Using improvement science to increase accuracy and reliability of gestational age documentation

Area of Science:

• Obstetrics and Gynecology
• Healthcare Quality Improvement
• Perinatal Health Data

Background:

• Accurate gestational age (GA) recording is crucial for clinical management, research databases, and vital statistics.
• Existing methods for GA recording in obstetric records lacked reliability, impacting data integrity.
• The Ohio Department of Health relies on accurate birth record data.

Purpose of the Study:

• To enhance the reliability of gestational age (GA) recording within maternal obstetric records.
• To implement and evaluate quality improvement interventions for GA data accuracy.
• To improve data for clinical decision-making and population-based perinatal research.

Main Methods:

• A prospective cohort study involving all hospital births was conducted.
• Quality improvement interventions were systematically applied through test cycles targeting various workgroups.
• Statistical process control and univariate analysis compared pre- and post-intervention GA recording reliability.

Main Results:

• Pre-intervention median daily GA reliability was 25%.
• Post-intervention, median GA reliability increased significantly to 78% (p < 0.01) across 8795 births.
• Improvements were noted in prenatal record completion and GA recording for high-risk infants (p < 0.01).

Conclusions:

• Standardized improvement science methods effectively increase gestational age (GA) recording reliability.
• Enhanced GA communication supports better clinical decisions and facilitates perinatal research.
• The interventions demonstrated a scalable approach to improving obstetric data quality.