Table 34 'Problems with Child Birth'

PSI 33: Problems with Child Birth
Review of an OECD PSI (33).
Dimension Description
Description of Specific
Aspects of Patient Safety
Serious complications or even death from delivery are catastrophic
events. Proper pre- and perinatal care and monitoring should be able to
avoid such events, making this theme suitable as a measure of patient
safety.
Aim of the PSI This PSI is intended to flag cases of maternal death or serious
morbidity associated with labour or delivery.
Level of Determination of
Patient Safety
Safety is assessed at the aggregated patient level.
Source(s) Originally a PSI from the Australian Council for Safety and Quality.
Maternal death is part of the JCAHO sentinel events indicator set and
is defined as the number of intrapartum (related to the birth process)
maternal deaths. Also WHO has developed a maternal death indicator
(33).
Extent of Clinically
Testing
The OECD Health Care Quality Indicators (HCQI) Project was
initiated to implement quality measures for international
benchmarking of medical care at the health system level. Five priority
areas including patient safety were selected. International expert
panels were formed to identify clinically important, scientifically
sound, and feasible measures based on a structured consensus process.
The consensus process was successfully completed in all five priority
areas leading to a recommendation of 86 indicators of which 21
covered patient safety (33).
The OECD panel considered an alternative measure to this one; the
alternative PSI serves as a fallback indicator should data collection for
this indicator prove difficult. The alternative measure captures
maternal complications and Maternal Death. Maternal death is part of
the JCAHO sentinel events indicator set and is defined as the number
of intrapartum (related to the birth process) maternal deaths. Also
WHO has developed a maternal death indicator (33).
Evidence of Clinically use
of Standards
No evidence of clinically use of standards was found.
PSI category Theme Related PSI: “Obstetrics”.
Data definitions Not specified.
Numerator Description Maternal death or serious morbidity associated with labour or delivery.
Denominator Description Total number of labour and deliveries.
Data Source Hospital morbidity data collection.
SImPatIE WP4 – Catalogue of Patients Safety Indicators
86
Identifying the
institutional context
Problems with child birth can have an ongoing burden on the hospital
system in increased length of stays and readmissions making this PSI
theme important in clinical, quality and economic policies.
Care Setting The PSI applies for high quality maternal care.
Professionals Responsible
for Health Care
Doctors and midwifes.
Lowest Level of Health
Care Delivery Addressed
Individual clinical department.
Allowance for Patient
Factors
No risk adjustment described.
Stratification by
Vulnerable Populations
No stratification.
Standard of Comparison No specific standards given.
Scoring Not specified.