Promoting accountability in obstetric care: Use of criteria-based audit in Viet Nam

Abstract

Audits can improve clinical and managerial practices, enhance the rational use of limited resources, and improve staff morale and motivation. Staff at five hospitals in Thanh Hoa and Quang Tri provinces (Viet Nam) used criteria-based audit (CBA) as a tool to improve the quality of emergency obstetric and newborn care. CBA compares current practice with standards based on the best available evidence and the local context. The audit cycle begins with a known problem, proceeds with an initial assessment and data collection, analysis of those data, formulation and implementation of an action plan, and a re-evaluation of the topic initially assessed. Teams found that clinical protocols for treating major obstetric complications were not followed, although, national guidelines had been issued in 2002. In an audit of facility organisation, staff addressed obstacles to the timely treatment of obstetric emergencies during off hours. In each audit, teams devised mechanisms to correct problems that resulted in significant improvements when the audit cycle was repeated. CBA improved adherence to national guidelines, improved record-keeping, heightened teamwork, and showed staff that they could identify and solve many of their own problems.

A national review of cesarean delivery in Ethiopia

“…One of the frequently cited benefits of conducting case reviews and audits with feedback is an improvement in record keeping [28,29]. The present review highlighted incomplete and uneven recordkeeping.…”

A criteria-based audit to improve early postnatal care in Jinja, Uganda

“…Inpatient numbers of mothers who gave birth in April 2016 were obtained from Enhancing rational use of limited resources Improving staff morale and motivation. Bailey et al (2010) report that maintaining audit cycles led to improvements in the quality of obstetric care in developing countries. Clinical audit emphasises provision of feedback on quality of performance, which motivates health professionals and improves job satisfaction and performance (Bailey et al, 2010).…”

“…Bailey et al (2010) report that maintaining audit cycles led to improvements in the quality of obstetric care in developing countries. Clinical audit emphasises provision of feedback on quality of performance, which motivates health professionals and improves job satisfaction and performance (Bailey et al, 2010). Based on the existing evidence, the LAMRN clinical audit team sought to carry out a systematic assessment of the quality of postnatal care being offered to the mothers and babies in the first 6 hours of birth at the maternity units of one regional referral hospital in Uganda.…”

Criterion-Based Audit of Hand Hygiene Performance During Caesarean Section at a Referral Hospital in Northern Tanzania: An Uncontrolled Interventional Study

“…Carefully designed criterion-based audit may provide one of the most efficient methods of audit. 20 According to Bailey and colleagues, 21 the CBA involves 5 steps described as an audit cycle ( Figure 2).…”