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Eur J Obstet Gynecol Reprod Biol. 2013 Jan;166(1):23-9. doi: 10.1016/j.ejogrb.2012.09.018. Epub 2012 Oct 13.

Intrapartum care quality indicators: a systematic approach for achieving consensus.

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Department of Obstetrics and Gynaecology, Hutt Hospital, Hutt Valley District Health Board, New Zealand.



To identify published maternity intrapartum quality indicators and rationalise them to a core set.


Prospective qualitative consensus group exercise. A literature search identified sets of intrapartum quality indicators in the English language. These were rationalised to a shortlist using criteria adapted from 'The Good Clinical Indicator Guide'. An expert panel from key UK professions and organisations utilised a modified Delphi process to devise a final agreed set of intrapartum quality indicators that are specific, measurable, modifiable and relevant to clinical practice. Each indicator was rated in two rounds of web-based surveys, followed by a final face-to-face meeting of the panel.


290 clinical indicators were identified within 96 clinical categories with up to 18 different definitions. After rationalisation, 10 core and 24 additional quality indicators entered the Delphi process. A final panel of 12 indicators was defined.


By using a simple Delphi process we have defined a set of broad clinical quality indicators that provide a comprehensive coverage of labour and delivery outcomes. We believe that this pragmatic portfolio will be useful for many wishing to develop performance monitoring and maternity dashboard systems.

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