Improving Quality of Care for Maternal and Newborn Health: Prospective Pilot Study of the WHO Safe Childbirth Checklist Program
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{"title"=>"Improving quality of care for maternal and newborn health: Prospective pilot study of the who safe childbirth checklist program", "type"=>"journal", "authors"=>[{"first_name"=>"Jonathan M.", "last_name"=>"Spector", "scopus_author_id"=>"35614785200"}, {"first_name"=>"Priya", "last_name"=>"Agrawal", "scopus_author_id"=>"7201900364"}, {"first_name"=>"Bhala", "last_name"=>"Kodkany", "scopus_author_id"=>"15122654200"}, {"first_name"=>"Stuart", "last_name"=>"Lipsitz", "scopus_author_id"=>"7005765736"}, {"first_name"=>"Angela", "last_name"=>"Lashoher", "scopus_author_id"=>"26324930800"}, {"first_name"=>"Gerald", "last_name"=>"Dziekan", "scopus_author_id"=>"57196418741"}, {"first_name"=>"Rajiv", "last_name"=>"Bahl", "scopus_author_id"=>"7005774403"}, {"first_name"=>"Mario", "last_name"=>"Merialdi", "scopus_author_id"=>"6602305913"}, {"first_name"=>"Matthews", "last_name"=>"Mathai", "scopus_author_id"=>"7005604180"}, {"first_name"=>"Claire", "last_name"=>"Lemer", "scopus_author_id"=>"26537499100"}, {"first_name"=>"Atul", "last_name"=>"Gawande", "scopus_author_id"=>"7003523910"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84861206091", "doi"=>"10.1371/journal.pone.0035151", "pui"=>"364837250", "pmid"=>"22615733", "scopus"=>"2-s2.0-84861206091", "issn"=>"19326203", "isbn"=>"1932-6203"}, "id"=>"34cd1596-e693-3a09-b16f-95165d76496c", "abstract"=>"BACKGROUND: Most maternal deaths, intrapartum-related stillbirths, and newborn deaths in low income countries are preventable but simple, effective methods for improving safety in institutional births have not been devised. Checklist-based interventions aid management of complex or neglected tasks and have been shown to reduce harm in healthcare. We hypothesized that implementation of the WHO Safe Childbirth Checklist program, a novel childbirth safety program for institutional births incorporating a 29-item checklist, would increase delivery of essential childbirth practices linked with improved maternal and perinatal health outcomes.\\n\\nMETHODS AND FINDINGS: A pilot, pre-post-intervention study was conducted in a sub-district level birth center in Karnataka, India between July and December 2010. We prospectively observed health workers that attended to women and newborns during 499 consecutively enrolled birth events and compared these with observed practices during 795 consecutively enrolled birth events after the introduction of the WHO Safe Childbirth Checklist program. Twenty-nine essential practices that target the major causes of childbirth-related mortality, such as hand hygiene and uterotonic administration, were evaluated. The primary end point was the average rate of successful delivery of essential childbirth practices by health workers. Delivery of essential childbirth-related care practices at each birth event increased from an average of 10 of 29 practices at baseline (95%CI 9.4, 10.1) to an average of 25 of 29 practices afterwards (95%CI 24.6, 25.3; p<0.001). There was significant improvement in the delivery of 28 out of 29 individual practices. No adverse outcomes relating to the intervention occurred. Study limitations are the pre-post design, potential Hawthorne effect, and focus on processes of care versus health outcomes.\\n\\nCONCLUSIONS: Introduction of the WHO Safe Childbirth Checklist program markedly improved delivery of essential safety practices by health workers. Future study will determine if this program can be implemented at scale and improve health outcomes.", "link"=>"http://www.mendeley.com/research/improving-quality-care-maternal-newborn-health-prospective-pilot-study-safe-childbirth-checklist-pro-15", "reader_count"=>148, "reader_count_by_academic_status"=>{"Unspecified"=>11, "Professor > Associate Professor"=>4, "Librarian"=>1, "Researcher"=>27, "Student > Doctoral Student"=>7, "Student > Ph. D. Student"=>22, "Student > Postgraduate"=>8, "Student > Master"=>36, "Other"=>9, "Student > Bachelor"=>8, "Lecturer"=>11, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>11, "Professor > Associate Professor"=>4, "Librarian"=>1, "Researcher"=>27, "Student > Doctoral Student"=>7, "Student > Ph. D. Student"=>22, "Student > Postgraduate"=>8, "Student > Master"=>36, "Other"=>9, "Student > Bachelor"=>8, "Lecturer"=>11, "Lecturer > Senior Lecturer"=>1, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>14, "Agricultural and Biological Sciences"=>7, "Philosophy"=>1, "Arts and Humanities"=>1, "Business, Management and Accounting"=>5, "Computer Science"=>2, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>7, "Environmental Science"=>1, "Nursing and Health Professions"=>18, "Mathematics"=>2, "Medicine and Dentistry"=>69, "Psychology"=>1, "Social Sciences"=>19}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>69}, "Social Sciences"=>{"Social Sciences"=>19}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>14}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>7}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>7}, "Computer Science"=>{"Computer Science"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>5}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>18}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Canada"=>1, "Netherlands"=>1, "United States"=>1, "South Africa"=>1, "United Kingdom"=>1, "Ghana"=>1, "Nigeria"=>1, "India"=>5, "Spain"=>3, "Indonesia"=>1}, "group_count"=>12}

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  • {"files"=>["https://ndownloader.figshare.com/files/637464"], "description"=>"<p>Observed in-facility mortality before and after intervention.</p>", "links"=>[], "tags"=>["in-facility"], "article_id"=>307949, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.t003", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Observed_in_facility_mortality_before_and_after_intervention_/307949", "title"=>"Observed in-facility mortality before and after intervention.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-05-16 02:12:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/637502"], "description"=>"a<p>Referred to study facility from another facility after labor started.</p>b<p>Attended fewer than 3 antenatal appointments.</p>", "links"=>[], "tags"=>["characteristics", "women", "newborns"], "article_id"=>307981, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.t002", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_characteristics_of_women_and_newborns_before_and_after_intervention_/307981", "title"=>"Demographic characteristics of women and newborns before and after intervention.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-05-16 02:13:01"}
  • {"files"=>["https://ndownloader.figshare.com/files/329036", "https://ndownloader.figshare.com/files/329137"], "description"=>"<div><h3>Background</h3><p>Most maternal deaths, intrapartum-related stillbirths, and newborn deaths in low income countries are preventable but simple, effective methods for improving safety in institutional births have not been devised. Checklist-based interventions aid management of complex or neglected tasks and have been shown to reduce harm in healthcare. We hypothesized that implementation of the WHO Safe Childbirth Checklist program, a novel childbirth safety program for institutional births incorporating a 29-item checklist, would increase delivery of essential childbirth practices linked with improved maternal and perinatal health outcomes.</p> <h3>Methods and Findings</h3><p>A pilot, pre-post-intervention study was conducted in a sub-district level birth center in Karnataka, India between July and December 2010. We prospectively observed health workers that attended to women and newborns during 499 consecutively enrolled birth events and compared these with observed practices during 795 consecutively enrolled birth events after the introduction of the WHO Safe Childbirth Checklist program. Twenty-nine essential practices that target the major causes of childbirth-related mortality, such as hand hygiene and uterotonic administration, were evaluated. The primary end point was the average rate of successful delivery of essential childbirth practices by health workers. Delivery of essential childbirth-related care practices at each birth event increased from an average of 10 of 29 practices at baseline (95%CI 9.4, 10.1) to an average of 25 of 29 practices afterwards (95%CI 24.6, 25.3; p<0.001). There was significant improvement in the delivery of 28 out of 29 individual practices. No adverse outcomes relating to the intervention occurred. Study limitations are the pre-post design, potential Hawthorne effect, and focus on processes of care versus health outcomes.</p> <h3>Conclusions</h3><p>Introduction of the WHO Safe Childbirth Checklist program markedly improved delivery of essential safety practices by health workers. Future study will determine if this program can be implemented at scale and improve health outcomes.</p> </div>", "links"=>[], "tags"=>["improving", "maternal", "newborn", "prospective", "childbirth", "checklist"], "article_id"=>124968, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0035151.s001", "https://dx.doi.org/10.1371/journal.pone.0035151.s002"], "stats"=>{"downloads"=>11, "page_views"=>44, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Improving_Quality_of_Care_for_Maternal_and_Newborn_Health_Prospective_Pilot_Study_of_the_WHO_Safe_Childbirth_Checklist_Program/124968", "title"=>"Improving Quality of Care for Maternal and Newborn Health: Prospective Pilot Study of the WHO Safe Childbirth Checklist Program", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-05-16 01:22:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/637426"], "description"=>"<p>Number of childbirth events observed at each period before and after intervention.</p>", "links"=>[], "tags"=>["childbirth", "events", "observed"], "article_id"=>307910, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.t001", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Number_of_childbirth_events_observed_at_each_period_before_and_after_intervention_/307910", "title"=>"Number of childbirth events observed at each period before and after intervention.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-05-16 02:11:50"}
  • {"files"=>["https://ndownloader.figshare.com/files/637189"], "description"=>"<p>Changes in rates of delivery of specific childbirth practices before and after intervention; (2a) On admission; (2b) From pushing until delivery; (2c) Soon after birth (within one hour); (2d); Before discharge (*P value = 0.052; all others p≤0.001).</p>", "links"=>[], "tags"=>["rates", "childbirth", "practices", "pushing", "discharge"], "article_id"=>307662, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.g002", "stats"=>{"downloads"=>2, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Changes_in_rates_of_delivery_of_specific_childbirth_practices_before_and_after_intervention_2a_On_admission_2b_From_pushing_until_delivery_2c_Soon_after_birth_within_one_hour_2d_Before_discharge_P_value_8202_8202_0_052_all_others_p_8804_0_001_/307662", "title"=>"Changes in rates of delivery of specific childbirth practices before and after intervention; (2a) On admission; (2b) From pushing until delivery; (2c) Soon after birth (within one hour); (2d); Before discharge (*P value = 0.052; all others p≤0.001).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-05-16 02:07:42"}
  • {"files"=>["https://ndownloader.figshare.com/files/637282"], "description"=>"<p>Frequency of initiation of medication therapy before and after intervention (*p<0.05).</p>", "links"=>[], "tags"=>["initiation"], "article_id"=>307768, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.g003", "stats"=>{"downloads"=>2, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Frequency_of_initiation_of_medication_therapy_before_and_after_intervention_p_lt_0_05_/307768", "title"=>"Frequency of initiation of medication therapy before and after intervention (*p<0.05).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-05-16 02:09:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/637090"], "description"=>"<p>Average rate of successful delivery of essential childbirth practices before and after intervention (p<0.001).</p>", "links"=>[], "tags"=>["childbirth", "practices"], "article_id"=>307574, "categories"=>["Biotechnology", "Cell Biology", "Mathematics", "Medicine"], "users"=>["Jonathan M. Spector", "Priya Agrawal", "Bhala Kodkany", "Stuart Lipsitz", "Angela Lashoher", "Gerald Dziekan", "Rajiv Bahl", "Mario Merialdi", "Matthews Mathai", "Claire Lemer", "Atul Gawande"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0035151.g001", "stats"=>{"downloads"=>3, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Average_rate_of_successful_delivery_of_essential_childbirth_practices_before_and_after_intervention_p_lt_0_001_/307574", "title"=>"Average rate of successful delivery of essential childbirth practices before and after intervention (p<0.001).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-05-16 02:06:14"}

PMC Usage Stats | Further Information

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Relative Metric

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