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A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium

(2017) MIDWIFERY. 48. p.60-68
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Abstract
Objective: to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. Design: key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). Setting: Flanders, Belgium Participants: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. Findings: after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. Key conclusions and implications for clinical practice: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.
Keywords
RANDOMIZED CONTROLLED-TRIAL, BREAST-FEEDING SUPPORT, FOLLOW-UP VISITS, LENGTH-OF-STAY, HOSPITAL DISCHARGE, HOME, READMISSION, MOTHERS, DURATION, NEWBORNS, Maternity Care, Quality indicators, Postnatal care, Length of stay, Delphi-survey

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Citation

Please use this url to cite or link to this publication:

MLA
Helsloot, Kaat et al. “A Systematic Approach Towards the Development of Quality Indicators for Postnatal Care After Discharge in Flanders, Belgium.” MIDWIFERY 48 (2017): 60–68. Print.
APA
Helsloot, K., Walraevens, M., Van Besauw, S., Van Parys, A.-S., Devos, H., Van Holsbeeck, A., & Roelens, K. (2017). A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium. MIDWIFERY, 48, 60–68.
Chicago author-date
Helsloot, Kaat, Mieke Walraevens, Saskia Van Besauw, An-Sofie Van Parys, Hanne Devos, Ann Van Holsbeeck, and Kristien Roelens. 2017. “A Systematic Approach Towards the Development of Quality Indicators for Postnatal Care After Discharge in Flanders, Belgium.” Midwifery 48: 60–68.
Chicago author-date (all authors)
Helsloot, Kaat, Mieke Walraevens, Saskia Van Besauw, An-Sofie Van Parys, Hanne Devos, Ann Van Holsbeeck, and Kristien Roelens. 2017. “A Systematic Approach Towards the Development of Quality Indicators for Postnatal Care After Discharge in Flanders, Belgium.” Midwifery 48: 60–68.
Vancouver
1.
Helsloot K, Walraevens M, Van Besauw S, Van Parys A-S, Devos H, Van Holsbeeck A, et al. A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium. MIDWIFERY. 2017;48:60–8.
IEEE
[1]
K. Helsloot et al., “A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium,” MIDWIFERY, vol. 48, pp. 60–68, 2017.
@article{8540676,
  abstract     = {Objective: to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. 
Design: key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). 
Setting: Flanders, Belgium 
Participants: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. 
Findings: after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. 
Key conclusions and implications for clinical practice: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.},
  author       = {Helsloot, Kaat and Walraevens, Mieke and Van Besauw, Saskia and Van Parys, An-Sofie and Devos, Hanne and Van Holsbeeck, Ann and Roelens, Kristien},
  issn         = {0266-6138},
  journal      = {MIDWIFERY},
  keywords     = {RANDOMIZED CONTROLLED-TRIAL,BREAST-FEEDING SUPPORT,FOLLOW-UP VISITS,LENGTH-OF-STAY,HOSPITAL DISCHARGE,HOME,READMISSION,MOTHERS,DURATION,NEWBORNS,Maternity Care,Quality indicators,Postnatal care,Length of stay,Delphi-survey},
  language     = {eng},
  pages        = {60--68},
  title        = {A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium},
  url          = {http://dx.doi.org/10.1016/j.midw.2017.02.008},
  volume       = {48},
  year         = {2017},
}

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