Introducing maternal morbidity audit in the Netherlands.
OBJECTIVE
To describe the panel audit process and to identify substandard care in selected women from a nationwide prospective cohort study into severe acute maternal morbidity (SAMM) in the Netherlands.


METHODS
Prospective audit of selected women with SAMM.


METHODS
Eight audit meetings held throughout the Netherlands.


METHODS
All pregnant women in the Netherlands.


METHODS
Before each meeting, SAMM details of selected women were sent to all panel members for individual assessment by completing an audit form. During a subsequent plenary meeting, findings were discussed and substandard care factors as judged by the majority of assessors were scored.


METHODS
Incidence of substandard care and recommendations for improving the quality of care.


RESULTS
Substandard care was identified in 53 of 67 women (79%). Specific recommendations were formulated concerning the procedure of audit and concerning local as well as national management guidelines.


CONCLUSIONS
Our findings reflect SAMM in the Netherlands and substandard care is present in four out of five women. Ongoing audit of women with SAMM is promoted both at local and national level.
van Dillen
J
J
Department of Obstetrics, Leiden University Medical Centre, Albinusdreef 2, Leiden, The Netherlands. gwamupanda@caiway.nl
Mesman
J A J M
JA
Zwart
J J
JJ
Bloemenkamp
K W M
KW
van Roosmalen
J
J
D005260:Female; D006801:Humans; D008428:Maternal Mortality; D008485:Medical Audit; D009017:Morbidity; D009426:Netherlands / Q000453:epidemiology; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011295:Prenatal Care / Q000592:standards*; D011446:Prospective Studies; D011787:Quality of Health Care