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The identification of key indicators to drive quality improvement in obstetric anaesthesia: results of the Obstetric Anaesthetists’ Association/National Perinatal Epidemiology Unit collaborative Delphi project

Abstract:
A three‐stage Delphi survey process was undertaken to identify the quality indicators considered the most relevant to obstetric anaesthesia. The initial quality indicators assessed were derived from national peer‐reviewed publications and were divided into service provision, service quality and clinical outcomes. A range of stakeholders were invited to participate and divided into three panels: obstetric anaesthetists; other maternity care health professionals; and women who had used maternity services. In total, 133 stakeholders registered to participate with 80% completing all three phases of the survey process. Participants ranked indicators for their relative importance using the grading of recommendations assessment, development and evaluation scale. From an initial list of 31 quality indicators, 11 indicators were rated as extremely important by > 90% of participants in at least two panels. These 11 indicators were presented to stakeholders; they were asked to vote for the five indicators they considered most relevant and useful for assessing and benchmarking the quality of obstetric anaesthesia provided. The indicators chosen were: the percentage of women who had an epidural/combined spinal‐epidural for labour analgesia with accidental dural puncture; the presence of guidelines for the referral of patients to an anaesthetist for antenatal review; whether there are dedicated elective caesarean section lists; the availability of point‐of‐care testing for estimation of haemoglobin concentration; and the percentage of epidurals for labour analgesia that provided adequate pain relief within 45 min of the start of epidural insertion. These indicators may be used for quality improvement and national benchmarking to support the implementation of quality standards in obstetric anaesthesia.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1111/anae.14861

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0002-1984-4575


Publisher:
Wiley
Journal:
Anaesthesia More from this journal
Volume:
75
Issue:
5
Pages:
617-625
Publication date:
2019-10-27
Acceptance date:
2019-08-25
DOI:
EISSN:
1365-2044
ISSN:
0003-2409
Pmid:
31657014


Language:
English
Keywords:
Pubs id:
1072180
Local pid:
pubs:1072180
Deposit date:
2020-07-31

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