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The value of incorporating avoidable factors into perinatal audits
R C Pattinson1, J D Makin, A Shaw
1Department of Obstetrics and Gynaecology, Kalafong Hospital, University of Pretoria.
Insights
Identifying avoidable factors in perinatal audits helps pinpoint critical areas for improvement. This system revealed that 58% of perinatal deaths involved avoidable factors, highlighting immediate needs in labor management and administrative processes.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Public Health
Background:
- Perinatal audits are crucial for evaluating and improving maternal and infant outcomes.
- Identifying avoidable factors within these audits can enhance the effectiveness of quality improvement initiatives.
- Previous studies have explored various components of perinatal mortality, but a systematic classification of avoidable factors is less established.
Purpose of the Study:
- To evaluate the utility of a system for identifying, classifying, and grading avoidable factors within perinatal audits.
- To determine if this systematic approach can effectively pinpoint specific problem areas in perinatal care.
- To assess the potential for cost-effective improvements based on identified avoidable factors.
Main Methods:
- A descriptive study was conducted on perinatal deaths of infants weighing over 1,000 g.
- The study population comprised a Black urban population in Pretoria, South Africa, between August 1991 and July 1992.
- Perinatal deaths were classified by primary obstetric and neonatal causes, and the presence of avoidable factors was assessed.
Main Results:
- The perinatal mortality rate was 26 per 1,000 deliveries.
- Avoidable factors were identified in 58% of all perinatal deaths.
- Immediately remedial problem areas included labor management, administrative issues with syphilis results, and fetal weight estimation.
Conclusions:
- The classification system for avoidable factors proved effective in identifying areas for immediate improvement in perinatal care.
- Addressing identified issues, such as patient education and clinic attendance, can lead to significant enhancements.
- The findings suggest that this systematic approach to avoidable factors offers a cost-effective strategy for reducing perinatal mortality.
Objective:
To assess whether incorporating a system of identifying, classifying and grading avoidable factors into a perinatal audit can be useful in identifying problem areas.
Design:
Descriptive study.
Setting:
Black urban population, Pretoria, South Africa.
Subjects:
All perinatal deaths of infants weighing more than 1,000 g from urban areas served by Kalafong Hospital between August 1991 and July 1992.
Methods:
All perinatal deaths were classified according to the primary obstetric cause of death and neonatal cause of death, and whether any avoidable factors were present which could have contributed to the death.
Results:
The perinatal mortality rate was 26/1,000 deliveries. Avoidable factors occurred in 58% of perinatal deaths. Our problem areas which were immediately remedial were identified as labour management-related problems, administrative problems in obtaining syphilis results, and estimation of fetal weight. Other problem areas which need to be solved are patient education, early attendance at clinics, improved documentation and continuing education of medical personnel.
Conclusion:
The use of this classification of avoidable factors has enabled the detection of problem areas that can be improved immediately at very little cost.