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dc.contributor.authorJohansen, Lars Thomas
dc.contributor.authorBraut, Geir Sverre
dc.contributor.authorAcharya, Ganesh
dc.contributor.authorAndresen, Jan Fredrik
dc.contributor.authorØian, Pål
dc.date.accessioned2021-09-23T13:20:57Z
dc.date.available2021-09-23T13:20:57Z
dc.date.created2021-09-20T08:57:21Z
dc.date.issued2021
dc.identifier.citationJohansen, L. T., Braut, G. S., Acharya, G., Andresen, J. F., & Øian, P. (2021). Adverse events reporting by obstetric units in Norway as part of their quality assurance and patient safety work: an analysis of practice. BMC Health Services Research, 21(1).en_US
dc.identifier.issn1472-6963
dc.identifier.urihttps://hdl.handle.net/11250/2780803
dc.description.abstractBackground The Norwegian Board of Health Supervision aims to contribute to the improvement of quality and patient safety in the healthcare services. Planned audits were performed to investigate how 12 selected Norwegian obstetric units reported and analyzed adverse events as the part of their quality assurance and patient safety work. Methods Serious adverse events coded as birth asphyxia, shoulder dystocia and severe postpartum hemorrhage that occurred during 2014 (the most recent year for which the quality assured data were available) were obtained from the Medical Birth Registry of Norway. The obstetric units were asked to submit medical records, internal adverse events reports, and their internal guidelines outlining which events should be reported to the quality assurance system. We identified the adverse events at each obstetric unit that were reported internally and/or to the central authorities. Two obstetricians carried out an evaluation of each event reported. Results Five hundred fifty-three serious adverse events were registered among 17,323 births that took place at the selected units. Twenty-one events were excluded because of incorrect coding or missing information. Eight events were registered in more than one category, and these were distributed to the category directly related to injury or adverse outcome. Nine of twelve (75 %) obstetric units had written guidelines describing which events should be reported. The obstetric units reported 49 of 524 (9.3 %) serious adverse events in their internal quality assurance system and 39 (7.4 %) to central authorities. Of the very serious adverse events, 29 of 149 (19.4 %) were reported. Twenty-three of 49 (47 %) reports did not contain relevant assessments or proposals for improving quality and patient safety. Conclusions This study showed that adverse event reporting and analyses by Norwegian obstetric units, as a part of quality assurance and patient safety work, are suboptimal. The reporting culture and compliance with guidelines need to be improved substantially for better safety in patient care, risk mitigation and clinical quality assurance.en_US
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.subjectsupervisionen_US
dc.subjectadverse eventen_US
dc.subjectasphyxiaen_US
dc.subjectshoulder dystociaen_US
dc.subjectpostpartum hemorrhageen_US
dc.subjectreporting cultureen_US
dc.subjectobstetric care uniten_US
dc.subjectfailure of treatmenten_US
dc.titleAdverse events reporting by obstetric units in Norway as part of their quality assurance and patient safety work: an analysis of practiceen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.description.versionpublishedVersionen_US
dc.rights.holder© The Author(s) 2021en_US
dc.source.pagenumber1-8en_US
dc.source.volume21en_US
dc.source.journalBMC Health Services Researchen_US
dc.source.issue1en_US
dc.identifier.doi10.1186/s12913-021-06956-6
dc.identifier.cristin1935740
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2


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