Am J Perinatol 2017; 34(10): 0958-0965
DOI: 10.1055/s-0037-1600898
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Using a State Birth Registry as a Quality Improvement Tool

Carole Lannon
1   James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
,
Heather C. Kaplan
1   James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
,
Kelly Friar
2   Ohio Public Health Partnership, Columbus, Ohio
,
Sandra Fuller
1   James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
,
Susan Ford
3   Rainbow Babies & Children's Hospital, Cleveland, Ohio
,
Beth White
4   Ohio Perinatal Quality Collaborative, Toledo, Ohio
,
John Besl
1   James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio
,
John Paulson
5   Ohio Department of Health, Center for Vital and Health Statistics, Columbus, Ohio
,
Michael Marcotte
6   Quality and Safety for Women's Services – TriHealth, Good Samaritan Hospital, Cincinnati, Ohio
,
Michael Krew
7   Aultman Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Aultman Hospital, Canton, Ohio
,
Jennifer Bailit
8   Obstetric Lead, Ohio Perinatal Quality Collaborative, Metro Health Medical Center, Cleveland, Ohio
,
Jay Iams
9   Ohio Perinatal Quality Collaborative, Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio
› Author Affiliations
Further Information

Publication History

03 January 2017

15 February 2017

Publication Date:
22 March 2017 (online)

Abstract

Background Birth registry data are universally collected, generating large administrative datasets. However, these data are typically not used for quality improvement (QI) initiatives in perinatal medicine because the quality and timeliness of the information is uncertain.

Objective We sought to identify and address causes of inaccuracy in recording birth registry information so that birth registry data could support statewide obstetrical quality initiatives in Ohio.

Study Design The Ohio Perinatal Quality Collaborative and the Ohio Department of Health Vital Statistics used QI techniques in 15 medium-sized maternity hospitals to identify and remove systemic sources of inaccuracy in birth registry data. The primary outcome was the rate of scheduled deliveries without medical indication between 370/7 and 386/7 weeks at participating hospitals from birth registry data.

Results Inaccurate birth registry data most commonly resulted from limited communication between clinical and medical record staff. The rate of scheduled births between 370/7 and 386/7 weeks' gestation without a documented medical indication as recorded in the birth registry declined by 35%.

Conclusion A QI initiative aimed at increasing the accuracy of birth registry information demonstrated the utility of these data for surveillance of perinatal outcomes and has led to ongoing efforts to support birth registrars in submitting accurate data.

Note

Results from this study were presented at the Academy for Healthcare Improvement Annual Meeting, Arlington, VA, April 26, 2013.


 
  • References

  • 1 Lain SJ, Hadfield RM, Raynes-Greenow CH. , et al. Quality of data in perinatal population health databases: a systematic review. Med Care 2012; 50 (04) e7-e20
  • 2 Donovan EF, Lannon C, Bailit J, Rose B, Iams JD, Byczkowski T. ; Ohio Perinatal Quality Collaborative Writing Committee. A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks' gestation. Am J Obstet Gynecol 2010; 202 (03) 243.e1-243.e8
  • 3 Bailit JL. ; Ohio Perinatal Quality Collaborative. Rates of labor induction without medical indication are overestimated when derived from birth certificate data. Am J Obstet Gynecol 2010; 203 (03) 269.e1-269.e3
  • 4 Institute for Healthcare Improvement. The Breakthrough Series: IHI's Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement. . Available at: www.IHI.org . Accessed 2003
  • 5 Kilo CM. A framework for collaborative improvement: lessons from the Institute for Healthcare Improvement's Breakthrough Series. Qual Manag Health Care 1998; 6 (04) 1-13
  • 6 Kilo CM. Improving care through collaboration. Pediatrics 1999; 103 (1, suppl E): 384-393
  • 7 Lannon CM, Flower K, Duncan P, Moore KS, Stuart J, Bassewitz J. The Bright Futures Training Intervention Project: implementing systems to support preventive and developmental services in practice. Pediatrics 2008; 122 (01) e163-e171
  • 8 ACOG Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 107: induction of labor. Obstet Gynecol 2009; 114 (2 Pt 1): 386-397
  • 9 American College of Obstetricians and Gynecologists. Patient Safety Checklist no. 2: inpatient induction of labor. Obstet Gynecol 2011; 118 (05) 1205-1206
  • 10 Ohio Perinatal Quality Collaborative, Ohio Department of Health. 13 key IPHIS variables. Available at: https://opqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org/files/Resources/Birth%20Registry%20Accuracy/13%20Key%20Variables%2010.2014.pdf . Accessed August 4, 2015
  • 11 Ohio Department of Health. Guide to Completing the Perinatal Record Perinatal Worksheet (IPHIS). Available at: http://www.odh.ohio.gov/ . Accessed December 28, 2016
  • 12 Ohio Perinatal Quality Collaborative. Welcome to OPQC! Available at: https://opqc.net/ . Accessed December 28, 2016
  • 13 Langley G, Nolan K, Nolan T, Norman C, Provost L. The Improvement Guide. A Practical Approach to Enhancing Organizational Performance. San Francisco: Jossey-Bass; 1996
  • 14 Moen R, Nolan T, Provost L. Quality Improvement through Planned Experimentation. New York: McGraw-Hill; 1999
  • 15 Perla RJ, Provost LP, Murray SK. The run chart: a simple analytical tool for learning from variation in healthcare processes. BMJ Qual Saf 2011; 20 (01) 46-51
  • 16 Ohio Perinatal Quality Collaborative. Birth Registry Accuracy. IPHIS Education Training Modules. Available at: https://www.opqc.net/projects/BirthRegistryAccuracyResources . Accessed December 28, 2016