This project focused on reducing blood transfusions during childbirth that can be a leading contributor to severe maternal morbidity (SMM). Using evidence‑based strategies from the AIM and CMQCC toolkits, the team implemented several interventions, including improved prenatal anemia management, early and aggressive response to abnormal bleeding using quantified blood loss (QBL), preferential use of certain uterotonic medications, and increased use of postpartum IV iron for patients with significant but asymptomatic anemia. Education was rolled out in Phase 1 (May 2023), and Phase 2 focused on standardizing provider notification thresholds for postpartum blood loss greater than 200 mL.

As a result, the hospital achieved a 26.1% overall reduction in blood transfusions across both phases, with a 24.3% reduction among African American/Black patients. These results demonstrate that standardized protocols, early intervention, and team‑based approaches can significantly reduce transfusion rates and improve equity and safety in obstetric care.