Quality-Improvement Tool Improves Iron Outcomes in Pregnancy

Toolkit includes diagnostic and management pathways plus educational resources

TUESDAY, Sept. 10, 2019 (HealthDay News) -- A standardized iron deficiency (ID) toolkit increases detection and management of anemia during pregnancy, according to a study published Aug. 20 in PLOS Medicine.

Jameel Abdulrehman, M.D., from University Health Network in Toronto, and colleagues developed and evaluated a novel quality-improvement toolkit: ID in pregnancy with maternal iron optimization (IRON MOM), which included clinical pathways for diagnosis and management, educational resources for clinicians and patients, templated laboratory requisitions, and standardized oral iron prescriptions. Laboratory data of all women seen in both the obstetrics clinic and the inpatient delivery ward settings at St. Michael's Hospital in Toronto were assessed to compare measures at preimplementation (2012 through 2016) and postimplementation (2017) of the toolkit.

The researchers identified 1,292 and 2,400 ferritin tests and 16,603 and 3,282 antenatal hemoglobin results at preintervention and postintervention, respectively. After implementation, there was a 10-fold increase in the rate of ferritin testing in the obstetric clinics and a lower risk for antenatal hemoglobin values <100 g/L (13.5 percent at preintervention versus 10.6 percent postintervention). Additionally, a significantly lower proportion of women received a blood transfusion during their pregnancy (1.2 percent at preintervention versus 0.8 percent postintervention) or immediately following delivery through eight weeks after delivery (2.3 percent at preintervention versus 1.6 percent postintervention).

"The IRON MOM toolkit is a low-tech strategy that could be easily scaled to other settings," the authors write.

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