Smooth
Families who choose to give birth at home or in a freestanding birth center deserve the best possible care when plans change and they need to access hospital services.
Smooth Transitions™ is a Washington state-based quality improvement program enhancing the safety of these hospital transfers.
We bring together community midwives, hospital providers and staff, and EMS personnel to build a collaborative model of care that puts birthing families at the center.
We offer presentations throughout Washington state and provide direct support to participating hospitals. We are also available to consult with perinatal collaboratives and organizations in other states interested in replicating this work.
In Memoriam Dr. Dale Reisner
Dr. Dale Reisner passed away in 2024 after decades as a maternal health leader, committed to advocacy in perinatal health, health equity, and various quality improvement projects and legislation, both in Washington State and nationally. She was instrumental in the development of Smooth Transitions from its inception, and continued to be deeply engaged until her passing. She was an extraordinary person who touched many lives, both as a kind and generous person as well as through her work. Dale’s presence, as a leader and friend, will be profoundly missed.
Mission: To address our shared responsibility for improving hospital transfers from planned community-based births to promote greater patient safety and satisfaction.
Goals:
- Improve the whole person safety* and efficiency of the transfer process through the establishment of system-wide protocols
- Collect and analyze transfer outcome data for the purpose of quality improvement
- Build greater collaboration between community-based midwives, EMS, doulas and hospital care team
- Enhance the patient experience of care when transfers occur
*Smooth Transitions considers “whole person safety” to encompass emotional, psychological, social, cultural, spiritual, and physical processes and outcomes.
“We believe that collaboration within an integrated maternity care system is essential for optimal mother-baby outcomes. All women and families planning a home or birth center birth have a right to respectful, safe, and seamless consultation, referral, transport and transfer of care when necessary. When ongoing inter-professional dialogue and cooperation occur, everyone benefits.”
Best Practice Guidelines: Transfer from Planned Home Birth to Hospital
“Like most hospitals, we have struggled with how best to accommodate patients who have planned an out-of-hospital birth under the care of a midwife but are transferred in during labor or postpartum. With the help of the Smooth Transitions team, we have significantly changed the attitudes and the experience of these transfers. The tools available through the Smooth Transitions™ playbook have guided us along this process, and I strongly recommend this program to any hospital that wants to improve the transfer experience for all involved.”
Roger Rowles MD, Former Medical Director of Perinatal Services, Virginia Mason Memorial Hospital, Yakima, WA
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