RT Book, Section A1 Moriates, Christopher A1 Arora, Vineet A1 Shah, Neel SR Print(0) ID 1164295011 T1 Implementing Value-Based Initiatives: A New Challenge for Clinicians and Healthcare Systems T2 Understanding Value-Based Healthcare YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-181698-4 LK accessmedicine.mhmedical.com/content.aspx?aid=1164295011 RD 2024/03/28 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