Document Detail

Monitoring obstetricians' performance with statistical process control charts.
MedLine Citation:
PMID:  17355271     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The main objective of this study was to pave the way towards proactive, continuous assessment of individuals and hospitals by demonstrating the application of evidence-based competency standards in maternity care using statistical performance monitoring. DESIGN: Retrospective study using data routinely collected by a large maternity hospital. SETTING: A large teaching hospital. POPULATION: Clinicians who routinely perform either amniocentesis or ventouse deliveries. METHOD: As a 'proof of principle', we have used statistical process control (SPC) charts to compare the observed complication rates for amniocentesis and ventouse delivery with the expected complication rates based on published data. MAIN OUTCOME MEASURES: The recorded complication rates for amniocentesis and ventouse delivery. RESULTS: The SPC charts identified significant variation in complication rates within the team and showed the ways in which prospective data can be used to provide continuous feedback to individuals on their performance. CONCLUSION: The study shows that statistical performance monitoring and, in particular, the use of control charts can be a valuable tool in the continuous assessment of individuals and the healthcare service being provided. The control charts provide a more immediate indication of current performance and provide an alternative to performance-based league tables for the presentation of yearly performance data.
S Lane; A Weeks; H Scholefield; Z Alfirevic
Publication Detail:
Type:  Journal Article     Date:  2007-03-12
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  114     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-18     Completed Date:  2007-05-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  614-8     Citation Subset:  AIM; IM    
Centre for Medical Statistics and Health Evaluation, University of Liverpool, Liverpool, UK.
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MeSH Terms
Amniocentesis / standards
Clinical Competence / standards*
Hospitals, Maternity / standards
Obstetrics / standards*
Pregnancy Complications / diagnosis*
Prenatal Diagnosis / standards,  statistics & numerical data*
Retrospective Studies
Vacuum Extraction, Obstetrical / standards

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