A RACOG sponsored pilot study of a quality assurance program regarding management of labour by provincial Fellows. Royal Australian College of Obstetricians and Gynaecologists.
OBJECTIVE
To develop an effective and practical self-administered obstetric audit program for use by clinicians within their own practice.


METHODS
The private and public practices of specialists in provincial practice.


METHODS
Two periods of 3 months in each Fellow's practice, separated by a period of 3 months to allow for data review, resulting in the review of management of 6708 singleton births.


METHODS
All provincial Fellows in active practice in Australia in early 1998 were invited to take part in a voluntary 'quality cycle' obstetric practice audit. The data from the first 3 month period was fed back to participating Fellows for review before a second 3-month audit period was undertaken.


RESULTS
One hundred and twenty provincial Fellows were invited to take part; 62 registered for the study, 58 commenced the project, and 52 completed the entire cycle. 60.1% of the 6708 women studied laboured spontaneously, 25.8% had labour induced, and 14.1% had elective Caesarean sections. 87.8% of the 5759 women who laboured gave birth vaginally. There was little change in the incidence of intervention in labour between the first and second study periods.


CONCLUSIONS
It is possible to design a worthwhile self-administered clinical audit in obstetric practice with which specialists in full-time practice can cope and which provides useful personalised feedback for the specialist.
Humphrey
M D
MD
Department of Obstetrics and Gynaecology, North Queensland Clinical School, The University of Queensland, Australia.
Maher
C F
CF
Panjari
M
M
D001315:Australia; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008485:Medical Audit; D009774:Obstetrics / Q000592:standards*; D010865:Pilot Projects; D011247:Pregnancy; D011364:Professional Practice / Q000592:standards*; D011785:Quality Assurance, Health Care; D012955:Societies, Medical; D011795:Surveys and Questionnaires