title: Promoting antenatal steroid use for fetal maturation: results from the California Perinatal Quality Care Collaborative.
abstract: OBJECTIVE
  The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before preterm (24 to 33 weeks of gestation) delivery. We hypothesized that mean performance would improve and the number of centers performing below the lowest quartile of the baseline year would decrease.
  
  
  METHODS
  In 1998, a statewide QI cycle targeting antenatal steroid use was announced, calling for the evaluation of the 1998 baseline data, dissemination of recommended interventions using member-developed educational materials, and presentations to California neonatologists in 1999-2000. Postintervention data were assessed for the year 2001 and publicly released in 2003. A total of 25 centers voluntarily participated in the intervention.
  
  
  RESULTS
  Antenatal steroid administration rate increased from 76% of 1524 infants in 1998 to 86% of 1475 infants in 2001 (P < .001). In 2001, 23 of 25 hospitals exceeded the 1998 lower-quartile cutoff point of 69.3%.
  
  
  CONCLUSIONS
  Regional collaborations represent an effective strategy for improving the quality of perinatal care.
authors.affiliation: California Perinatal Quality Care Collaborative, Palo Alto, California, USA. david.wirtschafter@juno.com
authors.forename: David D
authors.initials: DD
authors.lastname: Wirtschafter
authors.forename: Beate H
authors.initials: BH
authors.lastname: Danielsen
authors.forename: Elliott K
authors.initials: EK
authors.lastname: Main
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Korst
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Gregory
authors.forename: Andrew
authors.initials: A
authors.lastname: Wertz
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Gould
mesh_terms: D002140:California; D016208:Databases, Factual; D017723:Drug Utilization Review; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D019983:Guideline Adherence; D006764:Hospitals, Community; D006769:Hospitals, General; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D018743:Perinatal Care; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*
chemical_list: D013256:Steroids