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CMAJ. 2000 Oct 31;163(9):1163-6.

Induction of labour: a continuous quality improvement and peer review program to improve the quality of care.

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Birthing Program, British Columbia's Women's Hospital and Health Centre, Vancouver.

Erratum in

  • CMAJ 2001 Jan 9;164(1):16. Gryzbowski, S [corrected to Grzybowski, S].


This article describes a program developed to improve the process of planned induction of labour and to reduce the rates of inappropriate induction. The setting is a tertiary-care maternity hospital in urban Vancouver, BC, in which 7000 deliveries take place annually. Approximately 65% of these can be considered primary care; the remainder are secondary- or tertiary-level cases. Continuous quality improvement (CQI) methods were used by a multidisciplinary team, which included nursing staff, physicians, health records personnel and a CQI facilitator. Interventions included the development of a new induction-booking process, clear criteria for induction, feedback to caregivers about changes and a peer review system to oversee and maintain improvement. The overall induction rate for the institution decreased, and this change has been maintained.

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