Kaat Helsloot1, Mieke Walraevens2, Saskia Van Besauw3, An-Sofie Van Parys4, Hanne Devos5, Ann Van Holsbeeck6, Kristien Roelens7. 1. Faculty of Medicine & Health Sciences, Ghent University,Boskant 6, 9790 Elsegem, Belgium. Electronic address: kaat.helsloot@telenet.be. 2. Faculty of Medicine & Health Sciences, Ghent University, Verrebeke 8, 9660 Belgium. Electronic address: walraevens@me.com. 3. Flemish Centres of Expertise for Perinatal Care, Volkstraat 7, 2000 Antwerp, Belgium. Electronic address: Saskia@kraamvogel.be. 4. Faculty of Medicine and Health Sciences, Department of Obstetrics and Gynaecology, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Ansofie.vanparys@ugent.be. 5. Centres of Expertise for Perinatal Care, Tramstraat 69, 9052 Zwijnaarde, Belgium. Electronic address: info@kraamkaravaan.be. 6. Department of Obstetrics & Gynaecology, Faculty of Medicine & Health Sciences, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Ann.vanholsbeeck@uzgent.be. 7. Faculty of Medicine & Health Sciences, Department of Obstetrics & Gynaecology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Kristien.roelens@uzgent.be.
Abstract
OBJECTIVE: to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. DESIGN: key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). SETTING: Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. FINDINGS: after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.
OBJECTIVE: to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. DESIGN: key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). SETTING: Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. FINDINGS: after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.
Authors: Ramya Selvaraj; Jayalakshmy Ramakrishnan; Swaroop Kumar Sahu; Sitanshu Sekhar Kar; Gautam Roy Journal: J Family Med Prim Care Date: 2021-02-27