Improving birth certificate data accuracy in Alabama

Accurate vital statistics data are critical for monitoring population health and strategizing public health interventions. Previous analyses of statewide birth data have identified several factors that may reduce birth certificate accuracy including systematic errors and limited data review by clinicians. The aim of this initiative was to increase the proportion of hospitals in Alabama reporting accurate birth certificate data from 67% to 87% within 1 year.

The Alabama Perinatal Quality Collaborative led this statewide collaborative effort. Process measures included monthly monitoring of 11 variables across 5-10 patient birth certificates per month per hospital. Accuracy determination, defined as ≥95% accuracy of the variables analyzed, was performed by health care specialists at each hospital by comparing birth certificate variables from vital statistics with data obtained from original hospital source materials. Three months of retrospective, baseline accuracy data were collected before project initiation from which actionable drivers and change ideas were identified at individual hospitals. Data were analyzed using statistical process control measures.

Thirty-one hospitals entered data throughout the course of the initiative, accounting for 850 chart analyses and 9350 variable assessments. The least accurately reported variables included birth weight, maternal hypertension, and antenatal corticosteroid exposure. At baseline, 67% of hospitals reported birth certificate accuracy rates ≥ 95%, which increased to 90% of hospitals within 2 months and was sustained for the remainder of the initiative.

Statewide, multidisciplinary quality improvement efforts increased birth certificate accuracy vital to public health surveillance.