Document Detail


Putting theory into practice: the introduction of obstetric near-miss case reviews in the Republic of Moldova.
MedLine Citation:
PMID:  22215758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INITIAL ASSESSMENT: Providers have limited experience with clinical audits and perceive them as a way to punish individuals.
CHOICE OF SOLUTION: Near-miss case reviews were introduced. Discussing near-miss cases might be less threatening to providers than discussing maternal deaths because the women survived.
IMPLEMENTATION: The quality of audits was evaluated against explicit criteria in three pilot maternities.
EVALUATION: On average one case was discussed every 5-6 weeks. Information from women's interviews was presented at all meetings, although the quality of the women's interviews was low. The weakest aspect of care was monitoring and follow-up treatment; the majority of proposed actions concerned the availability or compliance to protocols (52-69%). Proposed actions were consistent with prior analysis (95-100%), formulated in a clear and measurable way (58-90%), but the rate of failure to identify important actions was quite high in one facility (33%). Actions were more likely to be implemented when they concerned organization and management, drugs and supplies and least likely when they concerned staff.
LESSONS LEARNED: It is relatively easy to build capacity in organizing obstetric 'near-miss' audits, but more difficult to ensure that discussions are transposed into actions. In settings with no tradition of patients' involvement, increased attention should be given to providers' capacity to tackle patient-related factors.
Authors:
Valentina Baltag; Véronique Filippi; Alberta Bacci
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Publication Detail:
Type:  Journal Article     Date:  2012-01-02
Journal Detail:
Title:  International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua     Volume:  24     ISSN:  1464-3677     ISO Abbreviation:  Int J Qual Health Care     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-09     Completed Date:  2012-07-11     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  9434628     Medline TA:  Int J Qual Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  182-8     Citation Subset:  IM    
Affiliation:
Making Pregnancy Safer Programme, World Health Organization Regional Office for Europe, Copenhagen Ø, Denmark. vba@euro.who.int
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MeSH Terms
Descriptor/Qualifier:
Emergency Medical Services
Female
Humans
Medical Audit*
Moldova
Obstetrics*
Pregnancy
Pregnancy Complications*
Quality Assurance, Health Care / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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