title: [Perinatal audit in the North of the Netherlands: the first 2 years].
abstract: OBJECTIVE
  Description of the implementation of local audit meetings and the identified substandard factors, points of special interest, actions for improvement and the opinion of the participating health care providers.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  A new organisation and methodology for perinatal mortality audit meetings was introduced in 15 collaborative structures in the northern part of the Netherlands in the period September 2007 to March 2010. During these multidisciplinary audit meetings, cases of perinatal mortality selected by the obstetric collaborative group were discussed in a structured way under the direction of an independent chairman.
  
  
  RESULTS
  In total 64 audit meetings were held, in which 677 perinatal health care providers took part at least once, and 112 cases of perinatal death were evaluated. 163 substandard factors were identified. These included : not following the protocol, guideline, standard (31%) or usual care (23%) and insufficient documentation (28%) and communication between health care providers (13%). 442 actions to improve care were reported divided over: 'external collaboration' (15%), 'internal collaboration' (17%), 'practice management' (26%) and 'training and education' (10%). The most valued aspects of the audit meetings were: their multidisciplinary character, the collaborative search for substandard factors, their security, the learning effect and the positive effect on collaboration.
  
  
  CONCLUSIONS
  Cases of perinatal mortality were discussed in all 15 perinatal collaborative structures in the northern part of the Netherlands. Substandard factors were identified, but further analysis of these factors merits attention. The participants concluded that the multidisciplinary approach and the collaboration during the audit meetings improved the cooperation between perinatal health care providers.
authors.affiliation: Universitair Medisch Centrum Groningen, Afd. Obstetrie en Gynaecologie, Groningen, the Netherlands. m.t.van.diem@og.umcg.nl
authors.forename: Mariet Th
authors.initials: MT
authors.lastname: van Diem
authors.forename: Klasien A
authors.initials: KA
authors.lastname: Bergman
authors.forename: Katelijne
authors.initials: K
authors.lastname: Bouman
authors.forename: Nico
authors.initials: N
authors.lastname: van Egmond
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Stant
authors.forename: Albertus
authors.initials: A
authors.lastname: Timmer
authors.forename: Lida H M
authors.initials: LH
authors.lastname: Ulkeman
authors.forename: Wenda B
authors.initials: WB
authors.lastname: Veen
authors.forename: Jan Jaap H M
authors.initials: JJ
authors.lastname: Erwich
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D008485:Medical Audit; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D018743:Perinatal Care / Q000379:methods / Q000592:standards*; D054238:Perinatal Mortality; D011247:Pregnancy