Towards an integrated perinatal care pathway for vulnerable women: The development and validation of quality indicators.

Autor: D'haenens F; Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium. Electronic address: Florence.dhaenens@ehb.be., Helsloot K; Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium. Electronic address: Kaat.helsloot@arteveldehs.be., Lauwaert K; Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium. Electronic address: Karen.lauwaert@arteveldehs.be., Agache L; Social Care Department, Artevelde University of Applied Sciences, Ghent, Belgium. Electronic address: Lien.agache@arteveldehs.be., de Velde GV; Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium; Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium. Electronic address: Griet.vandevelde@arteveldehs.be., De Frène V; Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium. Electronic address: Veerle.defrene@arteveldehs.be., Embo M; Midwifery Department, Artevelde University of Applied Sciences, Ghent, Belgium. Electronic address: Mieke.embo@arteveldehs.be., Vermeulen J; Midwifery Department, Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium; Department of Public Health, Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium. Electronic address: Joeri.vermeulen@ehb.be., Beeckman K; University Hospital Brussels, Nursing and Midwifery Research Unit, Belgium; Vrije Universiteit Brussel (VUB), Nursing and Midwifery Research Unit, Faculty of Medicine and Pharmacy & Universitair Ziekenhuis Brussel, Belgium; Verpleeg- en vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Belgium. Electronic address: Katrien.beeckman@uzbrussel.be., Fobelets M; Department of Public Health, Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium; Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Belgium. Electronic address: Maaike.fobelets@ehb.be.
Jazyk: angličtina
Zdroj: Midwifery [Midwifery] 2020 Oct; Vol. 89, pp. 102794. Date of Electronic Publication: 2020 Jul 07.
DOI: 10.1016/j.midw.2020.102794
Abstrakt: Objective: Development and validation of a set of quality indicators for vulnerable women during the perinatal period.
Design: A three-phase method was used. Phase 1 consisted of a literature review to identify publications for the development of care domains and potential QIs, as well as a quality assessment by the research team. In phase 2 an expert panel assessed the set of concept QIs in a modified three-round Delphi survey. Finally, semi-structured interviews with vulnerable women were conducted as a final quality assessment of a set of indicators (phase 3). Ethical approval was obtained from the ethics committee of the University Hospital Brussels and from the Ethics Committees of all the participating hospitals.
Setting: The Flemish Region and the Brussels Capital Region in Belgium.
Participants: Healthcare and social care professionals (n = 40) with expertise in the field of perinatal care provision for vulnerable families. Vulnerable women (n = 11) who gave birth in one of the participating hospitals.
Findings: The literature review resulted in a set of 49 potential quality indicators in five care domains: access to healthcare, assessment and screening, informal support, formal support and continuity of care. After assessment by the expert panel and vulnerable women, a final set of 21 quality indicators in five care domains was identified. First of all, organisation of care must involve an integrated multidisciplinary approach taking account of financial, administrative and social barriers (care domain 1: access to healthcare). Second, qualitative care includes the timely initiation of care, a general screening of the various aspects of vulnerability (biological, psychological, social and cognitive) and a risk assessment for all women (care domain 2: assessment and screening). Vulnerable women benefit from intensive formal and informal support taking account of individual needs and strengths (care domain 3: formal support; care domain 4: informal support). Finally, continuity of care needs to be guaranteed in line with vulnerable woman's individual needs (care domain 5: continuity of care).
Key Conclusions and Implications for Practice: Implementing quality indicators in existing and new care pathways offers an evidence-based approach facilitating an integrated view promoting a healthy start for woman and child. These quality indicators can assist healthcare providers, organisations and governmental agencies to improve the quality of perinatal care for vulnerable women.
Competing Interests: Declaration of Competing Interest None declared.
(Copyright © 2020. Published by Elsevier Ltd.)
Databáze: MEDLINE
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