This project seeks to achieve national voluntary consensus on a set of effective, well-specified performance measures to assess the quality of perinatal services..
Pregnancy and childbirth is the second most common reason for admission to a hospital, with 4.2 million childbirth-related hospital stays recorded in 20051. Pregnancy- and childbirth-related procedures accounted for the five most common procedures performed on patients ages 18-44, and the most common procedures performed on infants were those associated with birth2. Mortality and morbidity associated with pregnancy and childbirth is substantial, and evidence suggests is to a large extent preventable through high quality perinatal care. Poor quality care during the third trimester, labor and delivery, and postpartum translates into unnecessary complications, prolonged lengths of stay, costly NICU admissions, and anxiety and suffering for patients and families. Because the volume of maternity admissions is so high, deficiencies in perinatal care affect a large population of vulnerable patients and represent a significant opportunity for quality improvement.
While quality measurement and reporting for hospital performance has focused on common medical conditions such acute coronary syndrome, pneumonia, and surgical performance, the focus on maternal-child care has been limited. Without appropriate information about perinatal hospital performance at a national level, quality improvement efforts are unfocused and incentives for improvement are limited. A more complete set of perinatal performance measures endorsed by NQF would provide the tools for providers, purchasers and other stakeholder to create a national approach to quality improvement for mothers and babies.
This project will consider measures of care received during the last trimester of pregnancy through hospital discharge of both mother and newborn. Measures considered will address care provided by individual clinicians, such as physicians and midwives, as well as care provided by facilities, including hospitals and free-standing birthing centers.
This project, like all NQF activities, involves the active participation of representatives from across the spectrum of healthcare stakeholders. The project is guided by a Steering Committee whose members are nominated by NQF membership and members of the public. Selection and endorsement of perinatal care measures will be achieved through NQF’s formal Consensus Development Process.
Funding for this project has been provided by HCA, Inc.
For more information, contact Lisa McGonigal, MD, MPH, Program Director, at (202) 783-1300 or email your questions to perinatalcare@qualityforum.org 1HCUP Facts and Figures: Statistics on Hospital-based Care, 2005.
2
Ibid.