Cleveland Clinic Expands TeamBirth Model to Additional Labor and Delivery Sites to Improve Care, Address Health Disparities

Cleveland Clinic has expanded its TeamBirth model to labor and delivery units at main campus, Fairview and Hillcrest hospitals.

TeamBirth is a shared decision-making model that focuses on improving communication between caregivers and pregnant patients to bolster safety and quality of care. This follows the success of the program at Cleveland Clinic Akron General, an early U.S. adopter of TeamBirth in 2022.

In the TeamBirth model, the patient’s care team has “huddles” with patients on the birthing units at regular intervals before, during and after delivery to review the patient’s current condition and preferences, and to set clear expectations for what is to come. Whiteboards identifying the patient as the care team leader, the patient’s support person(s), every caregiver on the patient’s team, the patient’s preferences in care, and the agreed-upon care plans and progress for the patient and baby hang in all rooms in the birthing centers.

“We are delighted to expand this evidence-based program to these additional hospitals within our health system,” said Edward Chien, M.D., chairman of the Department of Obstetrics and Gynecology at Cleveland Clinic. “While it helps all women, it has been found to have a particular benefit for minority patients, many of whom have had their concerns minimized by the healthcare system in the past. This program ensures their voices and preferences are heard and respected.”

Implementing TeamBirth supports Cleveland Clinic’s Center for Infant and Maternal Health initiative, which was launched in 2023 to support at-risk women from pregnancy through their baby’s first year with a focus on improved access and coordinated care across many specialties.

TeamBirth was created by Ariadne Labs as a part of their Delivery Decisions Initiative. The model was implemented at Akron General through a partnership between March of Dimes and the U.S. Department of Health and Human Services to provide safe, equitable and outstanding maternity care for all patients, and to specifically address racial inequities and the disparity gap in outcomes for Black women. That includes implementation of activities such as maternity-specific implicit bias training, stratification and analysis of outcomes by race and ethnicity, formation of an anti-racism work group and adoption of TeamBirth. The Cleveland Clinic hospitals that are launching TeamBirth are incorporating these aspects into their work as well.

“Our team is very excited to implement this new practice model and provide even-better care for our patients who are delivering at our hospitals,” said Catherine Wilkins, M.D., who is one of the physician-leaders of this initiative. “We care deeply about every birthing person having a safe, uncomplicated delivery that is as dignified and pleasant as possible, and this is particularly important for patients who have had bad experiences in health care in the past that have made them understandably distrustful. An emphasis on shared decision-making is key to making that happen.”

The value of the program can be seen in data from Akron General. For example, the hospital’s Cesarean-section rate was disproportionately higher for Black patients than White patients before TeamBirth — 41% versus 27%, respectively. As of January 2024, those numbers were 22% for Black patients and 23% for White. Patient satisfaction has improved as well, with the team at Akron General receiving 100% satisfaction rates in:

• Friendliness/courtesy of the unit (in 2022: 90%)
• Staff concern, information about progress and baby’s condition (in 2022: 88%)
• Nurse promptness in responding to patient call (in 2022: 88%)
• Nurses attitude toward patient requests (in 2022: 87%)
• Doctor and staff working together during birth (in 2022: 85%)
• The team also achieved almost 95% satisfaction on how well patients felt their pain was managed during labor (in 2022: 72%).

“We have seen a marked improvement in outcomes and patient satisfaction scores since implementing TeamBirth and we are excited to see it expanding to other Cleveland Clinic hospitals,” said Jennifer Savitski, M.D., director of Obstetrics and Gynecology at Akron General who led the TeamBirth initiative there. “TeamBirth ensures every person has a voice in their birth experience.”