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Published on: February 16, 2011
Finding the right indicators for assessing quality midwifery care
Mieneke de Bruin-Kooistra1, Marianne P Amelink-Verburg, Simone E Buitendijk
1Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. mieneke.kooistra@rivm.nl
Summary
This study developed 26 quality indicators for low-risk maternity care in the Netherlands. These indicators, covering structure, process, and outcomes, were validated by multidisciplinary experts for monitoring midwifery and general practitioner care.
Area of Science:
- Maternal Health
- Healthcare Quality Improvement
- Primary Care Medicine
Background:
- Monitoring maternity care quality is crucial for low-risk women.
- Existing quality indicators may not fully capture the nuances of primary care midwifery and general practitioner (GP) services.
- A standardized set of indicators is needed for consistent quality assessment.
Purpose of the Study:
- To identify a comprehensive set of quality indicators for monitoring maternity care.
- Focus on low-risk women receiving care from primary care midwives and GPs in the Netherlands.
- Establish a feasible and relevant set of indicators for quality assessment.
Main Methods:
- Literature review, national guidelines, and expert opinion were used to generate an initial list of indicators.
- The Appraisal of Indicators through Research and Evaluation (AIRE) instrument criteria were applied to refine the list.
- A two-round Delphi survey involving a multidisciplinary stakeholder panel assessed indicator relevance and feasibility.
Main Results:
- An initial list of 115 potential indicators was reduced to 35 using AIRE criteria.
- A multidisciplinary expert panel recommended 26 indicators as relevant for midwifery care quality.
- The final set included 8 structure, 12 process, and 6 outcome indicators across various care phases.
Conclusions:
- A validated set of 26 quality indicators for low-risk maternity care provided by midwives and GPs was identified.
- The majority (83%) of proposed indicators were adopted by practicing maternity care providers.
- Multidisciplinary expert input was essential throughout the indicator development process.
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