Washington, DC – the National Quality Forum (NQF) Board of Directors has approved for endorsement 14 quality measures on perinatal care. The measures address a wide range of care concerns, including childbirth, pregnancy and post-partum care, and newborn care.
“With more than four million births in the United States each year, perinatal measures are needed to ensure the health and well-being of new mothers and newborns,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “This set of measures will help promote the type of high-quality care these populations deserve.”
For this project, NQF endorsed measures related to elective delivery, episiotomy, and caesarean section rates, as well as prophylactic antibiotic rates for women undergoing cesarean sections. NQF also endorsed measures dealing with hepatitis B vaccination rates for newborns, neonatal bloodstream infection rates, and exclusive breastfeeding rates during hospitalization. In all, 22 measures were evaluated against NQF’s endorsement criteria by a panel of providers, measurement experts, and consumer representatives; 14 measures were endorsed.
“These perinatal measures are a welcome addition to the NQF portfolio,” said Laura Riley, MD, medical director of labor and delivery at Massachusetts General Hospital and co-chair of the Perinatal and Reproductive Health Endorsement Maintenance Steering Committee. “Pregnancy and childbirth-related procedures account for the five most common medical procedures for women of child-bearing age, yet deaths during pregnancy and childbirth have doubled for women in the United States in the last 20 years. It’s critical that providers have the right measurement tools to help ensure mothers and newborns receive safe, high-quality care.”
The endorsed measures include those previously endorsed by NQF and newly submitted measures for initial endorsement. Twelve measures were previously endorsed, and two are new. The ongoing evaluation and updating of endorsed measures ensures the currency and relevance of NQF’s perinatal care portfolio.
“Lower quality care during pregnancy, childbirth, and the postpartum period can lead to unnecessary complications in women and newborns and wasted resources from overused procedures, prolonged hospital stays, and costly neonatal intensive care unit admissions,” said Carol Sakala, PhD, MSPH, director of programs at Childbirth Connection and co-chair of the Perinatal and Reproductive Health Endorsement Maintenance Steering Committee. “Use of this measure set for quality improvement and public reporting will help strengthen maternal and newborn health and the value of our considerable investment in maternity care.”
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 14 endorsed quality measures listed below by submitting an appeal no later than May 3 (to submit an appeal, go to the NQF Measure Database). For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.
- 0469: PC-01 Elective Delivery (Joint Commission)
- 0470: Incidence of Episiotomy (Christiana Care Health System)
- 0471: PC-02 Cesarean Section (Joint Commission)
- 0472: Appropriate Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision– Cesarean Section (Massachusetts General Hospital/Partners Health Care System)
- 0473: Appropriate DVT Prophylaxis in Women Undergoing Cesarean Delivery (Hospital Corporation of America)
- 0475: Hepatitis B Vaccine Coverage Among All Live Newborn Infants Prior to Hospital or Birthing Facility Discharge (Centers for Disease Control and Prevention)
- 0476: PC-03 Antenatal Steroids (Joint Commission)
- 1746: Intrapartum Antibiotic Prophylaxis for Group B Streptococcus (GBS) (Massachusetts General Hospital)
- 0477: Under 1500g infant Not Delivered at Appropriate Level of Care (California Maternal Quality Care Collaborative)
- 0478: Neonatal Blood Stream Infection Rate (NQI #3) (Agency for Healthcare Research and Quality)
- 1731: Health Care-Associated Bloodstream Infections in Newborns (Joint Commission)
- 0304: Late Sepsis or Meningitis in Very Low Birth Weight (VLBW) Neonates (risk-adjusted) (Vermont Oxford Network)
- 0480: PC-05 Exclusive Breast Milk Feeding (Joint Commission)
- 0483: Proportion of Infants 22 to 29 Weeks Gestation Screened for Retinopathy of Prematurity (Vermont Oxford Network)
NQF operates under a three-part mission to improve the quality of American healthcare by:
- building consensus on national priorities and goals for performance improvement and working in partnership to achieve them;
- endorsing national consensus standards for measuring and publicly reporting on performance; and
- promoting the attainment of national goals through education and outreach programs.