Muller Journal of Medical Sciences and Research

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 11  |  Issue : 2  |  Page : 55--58

Measure what you treasure! – A maternity dashboard


Joanna Jyothsna, Prema D' Cunha, Chethana Bolanthakodi 
 Department of Obstetrics and Gynecology, FMMCH, Mangalore, Karnataka, India

Correspondence Address:
Dr. Joanna Jyothsna
Department of Obstetrics and Gynecology, FMMCH, Kankanady, Mangalore - 575 002, Karnataka
India

Abstract

Background: Clinical quality dashboards equip hospitals with a simple method for maintaining and monitoring clinical quality indicators. The maternity dashboard. provides an opportunity to integrate managerial, organizational, and clinical audits to improve quality of care. It has four broad categories: clinical activity, workforce, clinical outcome, and complaints/risk incidents. It can be used to benchmark activity and monitor performance against the standards agreed locally for the maternity unit on a monthly basis. Aim: The aim of this study was to design and implement a maternity dashboard to improve maternal and child health care. Settings and Design: This was a retrospective observational study conducted at a tertiary care hospital. Materials and Methods: Data were collected manually from outpatient department, labor ward, neonatal intensive care unit registers, and electronic records from June 2018 to May 2019 in a tertiary care hospital. Goals for each of the parameters were set, as well as upper and lower thresholds, and the data were analyzed. A suggested approach is to use the traffic light system, such as “green,” “amber,” and “red.” All the parameters after analyzing were noted on the dashboard. Results: During the study period of 1 year, there were 3750 deliveries. Auditing was done for various clinical activity indicators along with clinical outcome (both maternal and neonatal) and triaged using traffic light colors on a monthly basis. Conclusions: Maternity dashboard facilitates targeted quality improvement initiatives. They help in comparing current performance against expected standards and hence helpful in driving changes toward optimum maternal and child health.



How to cite this article:
Jyothsna J, D' Cunha P, Bolanthakodi C. Measure what you treasure! – A maternity dashboard.Muller J Med Sci Res 2020;11:55-58


How to cite this URL:
Jyothsna J, D' Cunha P, Bolanthakodi C. Measure what you treasure! – A maternity dashboard. Muller J Med Sci Res [serial online] 2020 [cited 2021 Jun 23 ];11:55-58
Available from: https://www.mjmsr.net/text.asp?2020/11/2/55/316693


Full Text



 Introduction



Clinical quality dashboards are a method for maintaining and monitoring clinical quality indicators. The maternity dashboard[1] introduced by The Royal College of Obstetricians and Gynaecologists provides an opportunity to integrate managerial, organizational, and clinical audits to improve quality of care. It enables monitoring of various preselected parameters on a monthly basis and helps project difference between actual performance and expected goals. It has four broad categories: clinical activity, workforce, clinical outcome, and complaints/risk incidents. It can also be used to benchmark activity and monitor performance against the standards agreed locally for the maternity unit on a monthly basis.

 Materials and Methods



Various aspects of clinical governance such as clinical activity and maternal and neonatal outcomes were chosen as parameters. Data were collected manually from outpatient department, labor ward, neonatal intensive care unit registers, and electronic records from June 2018 to May 2019. Goals were set for each of these, along with upper and lower thresholds. Traffic light approach was used to grade performance. Parameters in “green” were considered as gold standard, and “amber” and “red” parameters depicted areas of weakness and warranted immediate corrective measures. All the parameters that are analyzed were noted on the dashboard.[2]

 Results and Discussion



Visual representation of the data acted as a guide, enhancing decision-making process and taking corrective action [Figure 1]. For example, our cesarean section rate has been well above the benchmark (average rate of 34.96%). This can be reduced by adopting better induction protocols and enhancing TOLAC. The peripartum hysterectomy rate also was in red zone and can be brought to green by making less invasive procedures like UAE more affordable. Third/fourth-degree perineal tears have been in green zone probably due to better training and workshops. Furthermore, the instrumental deliveries were noted to be less in number (average of 10.87%). Therefore, our goal will be to increase the number of instrumental deliveries which would reduce our C-section rate.{Figure 1}

 Conclusions



Maternity dashboards help in comparing current performance against expected standards and hence helpful in driving changes toward optimum maternal and child health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Arulkumaran S, Chandraharan E, Mahmood T, Louca O, Mannion C. Maternity dashboard -clinical performance and governance scorecard. RCOG. Good Pract 2008;7:1-8.
2Patel MS, Rathi B, Tashfeen K, Yarubi MA. Development and implementation of maternity dashboard in regional hospital for quality improvement at ground level: A pilot study. Oman Med J 2019;34:194-9.