The continuous audit of events and outcomes of labour and birth using the Ten Group Classification System and its role in quality improvement

Abstract

ObjectiveThe knowledge of a labour and birth unit’s rates of events and outcomes is essential to design any quality improvement initiative. It is in the same way important to have a system to analyse results of the ongoing changes within the unit. The Ten Group Classification System is the framework for doing this in a systematic and clinically relevant way. We aimed to use this classification system as a quality improvement tool. Study designAll labours and births during four years at a secondary level Hospital were included in a continuous analysis and of events and outcomes based on the Ten Group Classification System. From the results of the audit, policies and guidelines were designed and updated to improve outcomes. ResultsThe normal vaginal birth rate in Group 1 increased during the four-year-period and the Caesarean Section rate in Group 2 A dropped after the introduction of a new induction method. The overall Caesarean Section rate decreased. The experience of giving birth improved in Groups 1, 2 A and 3. ConclusionThe use of a continuous audit of events and outcomes based on a clinically significant classification for all women makes it possible to improve quality. Other labour and birth units are encouraged to collect and present data in a way that allows comparisons between units and over time.