Computerized Quality Assurance Assessment of Obstetric Anesthesia Care: New Outcome Indicators
Quality assurance assessment has previously viewed the structure and process of health care delivery systems as an approximation of the quality of patient care. Recently, the focus has begun to shift to include outcome in the indicators of quality care, so that ultimately healthcare institutions and providers may be compared on this basis. However assessment of outcome remains problematical -- what is to be measured, how are data to be collected and managed, how can patients be characterized in order to compare outcome data fairly from different patient populations, etc.? In 1990 the Joint Commission on Accreditation of Healthcare Organizations (USA) proposed outcome indicators for monitoring quality of care provided to obstetrical and anesthesia patients. We have developed a practical, computerized data management system that incorporates these indicators, as well as activity indices and pertinent patient demographic modifiers, into a quality assurance assessment of obstetric anesthesia care. We report our data from 12,483 consecutive obstetric anesthetics at a regional perinatal teaching center.