Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal

Malini Anand Nijagal; Stephanie Wissig; Caleb Stowell; Elizabeth Olson; Isis Amer-Wahlin; Gouke Bonsel; Allyson Brooks; Matthew Coleman; Shamala Devi Karalasingam; James M N Duffy; Tracy Flanagan; Stefan Gebhardt; Meridith E Greene; Floris Groenendaal; J Ravichandran R Jeganathan; Tessa Kowaliw; Marije Lamain-de-Ruiter; Elliott Main; Michelle Owens; Rod Petersen; Irwin Reiss; Carol Sakala; Anna Maria Speciale; Rachel Thompson; Oluwakemi Okunade; Arie Franx

doi:10.1186/s12913-018-3732-3

Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal

Malini Anand Nijagal, Stephanie Wissig, Caleb Stowell, Elizabeth Olson, Isis Amer-Wahlin, Gouke Bonsel, Allyson Brooks, Matthew Coleman, Shamala Devi Karalasingam, James M N Duffy, Tracy Flanagan, Stefan Gebhardt, Meridith E Greene, Floris Groenendaal, J Ravichandran R Jeganathan, Tessa Kowaliw, Marije Lamain-de-Ruiter, Elliott Main, Michelle Owens, Rod PetersenIrwin Reiss, Carol Sakala, Anna Maria Speciale, Rachel Thompson, Oluwakemi Okunade, Arie Franx

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.

METHODS: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set.

RESULTS: The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined.

CONCLUSIONS: We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care.

Original language	English
Article number	953
Journal	BMC Health Services Research
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12913-018-3732-3
Publication status	Published - 11 Dec 2018

Keywords

Consensus
DELPHI process
Delivery outcomes
Health outcomes
Obstetrics
Outcome measures
Patient-centred outcomes
Patient-reported
Perinatalhealth
Pregnancy
Perinatal health

Access to Document

10.1186/s12913-018-3732-3

s12913-018-3732-3Final published version, 571 KB

Cite this

Nijagal, M. A., Wissig, S., Stowell, C., Olson, E., Amer-Wahlin, I., Bonsel, G., Brooks, A., Coleman, M., Devi Karalasingam, S., Duffy, J. M. N., Flanagan, T., Gebhardt, S., Greene, M. E., Groenendaal, F., R Jeganathan, J. R., Kowaliw, T., Lamain-de-Ruiter, M., Main, E., Owens, M., ... Franx, A. (2018). Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal. BMC Health Services Research, 18(1), Article 953. https://doi.org/10.1186/s12913-018-3732-3

@article{f93f6669cb154910b9b8578bd448345f,

title = "Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal",

abstract = "BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.METHODS: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set.RESULTS: The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined.CONCLUSIONS: We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care.",

keywords = "Consensus, DELPHI process, Delivery outcomes, Health outcomes, Obstetrics, Outcome measures, Patient-centred outcomes, Patient-reported, Perinatalhealth, Pregnancy, Perinatal health",

author = "Nijagal, {Malini Anand} and Stephanie Wissig and Caleb Stowell and Elizabeth Olson and Isis Amer-Wahlin and Gouke Bonsel and Allyson Brooks and Matthew Coleman and {Devi Karalasingam}, Shamala and Duffy, {James M N} and Tracy Flanagan and Stefan Gebhardt and Greene, {Meridith E} and Floris Groenendaal and {R Jeganathan}, {J Ravichandran} and Tessa Kowaliw and Marije Lamain-de-Ruiter and Elliott Main and Michelle Owens and Rod Petersen and Irwin Reiss and Carol Sakala and Speciale, {Anna Maria} and Rachel Thompson and Oluwakemi Okunade and Arie Franx",

note = "Funding Information: This work was supported by the generous donations of the HCF Research Foundation, SA Health, Karolinska University Hospital, and Hoag Hospital. The funding institutions had no role in the design of the study nor in the collection, analysis and interpretation of the data or the writing of the manuscript. Publisher Copyright: {\textcopyright} 2018 The Author(s).",

year = "2018",

month = dec,

day = "11",

doi = "10.1186/s12913-018-3732-3",

language = "English",

volume = "18",

journal = "BMC Health Services Research",

issn = "1472-6963",

publisher = "BioMed Central",

number = "1",

}

Nijagal, MA, Wissig, S, Stowell, C, Olson, E, Amer-Wahlin, I, Bonsel, G, Brooks, A, Coleman, M, Devi Karalasingam, S, Duffy, JMN, Flanagan, T, Gebhardt, S, Greene, ME, Groenendaal, F, R Jeganathan, JR, Kowaliw, T, Lamain-de-Ruiter, M, Main, E, Owens, M, Petersen, R, Reiss, I, Sakala, C, Speciale, AM, Thompson, R, Okunade, O & Franx, A 2018, 'Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal', BMC Health Services Research, vol. 18, no. 1, 953. https://doi.org/10.1186/s12913-018-3732-3

TY - JOUR

T1 - Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal

AU - Nijagal, Malini Anand

AU - Wissig, Stephanie

AU - Stowell, Caleb

AU - Olson, Elizabeth

AU - Amer-Wahlin, Isis

AU - Bonsel, Gouke

AU - Brooks, Allyson

AU - Coleman, Matthew

AU - Devi Karalasingam, Shamala

AU - Duffy, James M N

AU - Flanagan, Tracy

AU - Gebhardt, Stefan

AU - Greene, Meridith E

AU - Groenendaal, Floris

AU - R Jeganathan, J Ravichandran

AU - Kowaliw, Tessa

AU - Lamain-de-Ruiter, Marije

AU - Main, Elliott

AU - Owens, Michelle

AU - Petersen, Rod

AU - Reiss, Irwin

AU - Sakala, Carol

AU - Speciale, Anna Maria

AU - Thompson, Rachel

AU - Okunade, Oluwakemi

AU - Franx, Arie

N1 - Funding Information: This work was supported by the generous donations of the HCF Research Foundation, SA Health, Karolinska University Hospital, and Hoag Hospital. The funding institutions had no role in the design of the study nor in the collection, analysis and interpretation of the data or the writing of the manuscript. Publisher Copyright: © 2018 The Author(s).

PY - 2018/12/11

Y1 - 2018/12/11

N2 - BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.METHODS: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set.RESULTS: The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined.CONCLUSIONS: We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care.

AB - BACKGROUND: Value-based health care aims to optimize the balance of patient outcomes and health care costs. To improve value in perinatal care using this strategy, standard outcomes must first be defined. The objective of this work was to define a minimum, internationally appropriate set of outcome measures for evaluating and improving perinatal care with a focus on outcomes that matter to women and their families.METHODS: An interdisciplinary and international Working Group was assembled. Existing literature and current measurement initiatives were reviewed. Serial guided discussions and validation surveys provided consumer input. A series of nine teleconferences, incorporating a modified Delphi process, were held to reach consensus on the proposed Standard Set.RESULTS: The Working Group selected 24 outcome measures to evaluate care during pregnancy and up to 6 months postpartum. These include clinical outcomes such as maternal and neonatal mortality and morbidity, stillbirth, preterm birth, birth injury and patient-reported outcome measures (PROMs) that assess health-related quality of life (HRQoL), mental health, mother-infant bonding, confidence and success with breastfeeding, incontinence, and satisfaction with care and birth experience. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were also defined.CONCLUSIONS: We propose a set of outcome measures for evaluating the care that women and infants receive during pregnancy and the postpartum period. While validation and refinement via pilot implementation projects are needed, we view this as an important initial step towards value-based improvements in care.

KW - Consensus

KW - DELPHI process

KW - Delivery outcomes

KW - Health outcomes

KW - Obstetrics

KW - Outcome measures

KW - Patient-centred outcomes

KW - Patient-reported

KW - Perinatalhealth

KW - Pregnancy

KW - Perinatal health

UR - http://www.scopus.com/inward/record.url?scp=85058346191&partnerID=8YFLogxK

U2 - 10.1186/s12913-018-3732-3

DO - 10.1186/s12913-018-3732-3

M3 - Article

C2 - 30537958

SN - 1472-6963

VL - 18

JO - BMC Health Services Research

JF - BMC Health Services Research

IS - 1

M1 - 953

ER -

Standardized outcome measures for pregnancy and childbirth, an ICHOM proposal

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this