Quality improvement in maternity care: promising approaches from the medical and public health perspectives

Abstract

Purpose of review: Quality-improvement activities affect every obstetrician and every birthing service in the country. This review will serve to introduce the obstetric practitioner to the latest evidence of effective quality-improvement methods and provide an understanding of the different roles of the various organizations involved.

Recent findings: Maternity quality improvement is an interrelated process with quality-improvement activities that occur at the hospital (e.g. protocols, checklists, drills, simulations, data collection and feedback and rapid-cycle quality-improvement projects), quality-improvement activities that occur at the level of a multihospital system or region (e.g. development of materials to support the hospital, development of quality-improvement leaders, provide pressure for change, benchmark outcomes), quality-improvement activities that occur within public agencies (e.g. public education campaigns) and still others that occur at governmental levels (e.g. selecting measures and targets, setting incentives and regulations, collecting administrative data). Quality collaboratives are relatively new, but can serve to jumpstart and coordinate the quality-improvement process among all the institutions involved.

Summary: This review helps hospital leaders identify the quality-improvement activities that will be most effective for their needs.