Maternal quality and safety programme

Maternity quality and safety programmeA multidisciplinary team at Waitemata DHB, the Maternity Clinical Governance Forum, is leading a programme, Waitemata DHB’s Maternity Quality and Safety Programme (MQSP) to improve the quality of maternity care services for our population. The MQSP is part of a national initiative led by the Ministry of Health.

The Maternity Clinical Governance Forum has wide representation, with members including two consumers, midwives, lead maternity carers, obstetricians, neonatologists, allied health staff and anaesthetists. The Forum meets monthly. The role of the forum is to lead the Maternity Quality and Safety Programme with a focus on:

  • Engaging and communicating with stakeholders
  • Overseeing safe practice
  • Overseeing clinically effective practice
  • Understanding the maternity experience

Fifteen goals were agreed for the 2014/2015 Maternity Quality and Safety Programme:

  1. To increase the number of women who register with a Lead Maternity Carer (LMC) by week 12 of their pregnancy
  2. To improve access to Maternal Mental health
  3. To improve communication and information to and from Stakeholders
  4. To improve our understanding of the health needs of Māori, Pacific, Asian and teen populations
  5. To increase access to information about services, guidelines and best practice
  6. To improve the validity and reliability of maternity health data
  7. To decrease the number of women who smoke in pregnancy
  8. To contribute to higher breastfeeding rates at three months of age, particularly for Māori, Pacific and Asian women
  9. To increase the number of women having a normal birth
  10. To improve care for mothers and babies using the National Maternity Clinical Indicators developed by the Ministry and other data
  11. To implement the referral guidelines
  12. To implement the national guideline for PPH
  13. To improve and standardise the postnatal care for women and their babies in the hospital setting
  14. To standardise the criteria and practice for labour Induction (IOL) regionally
  15. To reduce incidence 3rd and 4th degree trauma

A detailed report on how well we performed against these goals and the progress we have made to embed the programme is available on our organisational website [view our Waitemata DHB Maternity Quality and Safety Programme Annual Report 2014-2015].

The report sets out the clinical indicators the maternity team is using to measure and improve the care we deliver, and to track patient safety and outcomes:

Maternity Clinical Indicators

The publication of the 2012 Maternity Clinical Indicators has been carefully considered. We are fortunate that we are able to extrapolate local data to see current trends and we look forward to the forthcoming 2013 Clinical Indicators.

Indicator

2012

2013

2014

1.

Standard primiparae who have a spontaneous vaginal birth

66.5%

66.3%

65.4%

2.

Standard primiparae who undergo an instrumental vaginal birth

15.2%

15.6%

17.0%

3.

Standard primiparae who undergo Caesarean section

18.4%

18.4%

17.6%

4.

Standard primiparae who undergo induction of labour

4.8%

3.2%

4.1%

5.

Standard primiparae with an intact lower genital tract (no 1st-4th-degree tear or episiotomy)

21.1%

19.2%

15.0%

6.

Standard primiparae undergoing episiotomy and no 3rd-4th degree perineal tear

21.1%

24.2%

27.8%

7.

Standard primiparae sustaining a 3rd-4th degree perineal tear and no episiotomy

3.4%

4.3%

4.8%

8.

Standard primiparae undergoing episiotomy and sustaining a 3rd-4th degree perineal tear

1.1%

1.4%

1.1%

9.

General anaesthesia for Caesarean section

10.3%

8.6%

8.1%

10.

Blood transfusion after vaginal birth

1.2%

1.3%

1.1%

11.

Blood transfusion after Caesarean section

1.8%

1.7%

1.2%

12.

Premature births (delivery between 32 and 36 weeks)

5.2%

5.0%

4.9%


This work compliments the quality measures being developed by other clinical groups to monitor and improve the care we provide, for example the ‘surgical excellence metrics’ being developed by the surgical departments [view more about Surgical Excellence Metrics].

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