• Hee Young Cho, Sungwon Na, Man Deuk Kim, Incheol Park, Hyun Ok Kim, Young-Han Kim, Yong-Won Park, Ja Hae Chun, Seon Young Jang, Hye Kyung Chung, Dawn Chung, Inkyung Jung, and Ja-Young Kwon.
• Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
• Int J Qual Health Care. 2015 Dec 1; 27 (6): 459-65.

ObjectiveTo compare the outcomes of postpartum hemorrhage (PPH) episodes before and after the introduction of a clinical pathway known as the Severance Protocol to save postpartum bleeding through Expeditious care Delivery (SPEED).DesignThis study was designed as a retrospective analysis.SettingThe study was conducted in a hospital implementing SPEED.ParticipantsThe non-SPEED group included 74 patients with PPH who were treated before the introduction of SPEED, whereas the SPEED group included 155 patients.MethodsDifferences in outcomes were compared between groups.Main Outcome MeasuresReduction in treatment duration was the primary outcome measure, whereas uterus preservation was the secondary.ResultsNo significant intergroup differences were observed for hemoglobin levels, hematocrit values and vital signs upon patients' emergency room arrival. The turnaround time for hemoglobin, mean duration until treatment by obstetricians and gynecologists and duration between chest radiography ordering and performance significantly differed between the two groups (SPEED, 10.0 [1.0-30.0], 3.0 [0-25.0] and 23.0 [1.0-86.0] min, respectively; non-SPEED, 17.0 [1.0-37.0], 12.0 [0-62.0] and 46.0 [1.0-580.0] min, respectively; P < 0.001). Similarly, the mean duration until transfusion of cross-matched red blood cells (SPEED, 77.6 ± 58.6 min; non-SPEED, 103.4 ± 64.4 min; P = 0.015) and uterus preservation rate (SPEED, 90.1% [136/151]; non-SPEED, 81.7% [58/71]; P = 0.043) also differed significantly between the groups.ConclusionsClinical pathways enable prompt and efficient care for patients experiencing PPH through faster evaluation and access to red blood cell transfusion, resulting in a decrease in maternal mortality.© The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

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