Dataset Information

Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial.

ABSTRACT: OBJECTIVE:To study the effects of customer self-audit on the service quality (SQ) and customer quality (CQ) of maternity care. DESIGN:A community-based cluster-randomized controlled trial. SETTING:Twenty-one health centres and health posts in Tabriz, Iran. PARTICIPANTS:Of 21 health centres/health posts, 10 were randomly assigned to the intervention group and 11 randomly assigned to the control group. Participants were 185 pregnant women selected from health centre/post registration lists (intervention group: n = 92; control group: n = 93). INTERVENTIONS:The intervention was a customer self-audit based on the CenteringPregnancy® model of prenatal group care. The intervention group attended group support sessions focused on participants' opinions, questions, and self-management concerns. They also received sessions on experiential learning, coping, problem-solving, and goal-setting by a family health expert, a midwife, and a doctor. Control group participants continued to receive individual care. PRIMARY OUTCOME MEASURES:SQ and CQ were assessed using questionnaires. Patients rated the importance and performance of non-health quality dimensions. SQ was calculated as: SQ = 10 - (Importance × Performance). RESULTS:Total mean SQ scores were 7.63 (0.91) and 8.91 (0.76) for the control and intervention groups, respectively, a statistically significant difference (p<0.001). Compared with the control group, the intervention group scored higher on the SQ aspects confidentiality, communication, autonomy, availability of support group, dignity, safety, prevention, and accessibility. Total mean CQ scores for the control and intervention groups were 82.63(7.21) and 87.47 (6.75), respectively, a statistically significant difference (p<0.001). After intervention, 82.6% of intervention group participants and 50.5% of control group participants reached the highest stage of self-management, showing an ability to take care of themselves under stress and financial constraints. CONCLUSIONS:The group prenatal care customer self-audit improved the SQ and CQ of maternity care by increased involvement of participants and giving them active roles in the care process.

SUBMITTER: Gholipour K

PROVIDER: S-EPMC6181295 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial.

Gholipour Kamal K Tabrizi Jafar Sadegh JS Asghari Jafarabadi Mohammad M Iezadi Shabnam S Mardi Ahmad A

PloS one 20181011 10

<h4>Objective</h4>To study the effects of customer self-audit on the service quality (SQ) and customer quality (CQ) of maternity care.<h4>Design</h4>A community-based cluster-randomized controlled trial.<h4>Setting</h4>Twenty-one health centres and health posts in Tabriz, Iran.<h4>Participants</h4>Of 21 health centres/health posts, 10 were randomly assigned to the intervention group and 11 randomly assigned to the control group. Participants were 185 pregnant women selected from health centre/po ...[more]

PMID: 30307957

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Project description:BackgroundHealth care delivery organizations lack evidence-based strategies for using quality measurement data to improve performance. Audit and feedback (A&F), the delivery of clinical performance summaries to providers, demonstrates the potential for large effects on clinical practice but is currently implemented as a blunt one size fits most intervention. Each provider in a care setting typically receives a performance summary of identical metrics in a common format despite the growing recognition that precisionizing interventions hold significant promise in improving their impact. A precision approach to A&F prioritizes the display of information in a single metric that, for each recipient, carries the highest value for performance improvement, such as when the metric's level drops below a peer benchmark or minimum standard for the first time, thereby revealing an actionable performance gap. Furthermore, precision A&F uses an optimal message format (including framing and visual displays) based on what is known about the recipient and the intended gist meaning being communicated to improve message interpretation while reducing the cognitive processing burden. Well-established psychological principles, frameworks, and theories form a feedback intervention knowledge base to achieve precision A&F. From an informatics perspective, precision A&F requires a knowledge-based system that enables mass customization by representing knowledge configurable at the group and individual levels.ObjectiveThis study aims to implement and evaluate a demonstration system for precision A&F in anesthesia care and to assess the effect of precision feedback emails on care quality and outcomes in a national quality improvement consortium.MethodsWe propose to achieve our aims by conducting 3 studies: a requirements analysis and preferences elicitation study using human-centered design and conjoint analysis methods, a software service development and implementation study, and a cluster randomized controlled trial of a precision A&F service with a concurrent process evaluation. This study will be conducted with the Multicenter Perioperative Outcomes Group, a national anesthesia quality improvement consortium with >60 member hospitals in >20 US states. This study will extend the Multicenter Perioperative Outcomes Group quality improvement infrastructure by using existing data and performance measurement processes.ResultsThe proposal was funded in September 2021 with a 4-year timeline. Data collection for Aim 1 began in March 2022. We plan for a 24-month trial timeline, with the intervention period of the trial beginning in March 2024.ConclusionsThe proposed aims will collectively demonstrate a precision feedback service developed using an open-source technical infrastructure for computable knowledge management. By implementing and evaluating a demonstration system for precision feedback, we create the potential to observe the conditions under which feedback interventions are effective.International registered report identifier (irrid)PRR1-10.2196/34990.

Dataset Information

Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial.

Publications

Effects of customer self-audit on the quality of maternity care in Tabriz: A cluster-randomized controlled trial.

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