OBJECTIVE: The aim of this study is to implement the Ten Group Classification System (TGCS) and evaluate whether the introduction of the medical audit cycle reduces the cesarean section (CS) rate without increasing maternal-fetal risk. STUDY DESIGN: A prospective cohort study was performed including all women who gave birth during 21 months. The study was subdivided into three consecutive periods: (1) implementation of the TGCS identifying the major CS rate contributor groups (three months), (2) audit and report changes in the CS rates to the medical and midwifery staff according to the TGCS (6 months) and (3) discontinue interventions but continue auditing the CS rates (6 months). RESULTS: The first period CS rate of 36.8% was reduced to 26.5% after the introduction of interventions in the second period (RR 0.71 IC 0.63-0.81). After the intervention was stopped, the CS rate increased again to 31.8% (RR 1.19 IC 1.09-1.32). This is a decrease of 5.08% from the basal period (RR 0.86 IC 0.76-0.97). The asphyxia rate remained unchanged for the periods studied. CONCLUSION: Auditing through the TGCS and feedback is an effective, safe, and easy-to-implement strategy to reduce the CS rate. Its diffusion would allow reduction of the CS rates in countries as ours, and by means of the TGCS, figures can be compared within individual entities and others.
OBJECTIVE: The aim of this study is to implement the Ten Group Classification System (TGCS) and evaluate whether the introduction of the medical audit cycle reduces the cesarean section (CS) rate without increasing maternal-fetal risk. STUDY DESIGN: A prospective cohort study was performed including all women who gave birth during 21 months. The study was subdivided into three consecutive periods: (1) implementation of the TGCS identifying the major CS rate contributor groups (three months), (2) audit and report changes in the CS rates to the medical and midwifery staff according to the TGCS (6 months) and (3) discontinue interventions but continue auditing the CS rates (6 months). RESULTS: The first period CS rate of 36.8% was reduced to 26.5% after the introduction of interventions in the second period (RR 0.71 IC 0.63-0.81). After the intervention was stopped, the CS rate increased again to 31.8% (RR 1.19 IC 1.09-1.32). This is a decrease of 5.08% from the basal period (RR 0.86 IC 0.76-0.97). The asphyxia rate remained unchanged for the periods studied. CONCLUSION: Auditing through the TGCS and feedback is an effective, safe, and easy-to-implement strategy to reduce the CS rate. Its diffusion would allow reduction of the CS rates in countries as ours, and by means of the TGCS, figures can be compared within individual entities and others.
Authors: Mary A Vadnais; Michele R Hacker; Neel T Shah; JoAnn Jordan; Anna M Modest; Molly Siegel; Toni H Golen Journal: Jt Comm J Qual Patient Saf Date: 2016-11-15
Authors: Gianpaolo Maso; Monica Piccoli; Marcella Montico; Lorenzo Monasta; Luca Ronfani; Sara Parolin; Carmine Gigli; Daniele Domini; Claudio Fiscella; Sara Casarsa; Carlo Zompicchiatti; Michela De Agostini; Attilio D'Atri; Raffaela Mugittu; Santo La Valle; Cristina Di Leonardo; Valter Adamo; Mara Fracas; Giovanni Del Frate; Monica Olivuzzi; Silvio Giove; Maria Parente; Daniele Bassini; Simona Melazzini; Secondo Guaschino; Caterina Businelli; Franco G Toffoletti; Diego Marchesoni; Alberto Rossi; Sergio Demarini; Laura Travan; Giorgio Simon; Sandro Zicari; Giorgio Tamburlini; Salvatore Alberico Journal: Biomed Res Int Date: 2013-06-25 Impact factor: 3.411
Authors: Ana Pilar Betrán; Nadia Vindevoghel; Joao Paulo Souza; A Metin Gülmezoglu; Maria Regina Torloni Journal: PLoS One Date: 2014-06-03 Impact factor: 3.240