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Gaps in obstetric care processes - we can only improve what is being measured
Soder Sjukhuset, Dept Obstet & Gynecol, S-11883 Stockholm, Sweden.;Soder Sjukhuset, Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden..
Soder Sjukhuset, Dept Obstet & Gynecol, S-11883 Stockholm, Sweden.;Soder Sjukhuset, Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
Soder Sjukhuset, Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden.;Ctr Hosp Luxembourg, Luxembourg, Luxembourg..
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2018 (English)In: Journal of Perinatal Medicine, ISSN 0300-5577, E-ISSN 1619-3997, Vol. 46, no 2, p. 139-149Article in journal (Refereed) Published
Abstract [en]

A multifaceted intervention at all six obstetric units in the Stockholm Health Region was performed in 2008-2011 in order to increase safety for the newborn infants. Case-controlled criterion-based reviews of care processes during labor and delivery have been used to assess factors associated with suboptimal care during labor and delivery. Categories of increased risk of adverse outcome during labor and delivery were defined. Cases with low Apgar scores and healthy controls were scrutinized and compared to data from a study with an identical design performed before the intervention. The risk of suboptimal care increased twice among controls and three times among cases when reviewing specific criteria after a multifaceted intervention. There are still gaps in care processes that need attention. Improving guidelines is important but not enough alone, and the management of fetal surveillance needs further improvement. The complexity of reviewing care processes using criterion-based research methodology is highlighted.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH , 2018. Vol. 46, no 2, p. 139-149
Keywords [en]
Cardiotochography (CTG), criterion-based review, delivery, education, fetal monitoring
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-347096DOI: 10.1515/jpm-2016-0301ISI: 000423987200003PubMedID: 28343177OAI: oai:DiVA.org:uu-347096DiVA, id: diva2:1193042
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2018-03-26Bibliographically approved

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Högberg, Ulf

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