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Title: Evaluation of quality improvement for cesarean sections caesarean section programmes through mixed methods.
Authors: Bermúdez-Tamayo, Clara
Johri, Mira
Perez-Ramos, Francisco Jose
Maroto-Navarro, Gracia
Caño-Aguilar, Africa
Garcia-Mochon, Leticia
Aceituno, Longinos
Audibert, François
Chaillet, Nils
metadata.dc.contributor.authoraffiliation: [Bermúdez-Tamayo,C] Centre de recherche du CHUS, Sherbrooke, Canada. [Bermúdez-Tamayo,C; Maroto-Navarro,G; Garcia-Mochon,L] Andalusian School of Public Health, Granada, Spain. [Bermúdez-Tamayo,C; Maroto-Navarro,G] CIBERESP, Ciber de Epidemiologia y Salud Publica, Valencia, Spain. [Johri,M] Division of Global Health, University of Montreal, Hospital Research Centre (CRCHUM), Montreal, Canada. Department of Health Administration, School of Public Health, University of Montreal, Montreal, Canada. [Perez-Ramos,FJ] General Secretary of Quality Innovation and Public Health, Consejería de Igualdad, Salud y Políticas Sociales, Junta de Andalucía, Sevilla, Spain. [Caño-Aguilar,A] UGC Obstetrics and Gynaecology, Hospital Universitario San Cecilio, Granada, Spain. [Aceituno,L] UGC Gynaecology, Hospital La Inmaculada, Huercal-Overa, Almeria, Spain. [Audibert,F] Department of Obstetrics and Gynecology, University of Montreal, Montreal, Canada. Sainte Justine Hospital, Montreal ,Canada. [Chaillet,N] Department of Obstetrics and Gynaecology, Université de Sherbrooke, Sherbrooke, Canada.
Keywords: Caesarean section;Clinical practice guidelines;Economic evaluation;España;Canadá;Análisis costo-beneficio;Cesárea;Guía de práctica clínica;Control de calidad
metadata.dc.subject.mesh: Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Obstetric Surgical Procedures::Delivery, Obstetric::Cesarean Section
Medical Subject Headings::Publication Characteristics::Publication Formats::Guideline::Practice Guideline
Medical Subject Headings::Technology, Industry, Agriculture::Technology, Industry, and Agriculture::Technology::Quality Control
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Geographicals::Geographic Locations::Americas::North America::Canada
Medical Subject Headings::Health Care::Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis
Issue Date: 11-Dec-2014
Publisher: BioMed Central
Citation: Bermúdez-Tamayo C, Johri M, Perez-Ramos FJ, Maroto-Navarro G, Caño-Aguilar A, Garcia-Mochon L, et al. Evaluation of quality improvement for cesarean sections caesarean section programmes through mixed methods. Implement Sci 2014; 9(1):182
Abstract: BACKGROUND The rate of avoidable caesarean sections (CS) could be reduced through multifaceted strategies focusing on the involvement of health professionals and compliance with clinical practice guidelines (CPGs). Quality improvements for CS (QICS) programmes (QICS) based on this approach, have been implemented in Canada and Spain. OBJECTIVES Their objectives are as follows: 1) Toto identify clusters in each setting with similar results in terms of cost-consequences, 2) Toto investigate whether demographic, clinical or context characteristics can distinguish these clusters, and 3) Toto explore the implementation of QICS in the 2 regions, in order to identify factors that have been facilitators in changing practices and reducing the use of obstetric intervention, as well as the challenges faced by hospitals in implementing the recommendations. METHODS Descriptive study with a quantitative and qualitative approach. 1) Cluster analysis at patient level with data from 16 hospitals in Quebec (Canada) (n = 105,348) and 15 hospitals in Andalusia (Spain) (n = 64,760). The outcome measures are CS and costs. For the cost, we will consider the intervention, delivery and complications in mother and baby, from the hospital perspective. Cluster analysis will be used to identify participants with similar patterns of CS and costs based, and t tests will be used to evaluate if the clusters differed in terms of characteristics: Hospital level (academic status of hospital, level of care, supply and demand factors), patient level (mother age, parity, gestational age, previous CS, previous pathology, presentation of the baby, baby birth weight). 2) Analysis of in-depth interviews with obstetricians and midwives in hospitals where the QICS were implemented, to explore the differences in delivery-related practices, and the importance of the different constructs for positive or negative adherence to CPGs. Dimensions: political/management level, hospital level, health professionals, mothers and their birth partner. DISCUSSION This work sets out a new approach for programme evaluation, using different techniques to make it possible to take into account the specific context where the programmes were implemented.
Description: Study Protocol; Journal Article; Research Support, Non-U.S. Gov't; Erratum publicado en Implementation Science (2016) 11:37. DOI 10.1186/s13012-016-0402-x
metadata.dc.identifier.doi: 10.1186/s13012-014-0182-0
ISSN: 1748-5908 (Online)
Appears in Collections:01- Artículos - AGS Norte de Almería
01- Artículos - Consejería de Salud y Consumo
01- Artículos - EASP. Escuela Andaluza de Salud Pública
01- Artículos - Hospital San Cecilio

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