I immediately spun around to the chief nurse on the floor, "How'd you do that?" I had in mind the experience of so many other hospitals, including those in Massachusetts, which have had much higher rates and only recently have focused attention on this issue. (The problem being that pre-39 week babies suffer distress and problems much more often than full term babies. This puts them at risk and sometimes requires visits to the intensive care unit.)
Her response was way too simple: "We collectively agreed that this was a serious issue and that we would religiously follow the criteria for early induction laid out by ACOG (the American College of Obstetricians and Gynecologists.) If a doctor shows up wanting to induce an earlier delivery, any person on the staff is empowered to question the decision. In case of conflicting opinion, we jointly discuss it."
For those who want to follow the lead of this public hospital in California, check out the ACOG Practice Bulletin, "Clinical Management Guidelines for Obstetrician-Gynecologists: Induction of Labor," Number 107, August 2009.
Oh, by the way, did you notice that I said that the chart above was on the wall for all to see? That's the kind of transparency that helps an organization hold itself accountable to the high standards it has set for itself. Notice, too, that the goal is zero, not some national benchmark. As I have said before, there is no virtue in benchmarking yourself to a substandard norm. Bravo on all fronts to CCRMC.