Mallory D Woiski1, Hubertina C Scheepers2, Janine Liefers3, Marcus Lance4, Johanna M Middeldorp5, Fred K Lotgering1, Richard P Grol3, Rosella P Hermens3. 1. Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands. 2. Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands. 5. Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
INTRODUCTION: To systematically develop a set of guideline-based quality indicators for postpartum hemorrhage (PPH) as a tool to measure guideline adherence in actual PPH care. MATERIAL AND METHODS: A Rand-modified Delphi procedure was used to systematically achieve consensus among a panel of 22 experts on PPH care on recommendations extracted from evidence-based guidelines, Managing-Obstetrics-Emergencies-Trauma (MOET) instructions and international literature. The selected recommendations were individually rated on health gain (prevention of maternal mortality and morbidity) and overall efficiency by the expert panel. Subsequently, consensus about the most important recommendations to measure quality of PPH care among the panel members was reached, followed by a final approval. Last, definition of the final set by critical appraisal of the recommendations regarding measurability took place. The main outcome measure was a set of valid quality indicators for prevention and management of PPH. RESULTS: From the 69 extracted recommendations, 50 were selected and translated into 22 quality indicators on professional performance (n = 17) and organization of PPH care (n = 5). The professional performance indicators covered all fields of PPH care, such as prevention (n = 2) and management of PPH, including communication and documentation (n = 4), monitoring and prevention of shock (n = 3), use of blood products (n = 3) and treatment of PPH (n = 5). Organizational indicators (n = 5) were clustered into protocols and agreements, audit, accessibility and documentation. CONCLUSIONS: This study describes a stepwise systematic development of 22 performance and organizational indicators to use for measuring the whole care process of prevention and management of PPH.
INTRODUCTION: To systematically develop a set of guideline-based quality indicators for postpartum hemorrhage (PPH) as a tool to measure guideline adherence in actual PPH care. MATERIAL AND METHODS: A Rand-modified Delphi procedure was used to systematically achieve consensus among a panel of 22 experts on PPH care on recommendations extracted from evidence-based guidelines, Managing-Obstetrics-Emergencies-Trauma (MOET) instructions and international literature. The selected recommendations were individually rated on health gain (prevention of maternal mortality and morbidity) and overall efficiency by the expert panel. Subsequently, consensus about the most important recommendations to measure quality of PPH care among the panel members was reached, followed by a final approval. Last, definition of the final set by critical appraisal of the recommendations regarding measurability took place. The main outcome measure was a set of valid quality indicators for prevention and management of PPH. RESULTS: From the 69 extracted recommendations, 50 were selected and translated into 22 quality indicators on professional performance (n = 17) and organization of PPH care (n = 5). The professional performance indicators covered all fields of PPH care, such as prevention (n = 2) and management of PPH, including communication and documentation (n = 4), monitoring and prevention of shock (n = 3), use of blood products (n = 3) and treatment of PPH (n = 5). Organizational indicators (n = 5) were clustered into protocols and agreements, audit, accessibility and documentation. CONCLUSIONS: This study describes a stepwise systematic development of 22 performance and organizational indicators to use for measuring the whole care process of prevention and management of PPH.
Authors: Mallory D Woiski; Helena C van Vugt; Anneke Dijkman; Richard P Grol; Abraham Marcus; Johanna M Middeldorp; Ben W Mol; Femke Mols; Martijn A Oudijk; Martina Porath; Hubertina J Scheepers; Rosella P Hermens Journal: Matern Child Health J Date: 2016-10
Authors: Priscille Sauvegrain; Anne Alice Chantry; Coralie Chiesa-Dubruille; Hawa Keita; François Goffinet; Catherine Deneux-Tharaux Journal: PLoS One Date: 2019-02-12 Impact factor: 3.240
Authors: M J Schleedoorn; B H Mulder; D D M Braat; C C M Beerendonk; R Peek; W L D M Nelen; E Van Leeuwen; A A E M Van der Velden; K Fleischer; On Behalf Of The Turner Fertility Expert Panel Journal: Hum Reprod Date: 2020-05-01 Impact factor: 6.918