Open AccessA multi-approach management intervention can lower C-section rate trends: The experience of a Third Level Referral Center
Author(s) -
Antonio Giulio de Belvis,
Caterieri,
Carmen Angioletti,
Brigida Carducci,
Sergio Ferrazzani,
Antonio Lanzone,
Alessandro Caruso
Publication year - 2018
Publication title -
journal of hospital administration
Language(s) - English
Resource type - Journals
eISSN - 1927-7008
pISSN - 1927-6990
DOI - 10.5430/jha.v7n6p37
Subject(s) - medicine , referral , audit , psychological intervention , quality management , clinical audit , caesarian section , emergency medicine , operations management , family medicine , nursing , pregnancy , management system , accounting , biology , economics , business , genetics
Objective: To report the experience developed in a Third Level Referral Center in performing a multifaceted intervention strategy to reduce Caesarian Sections (CS) rate. A comparison of our results with the performance of the best Italian hospitals for number of deliveries and CS has been performed.Methods: A monitoring system was set up, based on a prospective collection of all deliveries from 2013 to 2017, according to Robson’s classification. Data have also been collected retrospectively at a regional and national level to compare our results to other institutions. The multi-approach intervention consisted of evidence based tools: process management, training, multiprofessionalism, development of planning and control systems, continuous monitoring, audit and feedback.Results: The percentage of primary CS decreased from 26.71% in 2013 to 15.03% in 2017 (RR adjusted considering the regional average: 0.87 in 2013; 0.57 in 2017, p .05; 0.74 in 2016, p < .001), while there was an increase in the annual volume of deliveries from 3,311 to 4,219.Conclusions: Our study confirms that multifaceted interventions can strengthen a continuous quality and safety improvement approach. This is of crucial relevance in the obstetric field and in the Italian country, where overall performance in CS needs to be improved.