On behalf of the American Journal of Obstetrics and Gynecology , the Editors are pleased to announce a new monthly series of articles on patient safety in obstetrics. Since the 1991 Institute of Medicine report which revealed that approximately 100,000 patients die each year in US hospitals due to medical errors, there has been a burgeoning interest in developing programs to eliminate as many errors as possible. While little real progress has been made in reducing the number of deaths due to errors, hospitals across the country are beginning to implement programs which are designed to improve upon this dismal record. Obstetrics, as a specialty and as an example of an intensive care–like setting, has been slow to respond. Asch et al in 2006 looked at 58 indicators of care, including many obstetric indicators, and found that only 54% of patients got recommended care. While many labor and delivery units around the country are beginning to implement a few elements of safety programs that have become popular like checklists, standardized protocols, simulations, and drills; few units have implemented comprehensive safety programs that include most, if not all, of the various elements that have been found to make a big difference in reducing errors in labor and delivery. Articles such as that published by Pettker et al at Yale are beginning to be published; these studies demonstrate that a more comprehensive program, including many of these elements, can indeed achieve better outcomes. It is clear that the American Journal of Obstetrics and Gynecology will provide an important service to our readers and ultimately to our patients by providing a series of articles from experts in this subject that provide information which will provide an impetus for the implementation of such programs in our own labor and delivery units. Our first article in this issue of the Journal is an overview of patient safety by Dr Peter Pronovost, the author of the book, Safe Patients, Smart Hospitals . Dr Pronovost is truly a pioneer in patient safety, implementing programs in the adult intensive care unit, starting with the simple standardization of central line insertions that reduced line infections to virtually zero, first in his own hospital at Johns Hopkins and then spreading throughout the country including a statewide program in Michigan. Following this introductory article, we will be publishing a monthly series of invited articles by experts in the field, including subjects like checklists, simulation, standardized protocols, reducing malpractice liability risk, physician/nurse interaction, certification in fetal heart rate monitoring, and more general articles demonstrating how such programs can be implemented, how they can be tracked, and how they can be proven to reduce errors and improve patient safety. I wish to thank my coeditors for this series—Drs Steven Clark, Eric Knox, and Daniel O’Keefe. We are truly excited to be providing this important series and we welcome comments from our readers as well as suggestions for further topics in this area and authors to write about them.
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