DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160979

A quality improvement tool - driver diagram: a model of driver diagram to reduce primary caesarean section rates

Naima Fathima

Abstract


Background: Quality improvement in health care is emerging as a science with proven, effective tools and methodologies. This article aims at presenting the importance of adopting one of the effective and simple methodologies and gives an example of a Driver Diagram in obstetrics.

Methods: Usefulness of driver diagram in understanding the aim and the interventions or changes.

Results: Various quality improvement tools can be used in the clinical context. Among them, driver diagram is most widely used at the start of an improvement initiative. The driver diagram in this article shows its applicability in one of the clinical aspects of obstetrics, to reduce primary caesarean section rates.

Conclusions: Driver diagram is an easy and a simple tool widely used in quality improvement activities. It is essential to use at the beginning of improvement initiatives.  


Keywords


Quality improvement, Driver diagram, Quality improvement tools, Primary caesarean section, Labour dystocia

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References


Langley GJ, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The improvement guide: a practical approach to enhancing organizational performance. 2nd edition. Jossey-Bass; 2009.

Batalden PB, Davidoff F. What is “quality improvement” and how can it transform healthcare? Qual Saf Health Care. 2007;16(1):2-3.

Simmons JC. Using six sigma to make a difference in health care quality. Qual Lett Healthc Lead. 2002;14(4):2-10.

Torres EJ, Guo KL. Quality improvement techniques to improve patient satisfaction. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2004;17(6):334-8.

Yank G. Quality improvement in health care organizations: a general systems perspective. Behav Sci. 1995;40(2):85-103.

Provost L, Bennett B. What's your theory? Driver diagram serves as tool for building and testing theories for improvement. Quality Progress. 2015;36-43.

Chaillet N, Dumont A. Evidence-based strategies for reducing cesarean section rates: a meta-analysis. Birth. 2007;34(1):53-64.

Strategies to reduce cesarean birth in low-risk women: comparative effectiveness review executive summary No. 80 (AHRQ Pub. No. 12(13)-EHC128-1).

Safe prevention of the primary cesarean delivery. Obstetric care consensus no. 1. american college of obstetricians and gynecologists. Obstet Gynecol. 2014;123:693-711.

Barber EL, Lundsberg LS, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118:29-38.

Kozhimannil KB, Law MR, Virnig BA. Cesarean delivery rates vary tenfold among US hospitals; reducing variation may address quality and cost issues. Health Aff. 2013;32:527-35.

Zhang J, Landy HJ, Branch DW, Burkman R, Haberman S, Gregory KD et al. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Consortium on safe labour. Obstet Gynecol. 2010;116:1281-7.

Rouse DJ, Owen J, Savage KG, Hauth JC. Active phase labour arrest: revisiting the 2-hour minimum. Obstet Gynecol. 2001;98:550-4.

Piper JM, Bolling DR, Newton ER. The second stage of labour: factors influencing duration. Am J Obstet Gynecol. 1991;165:976-9.

Cheng YW, Hopkins LM, Caughey AB. How long is too long: does a prolonged second stage of labour in nulliparous women affect maternal and neonatal outcomes? Am J Obstet Gynecol. 2004;191:933-8.