A Quality of Health Outcomes Model for guiding obstetrical practice.
OBJECTIVE
To describe the application of the Quality of Health Outcomes Model, introduced by the American Academy of Nursing Expert Panel on Quality of Health Care, to obstetrical care, particularly second-stage labor.


METHODS
The model is different from the more linear structure-process-outcome frameworks used in the past to a dynamic conceptualization of reciprocal relationships among the system, intervention, client, and outcome components. Analysis of these components can provide a comprehensive picture of the complexity of patient care decision making in hospital labor and delivery units.


CONCLUSIONS
Research findings indicate that interventions such as cesarean delivery and epidural analgesia may result in several significant quality of health outcomes for women that should receive increased attention. Uses of this model for shaping best practices among physicians and nurses and for setting directions for priorities in future interdisciplinary research and health policy are discussed.
Mayberry
L J
LJ
Division of Nursing, School of Education, New York University, 246 Greene Street, New York, NY 10012-1165, USA. linda.mayberry@nyu.edu
Gennaro
S
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D019985:Benchmarking / Q000458:organization & administration; D003659:Decision Making, Organizational; D036861:Delivery, Obstetric / Q000592:standards*; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D008427:Maternal Health Services / Q000592:standards*; D017146:Models, Organizational; D009773:Obstetric Nursing / Q000592:standards*; D009774:Obstetrics / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000592:standards*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D013597:Systems Analysis; D017749:Total Quality Management / Q000458:organization & administration