Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart
Article first published online: 18 JUN 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 10, pages 1225–1235, September 2010
How to Cite
Boulkedid, R., Sibony, O., Bossu-Salvador, C., Oury, J. and Alberti, C. (2010), Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 1225–1235. doi: 10.1111/j.1471-0528.2010.02632.x
- Issue published online: 16 AUG 2010
- Article first published online: 18 JUN 2010
- Accepted 4 May 2010. Published Online 18 June 2010.
- quality indicators
Please cite this paper as: Boulkedid R, Sibony O, Bossu-Salvador C, Oury J, Alberti C. Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart. BJOG 2010;117:1225–1235.
Objective To use cumulative sum (CUSUM) charts for the early detection of variations in quality of care in a maternity department.
Design Retrospective analysis of prospectively collected data.
Setting Maternity department of a teaching hospital in Paris (France).
Population Data from 20 519 women and 21 448 infants were collected between January 2000 and December 2007.
Methods CUSUM charts were used to monitor the rate of 19 pre-selected quality indicators over 3 years (2005–2007), against standards developed by department obstetrician gynaecologists. Periods with adverse event rates that did not meet the standards were identified.
Main outcome measures Quality indicator rates.
Results Indicators fell into three groups based on the number of periods with unacceptable rates: less than one per year [e.g. the rate of intensive care unit (ICU) admission of mothers and rate of third- or fourth-degree perineal tears]; one every 2–12 months on average (e.g. blood transfusion and sulprostone use in the overall population of women); and at least one per month (insufficient availability of epidural analgesia).
Conclusion CUSUM charts for a broad range of quality indicators can be used to monitor the quality of care in an obstetrics department. A prospective study investigating the ability of CUSUM-based monitoring to improve maternal and neonatal outcomes would be of interest.