A descriptive model of preventability in maternal morbidity and mortality.
OBJECTIVE
To develop a descriptive model of preventability for maternal morbidity and mortality that can be used in quality assurance and morbidity and mortality review processes.


METHODS
This descriptive study was part of a larger case-control study conducted at the University of Illinois at Chicago in which maternal deaths were cases and women with severe maternal morbidity served as controls. Morbidities and mortalities were classified by a team of clinicians as preventable or not preventable. Qualitative analysis of data was conducted to identify and categorize different types of preventable events.


RESULTS
Of 237 women, there were 79 women with preventable events attributable to provider or system factors. The most common types of preventable events were inadequate diagnosis/recognition of high-risk (54.4%), treatment (38.0%), and documentation (30.7%).


CONCLUSIONS
A descriptive model was illustrated that can be used to categorize preventable events in maternal morbidity and mortality and can be incorporated into quality assurance and clinical case review to enhance the monitoring of hospital-based obstetric care and to decrease medical error.
Geller
S E
SE
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA. sgeller@uic.edu
Cox
S M
SM
Kilpatrick
S J
SJ
D000328:Adult; D002423:Cause of Death; D002641:Chicago / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006785:Hospitals, University; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality / Q000639:trends*; D009017:Morbidity / Q000639:trends; D010298:Parity; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control*; D011256:Pregnancy Outcome / Q000208:ethnology; D011295:Prenatal Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods*; D011336:Probability; D011379:Prognosis; D012720:Severity of Illness Index