目的:制定一套监测产妇护理质量的核心指标。
方法:Delphi流程,然后进行面对面的共识会议。
方法:英文孕产单位。
方法:三个有代表性的专家小组:服务设计师,提供商和用户。
方法:参与者认为产妇护理指标很重要。
方法:参与者被要求完成一个两阶段的德尔菲过程,来自现有当地产妇仪表板的评分指标。一次共识会议讨论了结果并对指标进行了重新评分。
结果:总而言之,从现有仪表板中识别出六个领域的125个不同指标。在协商一致会议之后,14个指标符合最终核心集的纳入标准:预订时的吸烟率;未干预的出生率;罗布森第1组妇女的剖腹产率;罗布森第2组妇女的剖腹产率;罗布森第5组妇女的剖腹产率;阴道分娩的妇女中的三度和四度撕裂率;产后出血率≥1500毫升;在第8周的新生儿开始分娩时,在母乳喂养时住院的比例<
结论:核心结果集方法可用于纳入关键利益相关者的观点,以制定核心指标集来监测产科护理质量,从而实现改进。
■就监测产妇护理质量的核心指标达成共识。
OBJECTIVE: To develop a core metric set to monitor the quality of maternity care.
METHODS: Delphi process followed by a face-to-face
consensus meeting.
METHODS: English maternity units.
METHODS: Three representative expert panels: service designers, providers and users.
METHODS: 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.
UNASSIGNED: Achieving
consensus on core metrics for monitoring the quality of maternity care.