title: Effectiveness of a multifaceted strategy to improve the appropriateness of cesarean sections.
abstract: The objective was to assess the effectiveness of a multifaceted strategy for improving the appropriateness of indications for cesarean sections in two public Spanish hospitals. A multifaceted strategy was used including the adoption of a consensus protocol with indications for emergency and prescheduled cesarean sections, continuing education and improvement, and the correction of deficiencies in organization. A pre and post-intervention design was applied. The overall appropriateness rates for emergency cesarean sections increased from 68.3 to 84.3% in Son Llatzer Hospital, and from 80.0 to 92.0% in the hospital in Menorca. The overall cesarean section rates at the end of the post-intervention period decreased (not statistically significant) from 17.5 to 15.8% and from 29.0 to 22.0%, respectively. The multifaceted strategy applied seems to be effective in increasing the appropriateness of cesarean sections and possibly in decreasing the cesarean section rate.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital of Manacor, Carretera Manacor-Alcudia s/n, Manacor, Mallorca, Spain. acalvo@hospitalmanacor.org
authors.forename: Andrés
authors.initials: A
authors.lastname: Calvo
authors.forename: Carlos
authors.initials: C
authors.lastname: Campillo
authors.forename: Miguel
authors.initials: M
authors.lastname: Juan
authors.forename: Catalina
authors.initials: C
authors.lastname: Roig
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Hermoso
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Cabeza
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D002985:Clinical Protocols; D003657:Decision Making; D004630:Emergencies; D005260:Female; D006801:Humans; D011247:Pregnancy; D013030:Spain