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Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process
Author(s) -
Bunch KJ,
Allin B,
Jolly M,
Hardie T,
Knight M
Publication year - 2018
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.15282
Subject(s) - delphi method , caesarean section , medicine , breastfeeding , metric (unit) , pediatrics , nursing , obstetrics , pregnancy , operations management , computer science , engineering , artificial intelligence , genetics , biology
Objective To develop a core metric set to monitor the quality of maternity care. Design Delphi process followed by a face‐to‐face consensus meeting. Setting English maternity units. Population Three representative expert panels: service designers, providers and users. Main outcome measures Maternity care metrics judged important by participants. Methods Participants were asked to complete a two‐phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re‐scored the metrics. Results In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third‐ and fourth‐degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score <7 at 5 minutes; proportion of babies born at term admitted to the neonatal intensive care unit; proportion of babies readmitted to hospital at <30 days of age; breastfeeding initiation rate; and breastfeeding rate at 6–8 weeks. Conclusions Core outcome set methodology can be used to incorporate the views of key stakeholders in developing a core metric set to monitor the quality of care in maternity units, thus enabling improvement. Tweetable abstract Achieving consensus on core metrics for monitoring the quality of maternity care.