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Monitoring obstetricians’ performance with statistical process control charts

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The main objective of this study was to pave the way towards proactive, continuous assessment of individuals and hospitals by demonstrating the application of evidence-based competency standards in maternity care using statistical performance monitoring. Design

Retrospective study using data routinely collected by a large maternity hospital. Setting

A large teaching hospital. Population

Clinicians who routinely perform either amniocentesis or ventouse deliveries. Method

As a ‘proof of principle’, we have used statistical process control (SPC) charts to compare the observed complication rates for amniocentesis and ventouse delivery with the expected complication rates based on published data. Main outcome measures 

The recorded complication rates for aminocentesis and ventouse delivery. Results

The SPC charts identified significant variation in complication rates within the team and showed the ways in which prospective data can be used to provide continuous feedback to individuals on their performance. Conclusion

The study shows that statistical performance monitoring and, in particular, the use of control charts can be a valuable tool in the continuous assessment of individuals and the healthcare service being provided. The control charts provide a more immediate indication of current performance and provide an alternative to performance-based league tables for the presentation of yearly performance data.

Keywords: Amniocentesis; control charts; performance monitoring; statistical process control; ventouse delivery

Document Type: Research Article


Affiliations: 1: School of Reproductive and Developmental Medicine, University of Liverpool, Liverpool, UK 2: Liverpool Women’s NHS Foundation Trust, Liverpool, UK

Publication date: May 1, 2007


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