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Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care

OBJECTIVES: This study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC). DESIGN: Observational study. SETTING: De Soysa Maternity Hospital, the lar...

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Autores principales: Lazzerini, Marzia, Senanayake, Hematha, Mohamed, Rishard, Kaluarachchi, Athula, Fernando, Roshini, Sakalasuriya, Anshumalie, Ihsan, Fathima Reshma, Saravanabhava, Namasivayam, Gamaathige, Nalin, Jayawardane, Madura, Gamage, Ruwan Vidana, Covi, Benedetta, Wanzira, Humphrey, Businelli, Caterina, Piccoli, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368149/
https://www.ncbi.nlm.nih.gov/pubmed/30782885
http://dx.doi.org/10.1136/bmjopen-2018-023706
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author Lazzerini, Marzia
Senanayake, Hematha
Mohamed, Rishard
Kaluarachchi, Athula
Fernando, Roshini
Sakalasuriya, Anshumalie
Ihsan, Fathima Reshma
Saravanabhava, Namasivayam
Gamaathige, Nalin
Jayawardane, Madura
Gamage, Ruwan Vidana
Covi, Benedetta
Wanzira, Humphrey
Businelli, Caterina
Piccoli, Monica
author_facet Lazzerini, Marzia
Senanayake, Hematha
Mohamed, Rishard
Kaluarachchi, Athula
Fernando, Roshini
Sakalasuriya, Anshumalie
Ihsan, Fathima Reshma
Saravanabhava, Namasivayam
Gamaathige, Nalin
Jayawardane, Madura
Gamage, Ruwan Vidana
Covi, Benedetta
Wanzira, Humphrey
Businelli, Caterina
Piccoli, Monica
author_sort Lazzerini, Marzia
collection PubMed
description OBJECTIVES: This study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC). DESIGN: Observational study. SETTING: De Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka. DATA COLLECTION AND ANALYSIS: From July 2015 to June 2017, 150 variables were collected for each delivery using a standardised form and entered into a database. Data were analysed every 8 months, and the results made available to local staff. Outcomes of the study included: technical problems; data completeness; data accuracy; key database findings; and use of data. RESULTS: 7504 deliveries were recorded. No technical problem was reported. Data completeness exceeded that of other existing hospital recording systems. Less than 1% data were missing for maternal variables and less than 3% for newborn variables. Mistakes in data collection and entry occurred in 0.01% and 0.09% of maternal and newborn data, respectively. Key QoC indicators identified in comparison with international standards were: relatively low maternal mortality (0.053%); relatively high maternal near-miss cases (3.4%); high rate of induction of labour (24.6%), caesarean section (30.0%) and episiotomy (56.1%); relatively high rate of preterm births (9.4%); low birthweight rate (16.5%); stillbirth (0.97%); and of total deaths in newborn (1.98%). Based on key indicators identified, a list of recommendations was developed, including the use checklists to standardise case management, training, clinical audits and more information for patients. A list of lessons learnt with the implementation of the data collection system was also drawn. CONCLUSIONS: The study shows that the implemented system of data collection can produce a large quantity of reliable information. Most importantly, this experience provides an example on how database findings can be used for discussing hospital practices, identifying gaps and to agree on recommendations for improving QoC.
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spelling pubmed-63681492019-03-10 Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care Lazzerini, Marzia Senanayake, Hematha Mohamed, Rishard Kaluarachchi, Athula Fernando, Roshini Sakalasuriya, Anshumalie Ihsan, Fathima Reshma Saravanabhava, Namasivayam Gamaathige, Nalin Jayawardane, Madura Gamage, Ruwan Vidana Covi, Benedetta Wanzira, Humphrey Businelli, Caterina Piccoli, Monica BMJ Open Health Services Research OBJECTIVES: This study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC). DESIGN: Observational study. SETTING: De Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka. DATA COLLECTION AND ANALYSIS: From July 2015 to June 2017, 150 variables were collected for each delivery using a standardised form and entered into a database. Data were analysed every 8 months, and the results made available to local staff. Outcomes of the study included: technical problems; data completeness; data accuracy; key database findings; and use of data. RESULTS: 7504 deliveries were recorded. No technical problem was reported. Data completeness exceeded that of other existing hospital recording systems. Less than 1% data were missing for maternal variables and less than 3% for newborn variables. Mistakes in data collection and entry occurred in 0.01% and 0.09% of maternal and newborn data, respectively. Key QoC indicators identified in comparison with international standards were: relatively low maternal mortality (0.053%); relatively high maternal near-miss cases (3.4%); high rate of induction of labour (24.6%), caesarean section (30.0%) and episiotomy (56.1%); relatively high rate of preterm births (9.4%); low birthweight rate (16.5%); stillbirth (0.97%); and of total deaths in newborn (1.98%). Based on key indicators identified, a list of recommendations was developed, including the use checklists to standardise case management, training, clinical audits and more information for patients. A list of lessons learnt with the implementation of the data collection system was also drawn. CONCLUSIONS: The study shows that the implemented system of data collection can produce a large quantity of reliable information. Most importantly, this experience provides an example on how database findings can be used for discussing hospital practices, identifying gaps and to agree on recommendations for improving QoC. BMJ Publishing Group 2019-02-03 /pmc/articles/PMC6368149/ /pubmed/30782885 http://dx.doi.org/10.1136/bmjopen-2018-023706 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Health Services Research
Lazzerini, Marzia
Senanayake, Hematha
Mohamed, Rishard
Kaluarachchi, Athula
Fernando, Roshini
Sakalasuriya, Anshumalie
Ihsan, Fathima Reshma
Saravanabhava, Namasivayam
Gamaathige, Nalin
Jayawardane, Madura
Gamage, Ruwan Vidana
Covi, Benedetta
Wanzira, Humphrey
Businelli, Caterina
Piccoli, Monica
Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title_full Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title_fullStr Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title_full_unstemmed Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title_short Implementation of an individual patient prospective database of hospital births in Sri Lanka and its use for improving quality of care
title_sort implementation of an individual patient prospective database of hospital births in sri lanka and its use for improving quality of care
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368149/
https://www.ncbi.nlm.nih.gov/pubmed/30782885
http://dx.doi.org/10.1136/bmjopen-2018-023706
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