Reliability in perinatal audit. A qualitative study--a preliminary investigation

Area of Science:

• Perinatal Medicine
• Medical Audit
• Healthcare Quality Improvement

Background:

• Perinatal audit is crucial for improving maternal and infant outcomes.
• Assessing the reliability of perinatal audit processes is essential for its effectiveness.

Purpose of the Study:

• To describe consensus-building among perinatal audit experts.
• To examine inter-rater agreement between panels evaluating perinatal and neonatal care.

Main Methods:

• Questionnaire administered to 16 perinatal experts involved in audits.
• Analysis of audiotapes from expert discussions.
• Evaluation of 17 neonatal death cases by two independent panels.

Main Results:

• Experts reached consensus in 70-95% of cases after joint discussions.
• Audiotape analysis showed experts adjusted interpretations during discussions.
• High agreement between panels on antenatal (15/17), intrapartum (14/17), and neonatal (15/17) care evaluations.

Conclusions:

• Perinatal audit conclusions demonstrate reliability.
• Reliability is enhanced by expert knowledge, agreed standards, and expert discussion.
• The study suggests robust consensus and agreement in perinatal care evaluations.