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Improving Midwifery Practice: The American College of Nurse-Midwives' Benchmarking Project


  • Cathy Collins-Fulea CNM, MSN,

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    • Cathy Collins-Fulea, CNM, MSN, FACNM, is Section Head, Midwifery for the Henry Ford Health System, in Detroit, Michigan. She is the current Chair of the Division of Standards and Practice for the American College of Nurse-Midwives, and the past chair of the Section of Quality Management. She has led the ACNM Benchmarking Project since its inception.

  • Julie J. Mohr MSPH, PhD,

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    • Julie J. Mohr, MSPH, PhD, is Assistant Professor in the Department of Medicine at the University of Chicago, and Director of Research for the American Board of Medical Specialties. Dr. Mohr was involved in the initial efforts of the ACNM Benchmarking Project to provide education about the benchmarking process and support and direction for the ACNM efforts.

  • Jackie Tillett CNM, ND

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    • Jackie Tillett, CNM, ND, is Director of Midwifery, University of Wisconsin Medical School, Milwaukee Clinical Campus. She is currently the Chair of the Quality Management Section of the Division of Standards and Practice for ACNM. She has been involved with the ACNM Benchmarking Project since its inception.

Cathy Collins-Fulea, 2955 Skyline Drive, Windsor, Ontario, Canada, N9E 3A6. E-mail:


Quality management in clinical practice involves the use of numerous techniques that monitor the quality of care clinicians provide. Quality improvement is an approach to quality management that emphasizes system and processes, rather than a focus on individual performance. Quality improvement examines objective data to improve these processes, even when high standards of performance appear to have been met. Benchmarking measures one's processes and outcomes against “best in class” and is a part of a quality improvement program. By using benchmarking to provide goals for realistic process improvement and identification of the most efficient and effective methods of meeting all of their customer's needs, health care providers can document their effectiveness in terms of cost, quality, and satisfaction. This article details the American College of Nurse-Midwives' benchmarking project and presents benchmarks for obstetric practice from the year 2004.