Article Text
Abstract
Aim To assess current provision and implementation of maternity dashboards across the South West Strategic Health Authority (SW SHA)
Background Reductions in preventable obstetric harm are a priority: 50% of maternal deaths and 75% of intrapartum stillbirths are preventable with better care. Maternity data are routinely collected for all deliveries on different databases but cannot easily be turned into information.
Maternity dashboards measure, monitor and display quality indicators. Early identification of outcome deterioration allows early intervention and correction. Following RCOG recommendation it's unclear how dashboards have been implemented.
Methods Structured interviews with the lead Obstetrician and Risk Management Midwife from 12 SW SHA maternity units exploring quality measurement methods, including maternity dashboards.
Transcriptions were analysed using thematic analysis tools.
Results 10/12 units currently use maternity dashboards, varying widely in content.
Common themes identified included:
Subjective beneficial effects on risk management
Frustration regarding the wide range of quality indicators and national targets, seemingly divorced from clinical priorities
Lack of guidance for quality indicators and thresholds for action.
Desire for anonymised benchmarking
Benchmarking reservations, including potential issues controlling for population risk.
Conclusions A plethora of home-made dashboards exist with an equal range of clinical indicators and thresholds. A single national dataset and dashboard tool would help improve this situation and its frustrations.
We are introducing an automated dashboard for all participating units, to assess the feasibility of a common prospective risk-monitoring system.