Quality indicators for continuous monitoring to improve maternal and infant health in maternity departments: a modified Delphi survey of an international multidisciplinary panel

PLoS One. 2013;8(4):e60663. doi: 10.1371/journal.pone.0060663. Epub 2013 Apr 5.


Objective: Measuring the quality of inpatient obstetrical care using quality indicators is becoming increasingly important for both patients and healthcare providers. However, there is no consensus about which measures are optimal. We describe a modified Delphi method to identify a set of indicators for continuously monitoring the quality of maternity care by healthcare professionals.

Methodology and main findings: An international French-speaking multidisciplinary panel comprising 22 obstetricians-gynaecologists, 12 midwives, and 1 paediatrician assessed potential indicators extracted from a medical literature search, using a two-round Delphi procedure followed by a physical meeting. Each panellist rated each indicator based on validity and feasibility. In the first round, 35 panellists from 5 countries and 20 maternity units evaluated 26 indicators including 15 related to the management of the overall population of pregnant women, 3 to the management of women followed from the first trimester of pregnancy, 2 to the management of low-risk pregnant women, and 6 to the management of neonates. 25 quality indicators were kept for next step. In the second round, 27 (27/35: 77%) panellists selected 17 indicators; the remaining 8 indicators were discussed during a physical meeting. The final set comprised 18 indicators.

Conclusion: A multidisciplinary panel selected indicators that reflect the quality of obstetrical care. This set of indicators could be used to assess and monitor obstetrical care, with the goal of improving the quality of care in maternity units.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Data Collection*
  • Expert Testimony*
  • Feasibility Studies
  • Female
  • Health*
  • Hospital Departments / standards*
  • Humans
  • Infant
  • Internationality*
  • Mothers*
  • Obstetrics / standards
  • Pregnancy
  • Quality of Health Care / statistics & numerical data*

Grant support

This work was supported by the Réseau Mère-Enfant de la Francophonie. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.