were maternal and neonatal outcomes. The statistical tests performed were Fisher’s test for qualitative parameters and Kruskal-Wallis test for quantitative parameters. Results: Eight hundred patients were included during the study period. There was no significant difference in patient characteristics over the years. There was a significant improvement in protocol compliance: full compliance increased from 22.4% in 2015 to 76.5% in 2018 (p<0.0001). No difference was observed in the decision-delivery interval overall but compliance with the 15-minute decision-delivery interval imposed by a red coded protocol increased between 2015 and 2018 (p=0.0020). Conclusion: We observed a significant improvement in compliance with the color coded protocol between 2015 and 2018 and in the 15-minute decision-delivery deadline for the red code.

Peer review status:UNDER REVIEW

10 Apr 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
15 Apr 2021Assigned to Editor
15 Apr 2021Submission Checks Completed
29 Apr 2021Reviewer(s) Assigned