The articles in this issue of MCN The American Journal of Maternal Child Nursing reflect significant efforts by nurses to promote quality and safety for mothers and babies during their hospitalization. The first article by Thompson, Legorreta, Maher, and Lavin describes the multiyear process of getting funding for and planning, designing, and building a new labor and birth unit. Our large volume perinatal service moved into the new unit in the new hospital tower successfully after extensive collaboration and teamwork. Three hospital teams that accomplished a similar move are highlighted in the next article by VonBehren, Killion, Burke, Finkelmeier, and Zamora. There are remarkable consistencies in their experience and ours. Valuable tips are offered for nurse leaders given the opportunity for a new maternity unit. Very little information was available in the literature when we began our journey, so we hope others will find these data useful. Once we settled into the new unit, it became apparent that several clinical practices and unit operations could benefit from reevaluation and change. Bell, Bohannon, Porthouse, Thompson, and Vargo discuss a series of quality improvement projects focused on elective labor induction, scheduled cesarean birth, obstetric triage, and transfer of maternity patients within the hospital. Each of these projects was guided by the LEAN process that allowed for rapid improvement with the help of frontline clinicians.

When women are faced with a devastating diagnosis for their fetus during pregnancy, coordinated support and help with navigating the complex healthcare system is critical. The Fetal Care Team has been developed for this purpose and is described by Loyet, McLean, Graham, Antoine, and Fossick. Women hospitalized for days, weeks, and even months during a complicated pregnancy often experience stress and discomfort. An innovative program involving integrative therapies such as massage, healing touch, acupuncture, guided imagery, and reflexology for this population is presented by Schegel, Whalen, and Williamsen. Results indicate a significant reduction in stress and pain after the therapies. Many hospitals in the United States have implemented maternal hemorrhage protocols modeled after the California Maternal Quality Care Collaborative (CMQCC) (Bingham, Lyndon, Lagrew, & Main, 2011). Lyndon and Cape describe the lessons learned through their experiences in developing the CMQCC obstetric hemorrhage toolkit and collaborating with multiple stakeholders to ensure its success.

Each of the projects included in this special issue involved multidisciplinary collaboration and teamwork, without which these nurse leaders could not have achieved the outcomes described. I sincerely hope you enjoy reading all of the excellent articles in this issue of MCN and find the topics and details offered beneficial in promoting maternity care quality improvement in your practice.

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