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[Adverse events related to care in obstetric units]

https://arctichealth.org/en/permalink/ahliterature84340
Source
Tidsskr Nor Laegeforen. 2007 Oct 18;127(20):2670-2
Publication Type
Article
Date
Oct-18-2007
Author
Johansen Bente Kristin
Braut Brynhild
Schou Petter
Author Affiliation
Helsetilsynet i Oslo og Akershus, Postboks 8111 Dep, 0032 Oslo. bente.kristin.johansen@kunnskapssenteret.no
Source
Tidsskr Nor Laegeforen. 2007 Oct 18;127(20):2670-2
Date
Oct-18-2007
Language
Norwegian
Publication Type
Article
Keywords
Clinical Competence
Communication
Female
Fetal Monitoring - standards
Humans
Interprofessional Relations
Medical Errors - prevention & control - statistics & numerical data
Norway
Obstetric Labor Complications - diagnosis - therapy
Obstetrics and Gynecology Department, Hospital - organization & administration - standards
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications - diagnosis - therapy
Professional-Patient Relations
Quality Assurance, Health Care
Risk factors
Risk Management
Ultrasonography, Prenatal - standards
Abstract
BACKGROUND: The aim of the present investigation was to uncover whether adverse events related to care in obstetric units have been preceded by specific health care conditions, and whether such causal relations could be classified into general categories. MATERIAL AND METHOD: The data cover 47 supervision cases within the area of pregnancy--and birth care. The cases were handled by the Norwegian Board of Health centrally (n = 32) and the Norwegian Board of Health in the counties (n = 15) in the period 2003-2006. RESULTS: Several conditions caused the adverse events. They could be classified into the four main categories: communication--and cooperation failure, uncertain lines of responsibility, lack of qualification, and weaknesses in the organization. The examination of the material disclosed that at least 2/3 of the adverse event causes could be traced back to organization of the facility and uncertain lines of responsibility. INTERPRETATION: The causes of adverse events in obstetric units are often due to circumstances over which the individual health care personnel had no control. The classification of causes into four main categories can be used as a supplement tool in the internal improvement process at departments of obstetrics.
PubMed ID
17952150 View in PubMed
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Are Canadian hospitals providing family-centered maternity and newborn care?

https://arctichealth.org/en/permalink/ahliterature212669
Source
Leadersh Health Serv. 1996 Mar-Apr;5(2):16-20, 46
Publication Type
Article
Author
L. Hanvey
C. Levitt
G. Chance
Source
Leadersh Health Serv. 1996 Mar-Apr;5(2):16-20, 46
Language
English
Publication Type
Article
Keywords
Canada
Cesarean Section
Communication
Delivery, obstetric - statistics & numerical data
Family
Female
Hospital-Patient Relations
Humans
Infant Care - statistics & numerical data
Infant, Newborn
Labor, Obstetric
Mother-Child Relations
Obstetrics and Gynecology Department, Hospital - organization & administration - statistics & numerical data
Organizational Policy
Perinatal Care - organization & administration - statistics & numerical data
Pregnancy
Questionnaires
Rooming-in Care - statistics & numerical data
Abstract
A philosophy of family-centered maternity and newborn care requires that there be open communication between a woman, her family and health professionals; that the woman be able to choose people to support her, and have those people present during labour and birth; and that the mother and infant remain in close contact whenever possible following birth. Using data from a 1993 survey, the authors conclude that Canadian hospitals still have a long way to go before putting these ideals into practice.
PubMed ID
10156772 View in PubMed
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Caseload midwifery as organisational change: the interplay between professional and organisational projects in Denmark.

https://arctichealth.org/en/permalink/ahliterature270473
Source
BMC Pregnancy Childbirth. 2015;15:121
Publication Type
Article
Date
2015
Author
Viola Burau
Charlotte Overgaard
Source
BMC Pregnancy Childbirth. 2015;15:121
Date
2015
Language
English
Publication Type
Article
Keywords
Denmark
Female
Humans
Interprofessional Relations
Midwifery - organization & administration
Models, organizational
Obstetrics and Gynecology Department, Hospital - organization & administration
Organizational Innovation
Pregnancy
Qualitative Research
Workload
Abstract
The large obstetric units typical of industrialised countries have come under criticism for fragmented and depersonalised care and heavy bureaucracy. Interest in midwife-led continuity models of care is growing, but knowledge about the accompanying processes of organisational change is scarce. This study focuses on midwives' role in introducing and developing caseload midwifery. Sociological studies of midwifery and organisational studies of professional groups were used to capture the strong interests of midwives in caseload midwifery and their key role together with management in negotiating organisational change.
We studied three hospitals in Denmark as arenas for negotiating the introduction and development of caseload midwifery and the processes, interests and resources involved. A qualitative multi-case design was used and the selection of hospitals aimed at maximising variance. Ten individual and 14 group interviews were conducted in spring 2013. Staff were represented by caseload midwives, ward midwives, obstetricians and health visitors, management by chief midwives and their deputies. Participants were recruited to maximise the diversity of experience. The data analysis adopted a thematic approach, using within- and across-case analysis.
The analysis revealed a highly interdependent interplay between organisational and professional projects in the change processes involved in the introduction and development of caseload midwifery. This was reflected in three ways: first, in the key role of negotiations in all phases; second, in midwives' and management's engagement in both types of projects (as evident from their interests and resources); and third in a high capacity for resolving tensions between the two projects. The ward midwives' role as a third party in organisational change further complicated the process.
For managers tasked with the introduction and development of caseload midwifery, our study underscores the importance of understanding the complexity of the underlying change processes and of activating midwives' and managers' interests and resources in addressing the challenges. Further studies of female-dominated professions such as midwifery should offer good opportunities for detailed analysis of the deep-seated interdependence of professional and organisational projects and for identifying the key dimensions of this interdependence.
Notes
Cites: BMC Health Serv Res. 2013;13:24623819578
Cites: BJOG. 2012 Nov;119(12):1483-9222830446
Cites: Birth. 2000 Sep;27(3):156-6711251496
Cites: Aust J Midwifery. 2004 Mar;17(1):17-2215079981
Cites: Med J Aust. 1995 Sep 18;163(6):289-937565233
Cites: Soc Sci Med. 1997 Apr;44(7):1051-639089925
Cites: Aust Health Rev. 2005 Aug;29(3):332-916053438
Cites: Soc Sci Med. 2006 Mar;62(6):1330-4016150523
Cites: Soc Sci Med. 2006 Mar;62(6):1307-1816126316
Cites: Sociol Health Illn. 2005 Sep;27(6):722-3716283896
Cites: BMJ. 2008;337:a165518824488
Cites: Aust N Z J Obstet Gynaecol. 2008 Oct;48(5):454-6119032659
Cites: BMJ Qual Saf. 2011 Apr;20 Suppl 1:i18-2321450764
Cites: BMC Public Health. 2011;11 Suppl 5:S822168585
Cites: Aust Health Rev. 2012 May;36(2):169-7522624638
Cites: Soc Sci Med. 2012 Aug;75(4):717-2422627016
Cites: Cochrane Database Syst Rev. 2013;8:CD00466723963739
PubMed ID
26013394 View in PubMed
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[Centralization of obstetrical care and perinatal mortality in Norwegian counties during the period 1986-90]

https://arctichealth.org/en/permalink/ahliterature59563
Source
Tidsskr Nor Laegeforen. 1992 Nov 20;112(28):3585-6
Publication Type
Article
Date
Nov-20-1992
Author
A. Meberg
Source
Tidsskr Nor Laegeforen. 1992 Nov 20;112(28):3585-6
Date
Nov-20-1992
Language
Norwegian
Publication Type
Article
Keywords
Centralized Hospital Services
Female
Fetal Death - epidemiology
Humans
Infant mortality
Infant, Newborn
Norway - epidemiology
Obstetrics - organization & administration
Obstetrics and Gynecology Department, Hospital - organization & administration
Pregnancy
Notes
Comment On: Tidsskr Nor Laegeforen. 1992 Sep 20;112(22):2879-811412331
PubMed ID
1462334 View in PubMed
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[Centralization of obstetric care and perinatal mortality in Norwegian counties 1986-90. Analysis based on public statistics from the medical birth registry]

https://arctichealth.org/en/permalink/ahliterature59582
Source
Tidsskr Nor Laegeforen. 1992 Sep 20;112(22):2879-81
Publication Type
Article
Date
Sep-20-1992
Author
E. Lund
Author Affiliation
Institutt for samfunnsmedisin, Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 1992 Sep 20;112(22):2879-81
Date
Sep-20-1992
Language
Norwegian
Publication Type
Article
Keywords
Centralized Hospital Services - organization & administration
English Abstract
Female
Fetal Death - epidemiology
Hospitals, Maternity - organization & administration
Humans
Infant Mortality - trends
Infant, Newborn
Norway - epidemiology
Obstetrics - organization & administration
Obstetrics and Gynecology Department, Hospital - organization & administration
Pregnancy
Registries
Abstract
The relationship between centralization of obstetric care and perinatal mortality was studied in 19 Norwegian counties for the period 1986-90. No significant trend was found. However, during the period 1988-1990 prenatal mortality was significantly higher, with a relative risk of 1.21 (95% confidence interval 1.00-1.45), in the three counties with only one obstetric department than it was in all other counties. The analysis did not support the notion that greater centralization of obstetric care would decrease perinatal mortality.
Notes
Comment In: Tidsskr Nor Laegeforen. 1992 Nov 20;112(28):3585-61462334
Comment In: Tidsskr Nor Laegeforen. 1993 Jan 10;113(1):66-78424257
PubMed ID
1412331 View in PubMed
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[Centralization of obstetric care and perinatal mortality in Norwegian municipalities during 1986-90]

https://arctichealth.org/en/permalink/ahliterature59533
Source
Tidsskr Nor Laegeforen. 1993 Jan 10;113(1):66-7
Publication Type
Article
Date
Jan-10-1993
Author
P. Scheel
O K Danielsen
Source
Tidsskr Nor Laegeforen. 1993 Jan 10;113(1):66-7
Date
Jan-10-1993
Language
Norwegian
Publication Type
Article
Keywords
Female
Humans
Infant mortality
Infant, Newborn
Intensive Care, Neonatal - organization & administration
Norway - epidemiology
Obstetrics and Gynecology Department, Hospital - organization & administration
Pregnancy
Notes
Comment On: Tidsskr Nor Laegeforen. 1992 Sep 20;112(22):2879-811412331
PubMed ID
8424257 View in PubMed
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Child births in a modified midwife managed unit: selection and transfer according to intended place of delivery.

https://arctichealth.org/en/permalink/ahliterature58675
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Publication Type
Article
Date
Mar-2001
Author
J. Holt
I N Vold
B. Backe
M V Johansen
P. Oian
Author Affiliation
Department of Pediatrics, Nordland Central Hospital, Bodø, Norway.
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - organization & administration - utilization
Delivery Rooms - utilization
Delivery, Obstetric - classification
Female
Hospitals, Rural
Humans
Midwifery
Norway
Obstetrics and Gynecology Department, Hospital - organization & administration - standards
Outcome Assessment (Health Care)
Patient Selection
Patient transfer
Perinatal Care - organization & administration
Pregnancy
Pregnancy outcome
Prospective Studies
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: As small obstetrical departments may not be able to give second-level perinatal care, the delivery unit at Lofoten hospital was for the years 1997-98 reorganized to a modified midwife managed unit. Women at low obstetrical risk were delivered at this unit and women at high risk were referred to the central hospital. We assessed the effectiveness of the risk selection. MATERIAL AND METHODS: The study was a prospective, pragmatic, population-based trial. Desired outcome was defined as a non-operative delivery at 35-42 weeks gestational age giving an infant not needing resuscitation. Intermediate outcomes: Operative deliveries, infants transferred to neonatal intensive care unit and infants diverging from normal. The intended place of delivery was ultimately decided at admittance to the midwife managed unit. RESULTS: Of the 628 women in study 435 (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be delivered at the central hospital and 41 (6.5%) were transferred to the central hospital after admittance to the midwife managed unit. Desired outcome was recorded in 94% of the deliveries at the midwife managed unit as compared to 50.3% at the central hospital. Women who intended to be delivered at the midwife managed unit, needed fewer operative deliveries and relatively few infants were transferred to the neonatal intensive care unit or diverged from normal. CONCLUSIONS: As nearly 70% of the births occurred at the midwife managed unit and 94% of these deliveries had a desired outcome, this indicates an effective selection process. This model might be an alternative to centralization of births in sparsely population areas.
PubMed ID
11207485 View in PubMed
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[Comments concerning SBF's and SFOG's consensus report on physician-midwife team work in delivery rooms]

https://arctichealth.org/en/permalink/ahliterature64805
Source
Jordemodern. 1993 Jul-Aug;106(7-8):244-5
Publication Type
Article

57 records – page 1 of 6.