A systematic approach towards the development of a set of quality indicators for public reporting in community-based maternity care

• Published in: Midwifery 2013-04, Vol.29 (4), p.316-324
• Main Authors: Voerman, Gerlienke E., Calsbeek, Hilly, Maassen, Irma T.H.M., Wiegers, Trees A., Braspenning, Jozé
• Format: Article
• Language: English
• Subjects: Access to Information; Adult; Clinical guidelines; Community based; Community Health Centers - standards; Delphi Technique; Female; Guideline Adherence; Health professionals; Humans; Maternal Health Services - methods; Maternal Health Services - standards; Maternity care; Netherlands; Nursing; Pregnancy; Pregnant Women; Public reporting; Quality Assurance, Health Care - methods; Quality indicators; Quality Indicators, Health Care - standards; Quality management; Quality of care; Research Design; Standard of Care
• ISSN: 0266-6138; 1532-3099
• DOI: 10.1016/j.midw.2012.01.012

to demonstrate the process and outcome of a systematic approach towards the development of a set of quality indicators for public reporting on quality of community-based maternity care. a four-stepped approach was adopted. Firstly, we defined key elements of community-based maternity care, by performing a systematic search on care guidelines/ standards. Secondly, the literature was searched for existing indicators for maternity care, which were subsequently categorised according to the key elements and systematically selected on suitability of public presentation. The emerging set of indicators suitable for public reporting was presented to five health-care professionals using a Delphi technique (step 3). Based on the comments of the professionals, the set was adjusted and subsequently presented to the health-care consumers (a sample of pregnant women) in step four to test its validity, after which the final set was composed. health-care professionals in the field of maternity care and pregnant women. key elements of community-based maternity care were extracted from eight guidelines and care standards. We then extracted 10 documents with 223 indicators in total, from which 19 indicators covering the key elements were included in the first set and presented to experts. Based on their comments three indicators were deleted and four indicators were added to the set or slightly rephrased. These were subsequently judged by 13 pregnant women. Seventy-five per cent of the indicators were judged positively by them; no indicator was judged negatively. The set of indicators was thus left unchanged after this final step. the systematic approach adopted in this study resulted in an indicator set that was considered valid by both maternity care professionals and pregnant women, and is likely to satisfy the essential requirements on clinimetric properties. The next step will be to pilot test the indicator set on feasibility in daily clinical practice and to refine the set when necessary. In the future, maternity care professionals may use the set to present the quality of care they provide and to define issues of improvement. Pregnant women may use the information to make a founded choice between maternity care professionals, which ultimately should result in improved safety and quality of maternity care as well as patient satisfaction. Although we focused on the Dutch, community-based maternity care system, the approach used may be extrapolated to other care processes