Development of a peer review process to reduce maternal and infant adverse events associated with midwifery

The aim of this study was to establish a midwifery peer review (MPR) process to continuously improve and standardize the midwifery delivery process, thereby reducing maternal and infant adverse events.

First, the MPR committee (MPRC) was established. The co-chairs of our MPRC were the Head of the Nursing Department and the Nursing Director of the Obstetrics Department. Peer review targets included preventing the occurrence of nursing adverse events, improving nursing quality, and optimizing nursing management. We have established a specially digitized case submission system. All cases that met the evaluation criteria formed corresponding midwifery process improvement measures after a discussion at the meeting to continuously improve the level of midwifery.

Between 2014 and 2017, a total of 240 referrals were received by our committee, 211 of which met the criteria for peer review. Our analysis showed that the proportion of adverse events evaluated gradually decreased over time. The percentage of reviewed cases in 2014 was 7.543% of all deliveries (n = 63), which decreased to 6.747% in 2015 (n = 46). The rates in 2016 and 2017 were 5.310% (n = 51) and 5.280% (n = 51), respectively, and the MPRC recommendations resulted in positive practice changes. After reviewing more than 200 cases, the committee recommended the implementation of 20 new rules and regulations through summary and discussion, thus reducing or preventing many problems that are easily ignored during clinical service.

MPR could be an effective tool to improve obstetric quality and midwifery skills. The implementation of MPR promoted a safer environment for mothers and infants and led to a decrease in adverse events related to midwifery.