The “ASQUAM” programme: improving the standards of maternity care, using democratic prioritisation, guidelines and audit

Abstract

Evaluates the current success of projects within the Achieving Sustainable Quality in Maternity clinical effectiveness programme initiated in 1994 when 23 improvements in the standards of maternity care were chosen as priorities for improvement, and a further 22 added in 1996 and 1997. The interventions used to achieve improvement were guidelines, cyclical audit of cases, monthly feedback meetings, patient specific reminders and educational training sessions. The setting was North Staffordshire Maternity Acute and Community Services. Main outcome measures were measures of maternal morbidity and “near‐miss” mortality, perinatal morbidity and “near‐miss”, patients’ satisfaction, communication, staff well‐being. Presents results from the 45 audit topics. Concludes it is possible to achieve significant improvements in the quality of maternity care through the use of local guidelines, cyclical audit, monthly feedback meetings and training courses but there has not been the same success in achieving high standards in communication and informed choice.