Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study
Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) can highlight issues that remain unnoticed when using standard clinical quality indicators. However, estimations of the potential power of measuring PROMs and PREMs to identify unrecognised areas su...
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| Format: | Article |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/1/e001922.full |
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| author | Arie Franx Bas Van Rijn Pieter Bakx Anouk Klootwijk Hilmar Bijma Hiske Ernst-Smelt Marije Lamain-de Ruiter Anke Posthumus |
| author_facet | Arie Franx Bas Van Rijn Pieter Bakx Anouk Klootwijk Hilmar Bijma Hiske Ernst-Smelt Marije Lamain-de Ruiter Anke Posthumus |
| author_sort | Arie Franx |
| collection | DOAJ |
| description | Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) can highlight issues that remain unnoticed when using standard clinical quality indicators. However, estimations of the potential power of measuring PROMs and PREMs to identify unrecognised areas suitable for quality improvement are often limited by a lack of reliable real-world data. Here, we report on how the indicator set for PROMs and PREMs that was recently developed by the International Consortium for Health Outcome Measures can change perspectives on quality assessment in women receiving care for pregnancy and childbirth.Methods PROMs and PREMs were captured 6 months after childbirth via an online survey in a single academic maternity unit in the Netherlands between 2018 and 2019. Indicators of abnormality were scored using predefined cut-off values established by a national consensus group. We used regression analysis to identify associations between PROMs, PREMs and healthcare use, and further stratified data to explore the distribution of indicators among relevant patient subgroups.Results Of 2775 questionnaires, 645 were completed and linked to medical health records. Despite only 5% of women reporting overall dissatisfaction with care, suboptimal scores were often found; in birth experience for 32% of the population, and 42% who experienced painful sexual intercourse. Subgroup analysis further revealed associations with relevant indicators of quality of care; inadequate pain relief among women with preterm birth (OR 8.8), pain with sexual intercourse among women undergoing vaginal assisted delivery (OR 2.2) and women living in a deprived area had problematic birth experiences (coefficient −3.2).Conclusion Use of PROMs and PREMs in pregnancy and childbirth care provides new insights on quality of care, resulting in potentially actionable targets for improvement not normally identified with standard clinical quality indicators. Implementation strategies and follow-up are needed to act on these findings. |
| format | Article |
| id | doaj-art-6a123334e13343d9b0a21082751235eb |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-6a123334e13343d9b0a21082751235eb2024-12-31T14:55:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-02-0112110.1136/bmjoq-2022-001922Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort studyArie Franx0Bas Van Rijn1Pieter Bakx2Anouk Klootwijk3Hilmar Bijma4Hiske Ernst-Smelt5Marije Lamain-de Ruiter6Anke Posthumus7Department of Obstetrics & Gynaecology, Erasmus Medical Center, Rotterdam, NetherlandsDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsErasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands1 Department for Population Health and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, NetherlandsDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The NetherlandsBackground Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) can highlight issues that remain unnoticed when using standard clinical quality indicators. However, estimations of the potential power of measuring PROMs and PREMs to identify unrecognised areas suitable for quality improvement are often limited by a lack of reliable real-world data. Here, we report on how the indicator set for PROMs and PREMs that was recently developed by the International Consortium for Health Outcome Measures can change perspectives on quality assessment in women receiving care for pregnancy and childbirth.Methods PROMs and PREMs were captured 6 months after childbirth via an online survey in a single academic maternity unit in the Netherlands between 2018 and 2019. Indicators of abnormality were scored using predefined cut-off values established by a national consensus group. We used regression analysis to identify associations between PROMs, PREMs and healthcare use, and further stratified data to explore the distribution of indicators among relevant patient subgroups.Results Of 2775 questionnaires, 645 were completed and linked to medical health records. Despite only 5% of women reporting overall dissatisfaction with care, suboptimal scores were often found; in birth experience for 32% of the population, and 42% who experienced painful sexual intercourse. Subgroup analysis further revealed associations with relevant indicators of quality of care; inadequate pain relief among women with preterm birth (OR 8.8), pain with sexual intercourse among women undergoing vaginal assisted delivery (OR 2.2) and women living in a deprived area had problematic birth experiences (coefficient −3.2).Conclusion Use of PROMs and PREMs in pregnancy and childbirth care provides new insights on quality of care, resulting in potentially actionable targets for improvement not normally identified with standard clinical quality indicators. Implementation strategies and follow-up are needed to act on these findings.https://bmjopenquality.bmj.com/content/12/1/e001922.full |
| spellingShingle | Arie Franx Bas Van Rijn Pieter Bakx Anouk Klootwijk Hilmar Bijma Hiske Ernst-Smelt Marije Lamain-de Ruiter Anke Posthumus Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study BMJ Open Quality |
| title | Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study |
| title_full | Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study |
| title_fullStr | Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study |
| title_full_unstemmed | Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study |
| title_short | Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study |
| title_sort | patient reported outcome and experience measures for quality improvement in pregnancy and childbirth care a retrospective cohort study |
| url | https://bmjopenquality.bmj.com/content/12/1/e001922.full |
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