Date of Award

Fall 2018

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Patricia Puccilli


Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum hemorrhage management checklist was implemented based on the findings. Post intervention simulation drills were conducted to assess improvement. Defect rates were used to demonstrate improvement. Defect rates, steps in the nursing process, and reduction in non-value-added time to the process were all improved with checklist implementation. Utilizing a checklist to organize work assist in decision making during postpartum hemorrhage drills resulted in improved response and efficiency.