Development of quality evaluation indicator system of midwifery care in Shanghai

Abstract

Objective To develop a quality evaluation indicator system of midwifery care in line with the modern service concept in Shanghai area under the background of over-medicalization trend of midwifery services, and to guide the improvement direction of midwifery quality. Methods Guided by the evidence-based framework of midwifery quality and indicator selection principles, the indicators for evaluating midwifery quality were preliminarily selected by literature review and theoretical analysis. Two rounds of Delphi survey among 53 experts from Shanghai were conducted to decide the final quality evaluation indicator system of midwifery care. Analytic hierarchy process (AHP) and the importance′ sum average method were adopted to calculate weights coefficients of the indicators. Results 45 indicators for evaluating midwifery quality were preliminarily selected. The response rate of two rounds of Delphi survey were 76% and 100%, the authority coefficients were 0.90 and 0.89, expert opinion coordinate coefficients were 0.190 and 0.257, respectively. The final version of the indicator system consists of 11 structure quality indicators, 13 process quality indicators and 19 outcome quality indicators. The weight values of the three first-level indicators were 0.195 8, 0.310 8 and 0.493 4 respectively. The weight values of the 43 second-level indicators ranged from 0.016 1 to 0.028 6. Conclusions The quality evaluation indicator system of midwifery care developed fits evidence-based midwifery philosophy. It provides a scientific tool for midwifery quality evaluation in Shanghai, which can guide the improvement of midwifery quality. Key words: Midwifery; Quality; Evaluation Indicator; Weight; Shanghai city