North Bristol NHS Trust, UK; University of Bristol, UK.
Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):119-24. doi: 10.1016/j.ejogrb.2013.06.003. Epub 2013 Jul 2.
To assess the development of local clinical dashboards in line with UK national guidance and to identify ongoing issues being faced by maternity units, across an entire health region, in developing quality assurance systems.
A mixed-methods study involving all consultant-led maternity units in the South West of England Strategic Health Authority region (SWSHA). An electronic survey, followed by semi-structured interviews with the lead obstetrician and risk management midwife (or equivalent) of each maternity unit, to investigate methods employed to monitor outcomes locally, particularly the development of tools including maternity dashboards. Interviews were audio recorded, transcribed and thematically analysed to identify conceptual categories and themes.
12/15 eligible consultant-led maternity units participated in the study and 10/12 (83%) of these used a dashboard. There was an excessive number of non-standard indicators used by the maternity units, with 352 different quality indicators (QIs), covering 37 different indicator categories, with up to 39 different definitions for one particular QI. Issues identified were: an excess of indicators, disproportionate time taken to produce the dashboard, uncertainty surrounding thresholds for alert within the dashboards and a desire for more guidance and standardisation of indicators, and their use.
Following recommendation by the Royal College of Obstetricians and Gynaecologists, maternity dashboards have been widely adopted by maternity units across the SWSHA to provide a local quality assurance system. There is, however, wide variation in both the quality indicators monitored and their definition. There is an urgent requirement for a national and international core set of maternity QIs. Further guidance is also required to inform alert thresholds for adverse outcomes. These perinatal data are collected electronically, and automating the production of a standardised dashboard is both possible and desirable.
评估当地临床仪表板的开发情况，以符合英国国家指南，并确定整个健康区域的产科单位在开发质量保证系统时面临的持续问题。
这是一项涉及英格兰西南部战略卫生局地区（SWSHA）所有顾问领导的产科单位的混合方法研究。一项电子调查，随后对每个产科单位的首席产科医生和风险管理助产士（或同等职位）进行半结构化访谈，以调查用于监测当地结果的方法，特别是包括产科仪表板在内的工具的开发。访谈进行了录音、转录，并进行了主题分析，以确定概念类别和主题。
15 个符合条件的顾问领导的产科单位中有 12 个参加了研究，其中 10 个（83%）使用了仪表板。产科单位使用的非标准指标过多，有 352 个不同的质量指标（QIs），涵盖 37 个不同的指标类别，一个特定 QI 有多达 39 个不同的定义。确定的问题包括：指标过多，制作仪表板所需的时间不成比例，仪表板内警报阈值存在不确定性，以及对更多指导和指标及其使用的标准化的需求。
根据皇家妇产科医师学院的建议，SWSHA 各地的产科单位广泛采用了产科仪表板，以提供当地的质量保证系统。然而，监测的质量指标及其定义存在广泛差异。迫切需要制定国家和国际核心产科质量指标集。还需要进一步的指导，以告知不良结果的警报阈值。这些围产期数据是通过电子方式收集的，并且自动化生成标准化仪表板是可行且理想的。
