title: Use of quality indicators by obstetric caregivers in the Netherlands: A descriptive study.
abstract: OBJECTIVE
  To evaluate the use of quality indicators by obstetric caregivers in hospitals in the Netherlands.
  
  
  METHODS
  An anonymous, self-administered survey was conducted in a convenience sample of obstetricians and clinical midwives in Dutch hospitals. Descriptive statistics were used to analyse the data, both for all caregivers and stratified by hospital setting and profession (obstetricians and midwives). Differences between strata were tested at a 5% significance level.
  
  
  RESULTS
  The response rate to the online questionnaire was 61% (n=171/279). Of all respondents 83% were aware of the quality indicators and 63% contributed to their registration. Caregivers received information about the indicators by mail or in meetings according to 64% (internal indicators) and 48% (external indicators) of the respondents. Of the respondents 56% (internal indicators) and 41% (external indicators) stated to use the results of indicators when designing plans to improve the quality of care.
  
  
  CONCLUSIONS
  We conclude that obstetric quality indicators are not widely used by obstetricians and midwives in Dutch hospitals to improve quality of care. To improve quality of care and the effective use of quality indicators we suggest to focus first on registering outcome indicators. These indicators should be implemented in quality structures that ensure that action is taken.
authors.affiliation: Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, The Netherlands. Electronic address: eveliencellissen@ziggo.nl.
authors.forename: Evelien
authors.initials: E
authors.lastname: Cellissen
authors.affiliation: University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
authors.affiliation: University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Kit C B
authors.initials: KCB
authors.lastname: Roes
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008880:Midwifery; D009426:Netherlands; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000592:standards*
keywords: Obstetrics; Quality improvement; Quality indicators; Quality of care