Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review

Background There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS) rates. Method Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modi... Mehr ...

Verfasser: Melman, S
Schoorel, ECN
de Boer, K
Burggraaf, H
Derks, JB
van Dijk, D
van Dillen, J
Dirksen, CD
Duvekot, J.J.
Franx, A
Hasaart, THM
Huisjes, AJM
Kolkman, D
van Kuijk, S
Kwee, A
Mol, BW
van Pampus, MG
de Roon-Immerzeel, A
van Roosmalen, JJM
Roumen, FJME
Smid-Koopman, E
Smits, L
Spaans, WA
Visser, H
van Wijngaarden, WJ
Willekes, C
Wouters, MGAJ
Nijhuis, JG
Hermens, RPMG
Scheepers, HCJ
Dokumenttyp: Artikel
Erscheinungsdatum: 2016
Reihe/Periodikum: Melman , S , Schoorel , ECN , de Boer , K , Burggraaf , H , Derks , JB , van Dijk , D , van Dillen , J , Dirksen , CD , Duvekot , J J , Franx , A , Hasaart , THM , Huisjes , AJM , Kolkman , D , van Kuijk , S , Kwee , A , Mol , BW , van Pampus , MG , de Roon-Immerzeel , A , van Roosmalen , JJM , Roumen , FJME , Smid-Koopman , E , Smits , L , Spaans , WA , Visser , H , van Wijngaarden , WJ , Willekes , C , Wouters , MGAJ , Nijhuis , JG , Hermens , RPMG & Scheepers , HCJ 2016 , ' Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review ' , PLoS One (print) , vol. 11 , no. 1 . https://doi.org/10.1371/journal.pone.0145771
Schlagwörter: /dk/atira/pure/keywords/researchprograms/AFL001000/EMCMGC025201A / name=EMC MGC-02-52-01-A
Sprache: unknown
Permalink: https://search.fid-benelux.de/Record/base-29207876
Datenquelle: BASE; Originalkatalog
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Link(s) : https://pure.eur.nl/en/publications/b50c2c16-44ea-4928-a4fd-5058f0db4da4

Background There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS) rates. Method Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modified Delphi method. A multi-center study was performed and medical charts of 1024 women with a CS and a stratified and weighted randomly selected group of 1036 women with a vaginal delivery were analysed. Quality indicator frequency and adherence were scored in 2060 women with a CS or vaginal delivery. Results The expert panel developed 16 indicators on planned CS and 11 indicators on unplanned CS. Indicator adherence was calculated, defined as the number of women in a specific obstetrical situation in which care was performed as recommended in both planned and unplanned CS settings. The most frequently occurring obstetrical situations with low indicator adherence were: 1) suspected fetal distress (frequency 17%, adherence 46%), 2) nonprogressive labour (frequency 12%, CS performed too early in over 75%), 3) continuous support during labour (frequency 88%, adherence 37%) and 4) previous CS (frequency 12%), with adequate counselling in 15%. Conclusions We identified four concrete target groups for improvement of obstetrical care, which can be used as a starting point to reduce CS rates worldwide.