Related Experiment Videos
Holding up a mirror: changing obstetric practice through criterion-based clinical audit in developing countries.
P T Wagaarachchi1, W J Graham, G C Penney
1Dugald Baird Center for Research on Women's Health, Department of Obstetrics and Gynecology, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, UK. ogy158@abdn.ac.uk
Summary
Criterion-based clinical audit is a feasible method to improve obstetric care quality in developing countries. This quality assurance approach enhanced the management of severe obstetric complications in district hospitals.
Area of Science:
- Obstetrics and Gynecology
- Healthcare Quality Improvement
- Public Health in Developing Countries
Background:
- Improving the quality of obstetric care is critical in developing countries.
- District hospitals face challenges in managing life-threatening obstetric complications.
Purpose of the Study:
- To assess the feasibility and effectiveness of criterion-based clinical audit for improving obstetric care quality.
- To measure improvements in managing hemorrhage, eclampsia, infection, obstructed labor, and uterine rupture.
Main Methods:
- A "before and after" study design was employed, following a five-step audit cycle.
- 31 audit criteria were developed through literature review, expert panels, and pilot studies.
- Data were collected on 555 complications (Review I) and 342 complications (Review II) across four hospitals.
Main Results:
- Common areas for improvement in obstetric care were identified.
- Implementation of clinical protocols, staffing reviews, and training workshops were key improvement mechanisms.
- Significant improvements were observed in clinical monitoring, drug use, and record-keeping between audits.
Conclusions:
- Criterion-based clinical audit is a feasible and acceptable quality assurance method in district hospitals in developing countries.
- The audit process demonstrated improvements in the management of life-threatening obstetric complications.
- This approach holds promise for enhancing obstetric care quality and patient outcomes.