Monday, June 9, 2008

Grassroots Network: Action Needed: NQF proposed measures for perinatal care

The National Quality Forum (NQF) has drafted a set of performance measures of perinatal care (last trimester through hospital discharge of mother and newborn). This is the first time the NQF has specifically addressed perinatal care. The proposed “measurement set” is now public; YOU can comment, and the deadline for public comment is June 11.

There are quite a number of measures included. The NQF has a specific framework, and many people have put a lot of time and effort into drafting these measures, which are specifically to measure quality of maternity, including care when there are problems. You may not agree with, or even understand, all of the measures, but this is a situation where we need to look at the glass have full rather than the glass half empty.

It is hoped that many individuals and organization will provide comments.

For excellent background information, read Childbirth Connection’s analysis and comments.

Next, go here
. At the end of the brief article on that page, find a link to a pdf of “National Voluntary Consensus Standards for Perinatal Care”. This is the actual document, and includes information about the framework the NQF was working from, and some discussion and rationale for each measure considered, including those not included in the final draft.

While this may seem like a somewhat daunting task (the NQF document is 36 pages, double spaced), it did not take me long to look through it especially after reading the information on Childbirth Connection’s page.

Finally, you can comment on the report as a whole, and/or on individual measures, (see links in the left hand menu on the NQF site) and you can read the comments already submitted, including the excellent comments submitted by Childbirth Connection. Comments are quite limited in length, but there is nothing to say you can’t refer to a comment already submitted, or submit more than one comment on a particular measure.

Also, you can comment on just one or two items you don’t have to comment on everything. For example, the NQF had reasons why they did not include either proposed measure regarding VBACs, which is disturbing, and something you might want to comment on (see the last comment category “19. Measures not recommended”). Furthermore, the recommended measures focus on “outcomes”, and do not at all address the role of any birth practices on these outcomes. I am sure you will easily find one or more measures you feel are important to comment on!

Keep in mind that these proposed measures represent a lot of work, and are the FIRST TIME measures to assess the quality of perinatal care in the US, which is a good thing! In general, few projects like this are “perfect” on the first go, and it is good to remember that people who have worked on a project respond best to a combination of appreciation and constructive suggestions!

Susan Hodges “gatekeeper”

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