Quality Indicators during Delivery and the Immediate Postpartum Period: A Modified Delphi Study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Healthcare Quality Improvement

Background:

• Many French quality of care indicators lack clinician validation, potentially limiting their practical relevance.
• Need for measurable indicators specific to delivery and postpartum care that align with clinical practice.

Purpose of the Study:

• To define a core set of measurable indicators for delivery and immediate postpartum care quality.
• To ensure these indicators are meaningful and relevant to clinicians.

Main Methods:

• A literature review was conducted by a steering committee of nine obstetrics and public health specialists.
• A Rand-modified Delphi procedure involving two rounds and a physical meeting was used.
• Obstetrician-gynecologists and midwives rated indicator appropriateness, with consensus assessed.

Main Results:

• Initial assessment involved 145 panelists evaluating 77 indicators across labor, delivery, pain management, and maternal/neonatal morbidity.
• A second round involved 132 panelists assessing 42 indicators.
• The final consensus yielded 50 indicators and 2 definitions for perinatal care quality.

Conclusions:

• The Delphi procedure successfully selected 50 indicators reflecting perinatal care quality.
• These indicators are recommended for mandatory recording in French maternity ward birth registers for every delivery.