Quality Indicators During Delivery and the Immediate Postpartum Period: A Modified Delphi Study

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2023 Mar 29

PMID 36981505

Authors

Candy Guiguet-Auclair

Olivier Riviere

Laurent Gerbaud

Francoise Vendittelli

Affiliations

Soon will be listed here.

Abstract

Background: Our research hypothesis was that most French indicators of quality of care have been validated by experts who are not clinicians and might not always be meaningful for clinicians. Our objective was to define a core set of measurable indicators of care quality during delivery and the immediate postpartum period relevant to clinical practice.

Methods: A steering committee comprising nine specialists in obstetrics and/or public health conducted a literature review to develop potential indicators. A panel of obstetrician-gynecologists and midwives working in a delivery unit rated each indicator for appropriateness in a two-round Rand-modified Delphi procedure and a physical meeting. The consensus among the panelists was assessed.

Results: In the first round, 145 panelists (110 obstetrician-gynecologists and 35 midwives) assessed 77 indicators and 3 definitions: 6 related to labor onset, 20 to delivery, 3 to pain management, 23 to neonatal morbidity/mortality, and 28 to maternal morbidity. In the second round, 132 panelists (98 obstetrician-gynecologists and 34 midwives) assessed 42 indicators and 1 definition. The final set comprised 50 indicators and 2 definitions.

Conclusions: This Delphi procedure selected 50 indicators that reflect the quality of perinatal care. These indicators should be recorded in each French maternity ward's birth register for each delivery.

References

Sibanda T, Fox R, Draycott T, Mahmood T, Richmond D, Simms R . Intrapartum care quality indicators: a systematic approach for achieving consensus. Eur J Obstet Gynecol Reprod Biol. 2012; 166(1):23-9. DOI: 10.1016/j.ejogrb.2012.09.018. View

Sauvegrain P, Chantry A, Chiesa-Dubruille C, Keita H, Goffinet F, Deneux-Tharaux C . Monitoring quality of obstetric care from hospital discharge databases: A Delphi survey to propose a new set of indicators based on maternal health outcomes. PLoS One. 2019; 14(2):e0211955. PMC: 6372226. DOI: 10.1371/journal.pone.0211955. View

Korst L, Gregory K, Lu M, Reyes C, Hobel C, Chavez G . A Framework for the Development of maternal quality of care indicators. Matern Child Health J. 2005; 9(3):317-41. DOI: 10.1007/s10995-005-0001-y. View

Zeitlin J, Alexander S, Barros H, Blondel B, Delnord M, Durox M . Perinatal health monitoring through a European lens: eight lessons from the Euro-Peristat report on 2015 births. BJOG. 2019; 126(13):1518-1522. DOI: 10.1111/1471-0528.15857. View

Melman S, Schoorel E, de Boer K, Burggraaf H, Derks J, van Dijk D . Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review. PLoS One. 2016; 11(1):e0145771. PMC: 4718610. DOI: 10.1371/journal.pone.0145771. View

Bonfill X, Roque M, Aller M, Osorio D, Foradada C, Vives A . Development of quality of care indicators from systematic reviews: the case of hospital delivery. Implement Sci. 2013; 8:42. PMC: 3626798. DOI: 10.1186/1748-5908-8-42. View

Haller G, Camparini-Righini N, Kern C, Pfister R, Morales M, Berner M . [Patient safety indicators for obstetrics: a Delphi based study]. J Gynecol Obstet Biol Reprod (Paris). 2010; 39(5):371-8. DOI: 10.1016/j.jgyn.2010.05.011. View

Deneux-Tharaux C, Morau E, Dreyfus M . [Maternal mortality in France 2013-2015: An evolving profile]. Gynecol Obstet Fertil Senol. 2021; 49(1):1-2. DOI: 10.1016/j.gofs.2020.12.002. View

. Best practice advice on the 10-Group Classification System for cesarean deliveries. Int J Gynaecol Obstet. 2016; 135(2):232-233. DOI: 10.1016/j.ijgo.2016.08.001. View

10.

Robson M . Can we reduce the caesarean section rate?. Best Pract Res Clin Obstet Gynaecol. 2001; 15(1):179-94. DOI: 10.1053/beog.2000.0156. View

11.

Macfarlane A, Gissler M, Bolumar F, Rasmussen S . The availability of perinatal health indicators in Europe. Eur J Obstet Gynecol Reprod Biol. 2003; 111 Suppl 1:S15-32. DOI: 10.1016/j.ejogrb.2003.09.003. View

12.

Vendittelli F, Tassie M, Gerbaud L, Lemery D . Appropriateness of elective caesarean deliveries in a perinatal network: a cross-sectional study. BMC Pregnancy Childbirth. 2014; 14:135. PMC: 3986443. DOI: 10.1186/1471-2393-14-135. View

13.

Murphy M, Black N, Lamping D, McKEE C, Sanderson C, Askham J . Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998; 2(3):i-iv, 1-88. View

14.

Lazzaretto E, Nespoli A, Fumagalli S, Colciago E, Perego S, Locatelli A . Intrapartum care quality indicators: a literature review. Minerva Ginecol. 2017; 70(3):346-356. DOI: 10.23736/S0026-4784.17.04177-6. View

15.

Kesmodel U, Jolving L . Measuring and improving quality in obstetrics--the implementation of national indicators in Denmark. Acta Obstet Gynecol Scand. 2011; 90(4):295-304. DOI: 10.1111/j.1600-0412.2011.01078.x. View

16.

Say L, Chou D, Gemmill A, Tuncalp O, Moller A, Daniels J . Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014; 2(6):e323-33. DOI: 10.1016/S2214-109X(14)70227-X. View

17.

Talungchit P, Liabsuetrakul T, Lindmark G . Development and assessment of indicators for quality of care in severe preeclampsia/eclampsia and postpartum hemorrhage. J Healthc Qual. 2012; 35(3):22-34. DOI: 10.1111/j.1945-1474.2011.00183.x. View

18.

Vendittelli F, Barasinski C, Riviere O, Da Costa Correia C, Crenn-Hebert C, Dreyfus M . Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study. Healthcare (Basel). 2022; 10(6). PMC: 9222306. DOI: 10.3390/healthcare10060992. View

19.

Saturno-Hernandez P, Martinez-Nicolas I, Moreno-Zegbe E, Fernandez-Elorriaga M, Poblano-Verastegui O . Indicators for monitoring maternal and neonatal quality care: a systematic review. BMC Pregnancy Childbirth. 2019; 19(1):25. PMC: 6330388. DOI: 10.1186/s12884-019-2173-2. View

20.

Bailit J . Measuring the quality of inpatient obstetrical care. Obstet Gynecol Surv. 2007; 62(3):207-13. DOI: 10.1097/01.ogx.0000256800.21193.ce. View