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Assessing quality obstetrical care: development of standardized measures

Susan Mann1, Stephen Pratt, Paul Gluck

  • 1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, USA. smann@bidmc.harvard.edu

Joint Commission Journal on Quality and Patient Safety
|November 9, 2007
PubMed

Insights

This study developed new tools to measure obstetric care quality. The Adverse Outcome Index, Weighted Adverse Outcome Score, and Severity Index can benchmark care within and across institutions.

Area of Science:

  • Obstetrics
  • Healthcare Quality Improvement
  • Patient Safety

Background:

  • No standardized national quality indicators for obstetrics currently exist.
  • A study involving 15 institutions and over 28,000 patients aimed to address this gap.
  • Developed 10 outcome measures and 3 quality improvement tools for obstetric care.

Framework:

  • Introduced three novel obstetrical quality improvement outcome tools.
  • Adverse Outcome Index (AOI): Measures the percentage of deliveries with adverse events.
  • Weighted Adverse Outcome Score (WAOS): Calculates an adverse event score per delivery.
  • Severity Index (SI): Assesses the severity of patient outcomes.

Implementation:

  • The Adverse Outcome Index (AOI) averaged 9.2% during the pre-implementation phase.
  • The Weighted Adverse Outcome Score (WAOS) averaged 3 points pre-implementation.
  • The Severity Index (SI) averaged 31 points pre-implementation.

Implications:

  • The developed outcome measures (AOI, WAOS, SI) enable benchmarking of obstetric care.
  • These tools can be utilized nationally to define and assess quality obstetric care.
  • Potential to drive improvements in patient safety and outcomes in obstetrics.
Abstract

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