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Online Program

320169
Perinatal Quality Improvement Initiative: What's the Status of Florida's Perinatal Health?


Tuesday, November 3, 2015 : 12:30 p.m. - 12:50 p.m.

Lindsay Womack, MPH, Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
Humberto López Castillo, MD, MEd, MSc, CPH, Dept. of Community and Family Health, University of South Florida, Tampa, FL
Linda A. Detman, PhD, Department of Community & Family Health, The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, College of Public Health, Tampa, FL
William M. Sappenfield, MD MPH, Department of Community & Family Health, The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, College of Public Health, Tampa, FL
Audio (mp3) recording Recorded Presentation (mp4)
Background

Florida is developing new perinatal quality improvement indicators for hospitals to promote improved health care. The study objective was to assess the performance of pilot indicators at a hospital and state level.

Methods

Pilot indicators were tested using Florida linked birth certificate and hospital discharge data for 2004-2011. Initial indicators included rates of non-medically indicated early term deliveries, low-risk primary cesareans, failed inductions of labor, and antenatal corticosteroid use by hospital, compared to the distribution of remaining hospitals. Most indicators were either restricted to appropriate subpopulations, stratified by risk, or adjusted for risk.

Results

The non-medically indicated delivery rate was the only indicator to improve over time, which is likely attributed to state-wide quality improvement efforts focused on this issue. Low-risk primary cesarean and failed induction of labor rates remained stable; however, the top 25% of hospitals were widely distributed, indicating opportunities for improvement. Based on data from external reporting, the antenatal corticosteroid use rate had readily apparent data quality issues. Data quality appeared to play less of a role for other indicators.

Conclusions

The proposed indicators were used by participating pilot hospitals and partners to compare their rates to other hospitals and identify potential quality issues. This study also demonstrated that there are potential data quality issues that need to be explored. Based on other states’ quality collaborative experiences, using the new indicators will potentially promote hospital improvement in data reporting. The pilot indicators have the potential to be useful in identifying and developing specific quality improvement initiatives at Florida delivery hospitals.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Assess the performance of perinatal quality improvement pilot indicators at a hospital and state level.

Keyword(s): Quality Improvement, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have several years of experience as an epidemiologist working at the state and local level to improve the health of mothers and infants. As a current doctoral student, my research interests include improving the the quality of perinatal health care at the hospital and state level.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4244.0: Current Issues in Data & Epidemiology