GRACE-OB Clinical Framework

Improving patient experience, safety, and communication in obstetric anesthesia.

Clinical safety is not only physical—it is also psychological.

For many patients, obstetric anesthesia is one of the most vulnerable moments in healthcare.

GRACE-OB is a structured clinical framework designed to improve patient experience, communication, and documentation in obstetric anesthesia—without compromising efficiency or clinical rigor.

The Gap

Despite advances in safety, patients continue to report:

  • Pain or distress during procedures that was not anticipated

  • Feeling unprepared for what they would experience

  • Difficulty advocating for themselves in high-intensity settings

  • Documentation that does not fully reflect their experience

Clinical success does not always equate to patient safety as experienced by the patient.

What GRACE-OB is

GRACE-OB is a clinically grounded framework for improving how care is communicated, delivered, and documented in obstetric anesthesia.

It provides a structured approach to:

  • Preparing patients with realistic, transparent expectations

  • Supporting real-time advocacy and responsiveness in the OR

  • Integrating patient experience into clinical decision-making

  • Aligning documentation with both clinical care and patient understanding

GRACE-OB is designed to enhance existing workflows—not replace them.

Core Pillars

GRACE-OB is organized around five core pillars:

Grounded & Transparent Pre-Operative Care

Preparing patients with clear, realistic expectations and meaningful opportunity for questions and decision-making.

Real-Time Advocacy in the OR

Actively assessing comfort and responding to patient experience during care—not assuming silence equals comfort.

Affirming Language & Documentation

Using language that reflects patient experience accurately while maintaining clinical precision.

Integrated Clinical Decision-Making

Incorporating patient preferences, concerns, and real-time feedback into care decisions.

Post-Event Reflection & Continuity

Ensuring patient experience is acknowledged and informs ongoing care.

What GRACE-OB Addresses

GRACE-OB focuses on areas often underrepresented in traditional guidelines:

  • Pain and sensory experience during neuraxial anesthesia

  • Patient expectations vs actual experience

  • Communication gaps in high-acuity settings

  • Documentation that reflects both clinical care and patient experience

  • Psychological safety as a component of overall safety

Example Applications

GRACE-OB supports:

  • Pre-operative conversations that improve informed consent

  • Real-time adjustments in response to patient discomfort

  • Documentation that reflects both clinical events and patient experience

  • More consistent communication across providers and settings

Clinical Foundation

GRACE-OB is informed by clinical experience, patient-reported outcomes, and evolving standards in obstetric anesthesia.

Related work:

Anesthesiology (essay):
Davis, Anna E. M.A.1. Anesthesiologists and the Greatest Moment. Anesthesiology 144(4):p 1005-1007, April 2026. | DOI: 10.1097/ALN.0000000000005936

Who It’s For

  • Obstetric anesthesiologists

  • CRNAs and anesthesia teams

  • Labor & delivery teams

  • Health systems focused on patient experience and quality

Current Status

GRACE-OB is currently in early implementation and pilot development.

Additional materials, toolkit resources, and training options are in development.

Interest in GRACE-OB

If you are interested in pilot opportunities or early implementation:

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