TY - CHAP M1 - Book, Section TI - Implementing Value-Based Initiatives: A New Challenge for Clinicians and Healthcare Systems A1 - Moriates, Christopher A1 - Arora, Vineet A1 - Shah, Neel Y1 - 2015 N1 - T2 - Understanding Value-Based Healthcare AB - In the mid-1800s, giving birth could be dangerous. Ignaz Semmelweis worked as a house officer in an obstetrical ward in Vienna, Austria, where nearly one-in-six woman died following childbirth. In the other obstetrical clinic he worked in, the maternal mortality rate was less than half that, at 7%. He began to wonder why there was such a discrepancy in the outcomes between these two clinics. Ignaz noticed that doctors and medical students at the first clinic were often coming directly to the delivery room after performing autopsies, even frequently with a “disagreeable odor” on their hands. He began to hypothesize that there may be “cadaverous particles” that could be transmitted by the hands of these physicians resulting in harm for birthing mothers. He recommended hands be scrubbed in a chlorinated lime solution before every patient contact. Of course, we all know what happened. Hand-washing resulted in the mortality rate in the obstetrical ward to plummet to less than 3%.1 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1164295011 ER -