Code Crimson: A Postpartum Hemorrhage Bundled Intervention Quality Improvement Project

Abstract

Background: Postpartum hemorrhage (PPH) is a leading cause of maternity mortality in the United States. The Code Crimson project aimed to enhance PPH management by implementing a standardized intervention bundle to mitigate morbidity and mortality associated with PPH.

Local problem: At a large Philadelphia tertiary hospital, health disparities existed for severe maternal morbidity and mortality, and PPH was a significant factor.

Methods: A quality improvement design, using Plan-Do-Study-Act cycles and interrupted time series analysis, was undertaken.

Interventions: The Code Crimson project implemented a standardized bundle to manage PPH, including blood product administration and massive transfusion protocol activation.

Results: After implementing the Code Crimson bundle, there was a significant decrease in blood product use ( P < .001), with minor reductions in packed red blood cell administration over 4 units and mean blood loss.

Conclusions: The Code Crimson bundle effectively reduced blood product utilization for PPH treatment.