3/9/2017

C‐Sections for Single Live Full‐Term Head‐First Births to First‐Time Mothers (NTSV) January 2015 ‐ December 2015 WA Births at Non‐Military by Level of Care University of WA Medical Center 4

Tacoma General Hospital Swedish Medical Center ‐ First Hill

Level Providence Sacred Heart Med. Ctr

Evergreen Hospital Medical Center Overlake Hospital Medical Center

Valley Medical Center 3 St. Joseph Medical Center

Kadlec Regional Medical Center Peacehealth Southwest Medical Center Level Legacy At Salmon Creek Providence Reg. Med. Ctr, Everett Deaconess Medical Center Yakima Valley Memorial Hospital

Swedish Edmonds Hospital Trios Health Multicare Auburn Medical Center Swedish Medical Center ‐ Ballard St. Francis Community Hospital Providence St. Peter Hospital Swedish Medical Center ‐ Issaquah

2 Good Samaritan Hospital Providence St. Mary Medical Center Peacehealth St Joseph Hospital

Level Northwest Hospital & Med. Ctr. Highline Medical Center Providence Holy Family Hospital Harrison Medical Center ‐ Silverdale Group Health Coop. Central Hospital Central Hospital Peacehealth St. John Medical Center

Cascade Valley Hospital

Grays Harbor Community Hospital Providence Centralia Hospital

CAH ‐ Capital Medical Center

Non Samaritan Hospital

1 Valley Hospital And Medical Center

Island Hospital Walla Walla General Hospital Level Toppenish Community Hospital

Mid‐Valley Hospital Pullman Regional Hospital Kittitas Valley Healthcare Providence Mount Carmel Hospital Prosser Memorial Hospital Whidbey General Hospital St. Elizabeth Hospital CAH

1 Lake Chelan Community Hospital Othello Community Hospital Jefferson Healthcare

Level North Valley Hospital Statewide Rate = 23.5% Sunnyside Community Hospital Mason General Hospital Forks Community Hospital 0% 10% 20% 30% 40% 50% Washington does not currently have a stated target for this measure. C‐Sections NTSV=C‐Sections among Nulliparous Term Single live Vertex births, also described as single live full‐term head‐first births to first‐time mothers. Hospital Level of Care: The Washington State Department of Health compiles Perinatal Level of Care Guidelines (available at http://www.doh.wa.gov/Portals/1/Documents/Pubs/950154.pdf) which outline general functions, patient descriptors, and resources for basic (Level I), intermediate (Level II), intensive care (Level III, commonly referred to as Neonatal Intensive Care Unit or NICU), and Regional NICU (Level IV) obstetrical and neonatal services. Hospitals with Level III designation are distributed across the state to provide regionalized services with the appropriate level of care for pregnant women and newborns. The Critical Access Hospital (CAH) Program was created as a safety net device to assure Medicare beneficiaries access to health care services in rural areas. For specifications see http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/RuralHealth/HealthcareFacilityResources/CriticalAccessHospitals Excludes cases where mother was transferred to higher level care for maternal medical or fetal indicators for delivery, hospital births where intended place of birth was other than hospital, and hospitals with fewer than 20 single live full‐term head‐first births to first‐time mothers. 3/9/2017 Primary C‐Sections Among Term Singleton Vertex (TSV) Deliveries January 2015 ‐ December 2015 WA Births at Non‐Military Hospitals by Hospital Level of Care 4

University of WA Medical Center Tacoma General Hospital

Level Swedish Medical Center ‐ First Hill Providence Sacred Heart Med. Ctr

Overlake Hospital Medical Center

3 Evergreen Hospital Medical Center

St. Joseph Medical Center Valley Medical Center

Level Peacehealth Southwest Medical Center Kadlec Regional Medical Center Legacy At Salmon Creek Deaconess Medical Center Providence Reg. Med. Ctr, Everett Yakima Valley Memorial Hospital

Swedish Medical Center ‐ Ballard Swedish Edmonds Hospital Northwest Hospital & Med. Ctr. Multicare Auburn Medical Center

Swedish Medical Center ‐ Issaquah 2

Providence St. Peter Hospital Group Health Coop. Central Hospital Good Samaritan Hospital Level Trios Health St. Francis Community Hospital Providence St. Mary Medical Center Peacehealth St Joseph Hospital Harrison Medical Center ‐ Silverdale Skagit Valley Hospital Highline Medical Center Providence Holy Family Hospital Peacehealth St. John Medical Center Central Washington Hospital

Cascade Valley Hospital

CAH Grays Harbor Community Hospital ‐ Providence Centralia Hospital Olympic Medical Center Non

1 Capital Medical Center Island Hospital Samaritan Hospital

Level Valley Hospital And Medical Center Walla Walla General Hospital Toppenish Community Hospital

Mid‐Valley Hospital Newport Hospital & Health Services Pullman Regional Hospital Kittitas Valley Healthcare Whitman Medical Center Providence Mount Carmel Hospital Prosser Memorial Hospital Whidbey General Hospital CAH St. Elizabeth Hospital 1

Three Rivers Hospital Lake Chelan Community Hospital

Level North Valley Hospital Jefferson Healthcare Forks Community Hospital Othello Community Hospital Sunnyside Community Hospital Results WA 2016 Target = 14.7% Mason General Hospital Coulee Medical Center 0% 5% 10% 15% 20% 25% Primary C‐Sections TSV = C‐Sections for Single Live Full‐Term Head‐First Births (TSV) to women with no prior C‐sections. Hospital Level of Care: The Washington State Department of Health compiles Perinatal Level of Care Guidelines (available at http://www.doh.wa.gov/Portals/1/Documents/Pubs/950154.pdf) which outline general functions, patient descriptors, and resources for basic (Level I), intermediate (Level II), intensive care (Level III, commonly referred to as Neonatal Intensive Care Unit or NICU), and Regional NICU (Level IV) obstetrical and neonatal services. Hospitals with Level III designation are distributed across the state to provide regionalized services with the appropriate level of care for pregnant women and newborns. The Critical Access Hospital (CAH) Program was created as a safety net device to assure Medicare beneficiaries access to health care services in rural areas. For specifications see http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/RuralHealth/HealthcareFacilityResources/CriticalAccessHospitals Excludes cases where mother was transferred to higher level care for maternal medical or fetal indicators for delivery, hospital births where intended place of birth was other than hospital, and hospitals with fewer than 20 single live full‐term head‐first births to women with no prior C‐section. 3/9/2017

Vaginal Births After Single C‐Section (VBAC) for Term Single Head‐First Deliveries January 2015 ‐ December 2015 WA Births at Non‐Military Hospitals by Perinatal Region

Peacehealth St. John Medical Center (27) Peacehealth Southwest Medical Center (75) Legacy At Salmon Creek (119) Tacoma General Hospital (89)

Southwest Capital Medical Center (23) St. Joseph Medical Center (125) Providence St. Peter Hospital (49) Harrison Medical Center ‐ Silverdale (33)

Northwest Hospital & Med. Ctr. (78) Group Health Coop. Central Hospital (11) Highline Medical Center (26) St. Elizabeth Hospital (8) Peacehealth St Joseph Hospital (76) Swedish Medical Center ‐ First Hill (236)

Skagit Valley Hospital (38) Valley Medical Center (144) University of WA Medical Center (55) Swedish Edmonds Hospital (41) Northwest Swedish Medical Center ‐ Ballard (28)

St. Francis Community Hospital (29) Multicare Auburn Medical Center (37) Swedish Medical Center ‐ Issaquah (43) Providence Reg. Med. Ctr, Everett (95) Evergreen Hospital Medical Center (96) Overlake Hospital Medical Center (80) Island Hospital (3)

Valley Hospital And Medical Center (32) Trios Health (73) Providence Holy Family Hospital (53)

Kadlec Regional Medical Center (90) Deaconess Medical Center (30)

Eastern Providence Sacred Heart Med. Ctr (47) Pullman Regional Hospital (3) Statewide Rate = 27.1%

Yakima Valley Memorial Hospital (85)

Toppenish Community Hospital (13) Central Washington Hospital (46)

Central Kittitas Valley Healthcare (3)

0% 10% 20% 30% 40% 50% 60%

Washington does not currently have a stated target for this measure. Vaginal Births after Single C‐Section (VBAC) are vaginal births among live births to women with term single head‐first deliveries after a single prior c‐section. Number of prior c‐sections is determined by Birth Certificate number stated and longitudinal linkage. Number of vaginal births after single identified c‐section is shown next to hospital name. The Perinatal Regional Network is coordinated by the Department of Health and is a collaborative effort with the Health Care Authority/Medicaid. The program uses state and federal funds to contract with geographically strategic healthcare institutions to coordinate and implement state and regional quality improvement projects to decrease poor pregnancy outcomes for which Medicaid clients are at disproportionately increased risk. http://www.doh.wa.gov/PublicHealthandHealthcareProviders/HealthcareProfessionsandFacilities/BestPractices/MaternalandInfantHealth/PerinatalRegionalNetwork.aspx Excludes hospitals with fewer than 20 deliveries to women who are appropriate candidates for VBAC, and hospitals that do not offer planned vaginal birth delivery services after a prior cesarean section.