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Updated: Feb 1, 97 |
OBSQID | |
| Contact: Dr Kirsten Staehr Johansen WHO Europe Quality of Care Technologies Scherfigsvej 8 DK-2100 Copenhagen, Denmark Tel.: +45-39-17.18.64 Fax: +45-39-17.12.66 |
This made possible to monitor, evaluate and identify "best practices" in order to improve the quality and outcome of perinatal care in the European region.
In the European Union, approximately five million births end in 50000 perinatal deaths each year. Other serious adverse outcomes, e.g. maternal morbidity (excessive bleeding, mortality) and neurologic sequelae in the infant may be traced to lack of optimal care. Further, substantial differences in rates of interventions at delivery (e.g. caesarean sections; forceps delivery) can be found not only between but also within countries with the same measures of outcome.
Thus, the relevance of a large part of interventions can be brought into question.
The OBSQID Project was developed by WHO/EURO with the support of other CEC funded projects in obstetrical and perinatal care: QUAMC (funded by DG XII) and EuroPunch (DGXIII/AIM). The objective was to ensure quality assurance and continuous quality development in perinatal care, based on the European National Medical Association (EFMA) and the World Health Organization, Regional Office for Europe (WHO/EURO) policy and strategy for quality of care development. OBSQID created a pan-European network of researchers, health care providers, health care authorities, professional associations and third party payers, connected by a common database linked up through an electronic bulletin board.
The Quality Indicators: At the core of the project activities was the identification of strategic quality indicators for perinatal care, their validation, acceptance and inclusion in data collection tools (whether paper based or computerised) throughout the European region. A list of 21 indicators were identified at the OBSQID Consensus Conference held in Tubingen in October 1993 and these are now in the process of being tested for confirmation of their applicability and acceptance by health care authorities and providers.
This is the first step in a process which should lead to development of the following processes: quality assurance to allow comparison of outcome between peers with identical conditions and clientele; continuous quality development through analysis and feedback of data to identify and promote "best practices" and "centres of excellence" as well as compare own results to that of peers; perinatal death classification, by collection of standardised data through an expanded set of indicators to identify and characterise preventable fetal deaths and, through appropriate intervention, reduce adverse outcomes.
As a result of these activities, European databases were be set up for quality assurance and continuous quality development data and for perinatal death classification.
As secondary objectives, to mention only a few, OBSQID aimed at: refinement of existing computerised information tools and creation of telematic systems to capture, store, handle and analyse data; standardisation and harmonisation of data collection at the European level for health care providers and health administration; and creation of quality-oriented reimbursement policies for third party payers, which should promote both optimal outcome of perinatal care as well as greater cost effectivity and best use of available resources.
In conclusion, the overall concept of OBSQID had a significant impact on perinatal care throughout Europe, linking together health care providers at all levels. The project was innovative in that it united data collection capabilities at all technological levels, from a paper based tool to sophisticated telematic systems, ensuring communication within and between countries and promoted collaboration for provision of better health by all partners in health care.
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