Open AccessGuideline‐based development of quality indicators for prevention and management of postpartum hemorrhage
Author(s) -
Woiski Mallory D.,
Scheepers Hubertina C.,
Liefers Janine,
Lance Marcus,
Middeldorp Johanna M.,
Lotgering Fred K.,
Grol Richard P.,
Hermens Rosella P.
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12718
Subject(s) - medicine , guideline , documentation , delphi method , quality management , audit , quality (philosophy) , process management , nursing , operations management , management system , accounting , business , philosophy , statistics , mathematics , epistemology , pathology , computer science , economics , programming language
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 .