Promoting antenatal steroid use for fetal maturation: Results from the California Perinatal Quality Care Collaborative

The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before...

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Bibliographic Details
Published in:The Journal of pediatrics 2006-05, Vol.148 (5), p.606-612.e1
Main Authors: Wirtschafter, David D., Danielsen, Beate H., Main, Elliott K., Korst, Lisa M., Gregory, Kimberly D., Wertz, Andrew, Stevenson, David K., Gould, Jeffrey B.
Format: Article
Language:English
Subjects:
Biological and medical sciences
California
Databases, Factual
Drug Utilization Review
Female
Fetal Organ Maturity
General aspects
Gestational Age
Guideline Adherence
Hospitals, Community
Hospitals, General
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Medical sciences
Perinatal Care
Practice Guidelines as Topic
Pregnancy
Retrospective Studies
Steroids - administration & dosage
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Summary:The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before preterm (24 to 33 weeks of gestation) delivery. We hypothesized that mean performance would improve and the number of centers performing below the lowest quartile of the baseline year would decrease. In 1998, a statewide QI cycle targeting antenatal steroid use was announced, calling for the evaluation of the 1998 baseline data, dissemination of recommended interventions using member-developed educational materials, and presentations to California neonatologists in 1999–2000. Postintervention data were assessed for the year 2001 and publicly released in 2003. A total of 25 centers voluntarily participated in the intervention. Antenatal steroid administration rate increased from 76% of 1524 infants in 1998 to 86% of 1475 infants in 2001 ( P < .001). In 2001, 23 of 25 hospitals exceeded the 1998 lower-quartile cutoff point of 69.3%. Regional collaborations represent an effective strategy for improving the quality of perinatal care.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2005.12.058