Dataset Information

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

ABSTRACT:

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.

SUBMITTER: Bunch KJ

PROVIDER: S-EPMC6220866 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

Bunch K J KJ Allin B B Jolly M M Hardie T T Knight M M

BJOG : an international journal of obstetrics and gynaecology 20180614 12

<h4>Objective</h4>To develop a core metric set to monitor the quality of maternity care.<h4>Design</h4>Delphi process followed by a face-to-face consensus meeting.<h4>Setting</h4>English maternity units.<h4>Population</h4>Three representative expert panels: service designers, providers and users.<h4>Main outcome measures</h4>Maternity care metrics judged important by participants.<h4>Methods</h4>Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local m ...[more]

PMID: 29770557

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Project description:BackgroundConsiderable health inequities documented in Israel between communities, populations and regions, undermine the rights of all citizens to optimal health. The first step towards health equity is agreement on a set of national indicators, reflecting equity in healthcare provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We describe the process of reaching a consensus on a defined set of national equity indicators.MethodsThe study was conducted between January 2019 and June 2020, in a multistage design: (A) Identifying appropriate and available inequity measures via interviews with stakeholders. (B) Agreement on the screening criteria (public health importance; gap characteristics; potential for change; public interest) and relative weighting. (C) Constructing the consultation framework as an online, 3-round Delphi technique, with a range of experts recruited from the health, welfare and education sectors.ResultsParticipants were of diverse age, gender, geographic location, religion and ethnicity, and came from academia, healthcare provision, government ministries and patient representative groups. Thirty measures of inequity, presented to participants, represented the following domains: Health promotion (11 indicators), acute and chronic morbidity (11), life expectancy and mortality (2), health infrastructures and affordability of care (4), education and employment (2). Of the 77 individuals contacted, 75 (97%) expressed willingness to participate, and 55 (73%) completed all three scoring rounds. The leading ten indicators were: Diabetes care, childhood obesity, adult obesity, distribution of healthcare personnel, fatal childhood injuries, cigarette smoking, infant mortality, ability to afford care, access to psychotherapy and distribution of hospital beds. Agreement among raters, measured as intra-class correlation coefficient (ICC), was 0.75.ConclusionA diverse range of consultants reached a consensus on the most important national equity indicators, including both clinical and system indicators. Results should be used to guide governmental decision-making and inter-sectoral strategies, furthering the pursuit of a more equitable healthcare system.

Dataset Information

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

Objective

Design

Setting

Population

Main outcome measures

Methods

Results

Conclusions

Tweetable abstract

Publications

Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

Similar Datasets

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