ABSTRACT
OBJECTIVES: to propose a composite indicator for maternity hospital classification. DESIGN: descriptive analysis of maternity hospitals through a composite indicator and analysis of its association with infant readmissions within 30 days from the childbirth. SETTING AND PARTICIPANTS: 56 maternity units in Sicily, accounting for 44.436 newborns in 2014. MAIN OUTCOME MEASURES: infant readmission rates within 30 days from the childbirth. RESULTS: low-level hospitals show higher infant readmission rates (odds ratio: 1.3) which may be seen as a signal of inappropriateness of maternity care. CONCLUSIONS: the proposed indicator allows for a classification of maternity hospitals taking into account for different dimensions of the quality of care; it allows the identification of critical signals related to the considered dimensions.
Subject(s)
Hospitals, Maternity/classification , Quality Indicators, Health Care , Adult , Cesarean Section/statistics & numerical data , Female , Hospitals, Maternity/statistics & numerical data , Humans , Infant, Newborn , Intensive Care Units, Neonatal/statistics & numerical data , Logistic Models , Patient Readmission/statistics & numerical data , Patient Transfer/statistics & numerical data , Pregnancy , Procedures and Techniques Utilization , Quality of Health Care , SicilyABSTRACT
Creating an environment that optimally supports exclusive breastfeeding can require a cultural transformation. Our initial attempt at obtaining Baby-Friendly Hospital Initiative (BFHI) designation was unsuccessful when surveyors determined insufficient enculturation of BFHI practices. Using Kotter's theory of change, we overcame the barriers, enhanced our practices, and effectively transformed the culture, and our facility ultimately became the first maternity hospital in Pennsylvania to obtain BFHI designation. Nursing leadership was essential to this process. Our experience serves as a template for others seeking to achieve Healthy People 2020 goals related to breastfeeding.
Subject(s)
Breast Feeding/trends , Hospitals, Maternity/classification , Nursing Process/standards , Organizational Innovation , Accreditation , Breast Feeding/methods , Breast Feeding/psychology , Education, Nursing, Continuing/trends , Female , Hospitals, Maternity/standards , Humans , Infant Care/methods , Infant Care/standards , Infant, Newborn , Nursing Process/trends , Postnatal Care/methods , Pregnancy , Program Development/methods , Program Evaluation/methods , Surveys and QuestionnairesABSTRACT
We aimed to develop a maternity hospital classification, using stable and easily available criteria, that would have wide application in maternity services research and allow comparison across state, national and international jurisdictions. A classification with 13 obstetric groupings (12 hospital groups and home births) was based on neonatal care capability, urban and rural location, annual average number of births and public/private hospital status. In a case study of early elective birth we demonstrate that neonatal morbidity differs according to the maternity hospital classification, and also that the 13 groups can be collapsed in ways that are pragmatic from a clinical and policy decision-making perspective, and are manageable for analysis.
Subject(s)
Hospitals, Maternity/classification , Maternal Health Services , Birth Rate , Female , Health Services Research , Hospitals, Private/classification , Hospitals, Public/classification , Humans , Infant, Newborn , Perinatal Care , PregnancyABSTRACT
Al mismo tiempo, la sociedad tradicional nos envuelve en otra contradicción. Por un lado, exalta la maternidad como la suprema función de las mujeres, relacionándola con la fertilidad de la tierra y los atributos de la diosas tutelares de la humanidad
Subject(s)
Humans , Maternal Welfare/classification , Hospitals, Maternity/classification , Maternal and Child Health , Maternal Health Services , Bolivia , Fertility , Women's HealthABSTRACT
Los objetivos de la asesoria fueron: Presentar a las autoridades nacionales de salud un método para detectar la prevalencia de malformaciones congénitas con una vigilancia basada en varias maternidades del país. Diseñar los formularios a utilizarse en esta vigilancia. Contactar a los responsables de las maternidades elegidas por las autoridades para participar del estudio e introducir la mecánica de la vigilancia
