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
Sonja MelmanHubertina C J Scheepers

Abstract

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. 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. 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 ...Continue Reading

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Citations

Aug 26, 2016·PloS One·Lotte Berdiin ColmornUNKNOWN NOSS study group
Jul 16, 2017·BMC Pregnancy and Childbirth·Sonja MelmanRosella Petronella Maria Gemma Hermens
May 29, 2021·Journal of Perinatal Medicine·Dorothea M KoppesHubertina C Scheepers
Aug 28, 2021·International Journal of Environmental Research and Public Health·Lahai TuckerChiyembekezo Kachimanga

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