Control de calidad del seguimiento del embarazo normal en atención primaria

Abstract

GENERAL: to increase the quality of mother-baby care in our population. SPECIFIC: to improve by at least 10% the record of activities with poorest compliance at the first evaluation on the quality cycle.Quality cycle of the normal pregnancy monitoring programme in primary care (PC). The scientific-technical dimension of quality was the one studied. There was a retrospective, crossed evaluation, on internal initiative, about the clinical records of the pregnant women. SEQUENCE: first evaluation of pregnancies in 1994-95; application of corrective measures in 1996; second evaluation of pregnancies in 1997-98.Primary care.All the pregnancies monitored by our PC team during the periods described.CRITERIA EVALUATED: care activities of the programme for monitoring normal pregnancies in Area 10. First evaluation (n = 54): 11.5% overall non-compliance. The criteria with under 80% compliance were: folic acid supplement, counselling, diagnosis of pregnancy diabetes and attendance in the month after delivery. Second evaluation (n = 69): 6.3% overall non-compliance. All activities surpassed 80% compliance except obstetric examination on the first visit, attendance a week after delivery and attendance a month after delivery.After introducing certain simple corrective measures, we achieved overall improvement of over 40% and increased compliance in most activities, except for attendance after delivery and obstetric examination on the first visit. We think a continuous cycle of quality improvement needs to be maintained in order to achieve adequate mother-baby care.