Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| Outros Autores: | , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/31406 |
Resumo: | Agência Nacional de Saúde Suplementar. Diretoria de Desenvolvimento Setorial. Rio de Janeiro, RJ, Brasil. |
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Torres, Jacqueline AlvesLeal, Maria do CarmoDomingues, Rosa Maria Soares MadeiraEsteves-Pereira, Ana PaulaNakano, Andreza RodriguesGomes, Maysa LuduviceFigueiró, Ana ClaudiaNakamura-Pereira, MarcosOliveira, Elaine Fernandes Viellas deAyres, Bárbara Vasques da SilvaSandall, JaneBelizán, José M.Hartz, Zulmira Maria de Araújo2019-02-04T17:22:24Z2019-02-04T17:22:24Z2018TORRES, Jacqueline Alves et al. Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol. Reproductive Health, v. 15, n. 1, p. 194, 2018.1742-4755https://www.arca.fiocruz.br/handle/icict/3140610.1186/s12978-018-0636-yengBMC (part os Springer Nature)Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocolinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleAgência Nacional de Saúde Suplementar. Diretoria de Desenvolvimento Setorial. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Rio de Janeiro. Faculdade de Enfermagem. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.King's College London. Department of Women and children's Health. London, England.Institute for Clinical Effectiveness and Health Policy (IECS). Buenos Aires, Argentina.Universidade Nova de Lisboa. Instituto de Higiene e Medicina Tropical. Lisboa, Portugal.Background: In Brazilian private hospitals, caesarean section (CS) is almost universal (88%) and is integrated into the model of birth care. A quality improvement intervention, “Adequate Birth” (PPA), based on four driving components (governance, participation of women and families, reorganisation of care, and monitoring), has been implemented to help 23 hospitals reduce their CS rate. This is a protocol designed to evaluate the implementation of PPA and its effectiveness at reducing CS as a primary outcome of birth care. Methods: Case study of PPA intervention conducted in 2017/2018. We integrated quantitative and qualitative methods into data collection and analysis. For the quantitative stage, we selected a convenient sample of twelve hospitals. In each of these hospitals, we included 400 women. This resulted in a total sample of 4800 women. We used this sample to detect a 2.5% reduction in CS rate. We interviewed managers and puerperal women, and extracted data from hospital records. In the qualitative stage, we evaluated a subsample of eight hospitals by means of systematic observation and semi-structured interviews with managers, health professionals and women. We used specific forms for each of the four PPA driving components. Forms for managers and professionals addressed the decision-making process, implemented strategies, participatory process in strategy design, and healthcare practice. Forms for women and neonatal care addressed socio-economic, demographic and health condition; prenatal and birth care; tour of the hospital before delivery; labour expectation vs. real experience; and satisfaction with care received. We will estimate the degree of implementation of PPA strategies related to two of the four driving components: “participation of women and families” and “reorganisation of care”. We will then assess its effect on CS rate and secondary outcomes for each of the twelve selected hospitals, and for the total sample. To allow for clinical, socio-demographic and obstetric characteristics in women, we will conduct multivariate analysis. Additionally, we will evaluate the influence of internal context variables (the PPA driving components “governance” and “monitoring”) on the degree of implementation of the components “participation of women and families” and “reorganisation of care”, by means of thematic content analysis. This analysis will include both quantitative and qualitative data. Discussion: The effectiveness of quality improvement interventions that reduce CS rates requires examination. This study will identify strategies that could promote healthier births.Caesarean sectionHealth evaluationImplementation researchMaternal and child healthParturitioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/31406/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALEvaluation of a quality_Rosa_Domingues_INI_2018.pdfEvaluation of a quality_Rosa_Domingues_INI_2018.pdfapplication/pdf1549463https://www.arca.fiocruz.br/bitstream/icict/31406/2/Evaluation%20of%20a%20quality_Rosa_Domingues_INI_2018.pdf1e8e0dbe9190f8c2d582e45074f9babbMD52TEXTEvaluation of a quality_Rosa_Domingues_INI_2018.pdf.txtEvaluation of a quality_Rosa_Domingues_INI_2018.pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| title |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| spellingShingle |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol Torres, Jacqueline Alves Caesarean section Health evaluation Implementation research Maternal and child health Parturition |
| title_short |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| title_full |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| title_fullStr |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| title_full_unstemmed |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| title_sort |
Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol |
| author |
Torres, Jacqueline Alves |
| author_facet |
Torres, Jacqueline Alves Leal, Maria do Carmo Domingues, Rosa Maria Soares Madeira Esteves-Pereira, Ana Paula Nakano, Andreza Rodrigues Gomes, Maysa Luduvice Figueiró, Ana Claudia Nakamura-Pereira, Marcos Oliveira, Elaine Fernandes Viellas de Ayres, Bárbara Vasques da Silva Sandall, Jane Belizán, José M. Hartz, Zulmira Maria de Araújo |
| author_role |
author |
| author2 |
Leal, Maria do Carmo Domingues, Rosa Maria Soares Madeira Esteves-Pereira, Ana Paula Nakano, Andreza Rodrigues Gomes, Maysa Luduvice Figueiró, Ana Claudia Nakamura-Pereira, Marcos Oliveira, Elaine Fernandes Viellas de Ayres, Bárbara Vasques da Silva Sandall, Jane Belizán, José M. Hartz, Zulmira Maria de Araújo |
| author2_role |
author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Torres, Jacqueline Alves Leal, Maria do Carmo Domingues, Rosa Maria Soares Madeira Esteves-Pereira, Ana Paula Nakano, Andreza Rodrigues Gomes, Maysa Luduvice Figueiró, Ana Claudia Nakamura-Pereira, Marcos Oliveira, Elaine Fernandes Viellas de Ayres, Bárbara Vasques da Silva Sandall, Jane Belizán, José M. Hartz, Zulmira Maria de Araújo |
| dc.subject.en.pt_BR.fl_str_mv |
Caesarean section Health evaluation Implementation research Maternal and child health Parturition |
| topic |
Caesarean section Health evaluation Implementation research Maternal and child health Parturition |
| description |
Agência Nacional de Saúde Suplementar. Diretoria de Desenvolvimento Setorial. Rio de Janeiro, RJ, Brasil. |
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2018 |
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2018 |
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2019-02-04T17:22:24Z |
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2019-02-04T17:22:24Z |
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TORRES, Jacqueline Alves et al. Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol. Reproductive Health, v. 15, n. 1, p. 194, 2018. |
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https://www.arca.fiocruz.br/handle/icict/31406 |
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1742-4755 |
| dc.identifier.doi.none.fl_str_mv |
10.1186/s12978-018-0636-y |
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TORRES, Jacqueline Alves et al. Evaluation of a quality improvement intervention for labour and birth care in Brazilian private hospitals: a protocol. Reproductive Health, v. 15, n. 1, p. 194, 2018. 1742-4755 10.1186/s12978-018-0636-y |
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