Blueprint for action: steps toward a high-quality, high-value maternity care system.
ABSTRACT Childbirth Connection hosted a 90th Anniversary national policy symposium, Transforming Maternity Care: A High Value Proposition, on April 3, 2009, in Washington, DC. Over 100 leaders from across the range of stakeholder perspectives were actively engaged in the symposium work to improve the quality and value of U.S. maternity care through broad system improvement. A multi-disciplinary symposium steering committee guided the strategy from its inception and contributed to every phase of the project. The "Blueprint for Action: Steps Toward a High Quality, High Value Maternity Care System", issued by the Transforming Maternity Care Symposium Steering Committee, answers the fundamental question, "Who needs to do what, to, for, and with whom to improve the quality of maternity care over the next five years?" Five stakeholder workgroups collaborated to propose actionable strategies in 11 critical focus areas for moving expeditiously toward the realization of the long term "2020 Vision for a High Quality, High Value Maternity Care System", also published in this issue. Following the symposium these workgroup reports and recommendations were synthesized into the current blueprint. For each critical focus area, the "Blueprint for Action" presents a brief problem statement, a set of system goals for improvement in that area, and major recommendations with proposed action steps to achieve them. This process created a clear sightline to action that if enacted could improve the structure, process, experiences of care, and outcomes of the maternity care system in ways that when anchored in the culture can indeed transform maternity care.
- SourceAvailable from: Mariana Arcaya[Show abstract] [Hide abstract]
ABSTRACT: Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses.PLoS Medicine 10/2014; 11(10):e1001745. · 15.25 Impact Factor
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ABSTRACT: Wprowadzenie. Ciąża, poród oraz okres połogowy dla każdej kobiety jest wyjątkowym wydarzeniem. Towarzyszy temu wiele skrajnych emocji od radości i spełnienia po obawy i lęk. Kobiety obawiają się o swoje zdrowie, zdrowie dziecka. Boją się bólu związanego z porodem, możliwych komplikacji porodowych. Odpowiednia opieka i wsparcie emocjonalne personelu medycznego w tym wyjątkowych chwilach pozwala kobietom przeżywać je radośnie i cieszyć się z macierzyństwa. Cel pracy. Ocena wsparcia emocjonalnego w oddziałach położniczych w opiniach pacjentek. Materiał i metoda. Przebadano 112 położnic po porodach poprzez cięcie cesarskie z 3 szpitali powiatowych województwa lubelskiego. Narzędziem badawczym wykorzystanym w badaniu był autorski kwestionariusz ankiety zawierający pytania dotyczące: poziomu zaspokojenia potrzeb biopsychospołecznych położnic a także ocenę satysfakcji z opieki personelu nad położnicą i noworodkiem. Ocenie poddano również poziom zaspokojenia potrzeb biopsychospołecznych położnic. Wyniki. Większość pacjentek oddziałów położniczych otrzymała wystarczające wsparcie emocjonalne ze strony personelu medycznego. Poziom opieki na oddziałach położniczych został przez znaczny odsetek pacjentek oceniony na poziomie bardzo dobrym. Wniosek. W pewnych obszarach zaobserwowano jednak występowanie braków: w przypadku personelu lekarskiego dotyczyło to sposobu przekazywania informacji, zaś w przypadku personelu pielęgniarskiego brak możliwości obserwowania przez położnice wykonywanych przez personel zabiegów pielęgnacyjnych. Introduction. Pregnancy, childbirth and puerperal period is a special event for every woman. They are accompanied by a lot of extreme emotions, through joy and fulfillment to fear and anxiety. Women are afraid for their health and their child’s health. They are afraid of the pain associated with childbirth, possible delivery complications. Appropriate care and emotional support of the medical staff in these special moments allow women to live through the experience happily and enjoy motherhood. Aim. To assess the emotional support in maternity wards in the patients’ opinion. Materials & method. We studied 112 women after childbirth by cesarean section in three community hospitals of the Lublin Province. The research tool used in the original study was a questionnaire containing questions concerning the level of bio-psycho-social needs of the women and assessing the satisfaction with medical care of the women and newborns. The evaluation assessed the level of meeting the bio-psycho-social needs of patients’. Results. Most women received enough emotional support from the medical staff. The level of care in maternity wards was assessed at a very good level. Conclusion. In some areas, however, some deficiencies were observed: in case of the medical personnel it was related to ways of supplying information and in case of the nursing staff it was the lack of opportunity to observe nursing staff during newborn care.Hygeia Public Health. 01/2013; 48(3):346-351.
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ABSTRACT: Background Maternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers’ expressed needs is unclear. This study examines open-text survey comments to identify women’s unmet needs and priorities for maternity care. It is then considered whether these needs and priorities are addressed in current reform plans. Methods Women who had a live single or multiple birth in Queensland, Australia, in 2010 (n 3,635) were invited to complete a retrospective self-report survey. In addition to questions about clinical and interpersonal maternity care experiences from pregnancy to postpartum, women were asked an open-ended question “Is there anything else you’d like to tell us about having your baby?” This paper describes a detailed thematic analysis of open-ended responses from a random selection of 150 women (10% of 1,510 who responded to the question). Results Four broad themes emerged relevant to improving women’s experiences of maternity care: quality of care (interpersonal and technical); access to choices and involvement in decision-making; unmet information needs; and dissatisfaction with the care environment. Some of these topics are reflected in current reform goals, while others provide evidence of the need for further reforms. Conclusions The findings reinforce the importance of some existing maternity reform objectives, and describe how these might best be met. Findings affirm the importance of information provision to enable informed choices; a goal of Queensland and national reform agendas. Improvement opportunities not currently specified in reform agendas were also identified, including the quality of interpersonal relationships between women and staff, particular unmet information needs (e.g., breastfeeding), and concerns regarding the care environment (e.g., crowding and long waiting times).BMC Pregnancy and Childbirth 10/2014; 14:366. · 2.15 Impact Factor