Development of a Maternal Equity Safety Bundle to Eliminate Racial Inequities in Massachusetts.
Development of a Maternal Equity Safety Bundle to Eliminate Racial Inequities in Massachusetts.
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DOI：
10.1097/aog.0000000000005322
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发表时间：
2023-10-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
--
作者：
通过专家共识建立结构、流程和结果衡量标准，为孕产妇安全捆绑包创建基础设施，以减少孕产妇健康方面的不平等。 PNQIN（马萨诸塞州围产期-新生儿质量改善网络）寻求通过选择和制定措施来制定解决马萨诸塞州孕产妇健康不平等问题的捆绑包，以适应减少围产期种族和民族差异概念框架和孕产妇安全共识包。本研究描述了制定基于共识的措施的过程，以在参与孕产妇健康创新联盟的马萨诸塞州医院实施 PNQIN 孕产妇公平捆绑包。我们的团队采用混合方法，通过共识创建了 PNQIN 孕产妇权益捆绑包，包括文献综述、专家访谈和修改后的德尔菲流程，以编制、定义和选择措施来推动以孕产妇权益为重点的行动。通过有目的的滚雪球抽样来确定利益相关者，其中包括妇产科医生、助产士、护士、流行病学家和种族平等学者。 Dedoose 9.0 用于完成采访记录的归纳分析。采用修改后的德尔菲法就 PNQIN 孕产妇权益捆绑包的建议和措施达成共识。已完成二十五次访谈。出现了七个主题，包括需要 1）按种族、民族和语言进行数据分层； 2) 进行准备情况评估； 3）文化转向公平； 4）纳入反种族主义和偏见培训； 5）解决非学术型医院面临的挑战； 6) 生命全程方法； 7) 选择实施时机。通过专家访谈确定了 20 项初始质量衡量标准（结构、过程和结果）。团体共识支持将 10 项措施纳入该捆绑包中。为孕产妇公平安全捆绑选择和定义了结构、过程和结果质量衡量标准，旨在在分娩设施中创建注重公平的基础设施和针对公平的具体行动。在分娩设施实施注重公平的安全捆绑措施可能会缩小孕产妇结局方面的种族差距。
Establishing structure, process, and outcome measures through expert consensus creates the infrastructure for a maternal safety bundle to reduce inequities in maternal health. The PNQIN (Perinatal-Neonatal Quality Improvement Network of Massachusetts) sought to adapt the Reduction of Peripartum Racial and Ethnic Disparities Conceptual Framework and Maternal Safety Consensus Bundle by selecting and defining measures to create a bundle to address maternal health inequities in Massachusetts. This study describes the process of developing consensus-based measures to implement the PNQIN Maternal Equity Bundle across Massachusetts hospitals participating in the Alliance for Innovation on Maternal Health Initiative. Our team used a mixed-methods approach to create the PNQIN Maternal Equity Bundle through consensus including a literature review, expert interviews, and a modified Delphi process to compile, define, and select measures to drive maternal equity-focused action. Stakeholders were identified by purposive and snowball sampling and included obstetrician–gynecologists, midwives, nurses, epidemiologists, and racial equity scholars. Dedoose 9.0 was used to complete an inductive analysis of interview transcripts. A modified Delphi method was used to reach consensus on recommendations and measures for the PNQIN Maternal Equity Bundle. Twenty-five interviews were completed. Seven themes emerged, including the need for 1) data stratification by race, ethnicity and language; 2) performance of a readiness assessment; 3) culture shift toward equity; 4) inclusion of antiracism and bias training; 5) addressing challenges of nonacademic hospitals; 6) a life-course approach; and 7) selection of timing of implementation. Twenty initial quality measures (structure, process, and outcome) were identified through expert interviews. Group consensus supported 10 measures to be incorporated into the bundle. Structure, process, and outcome quality measures were selected and defined for a maternal equity safety bundle that seeks to create an equity-focused infrastructure and equity-specific actions at birthing facilities. Implementation of an equity-focused safety bundle at birthing facilities may close racial gaps in maternal outcomes.
马萨诸塞州严重孕产妇发病率的趋势和不平等：最近二十年来仔细观察。
影响因子：
3.7
作者：
Diop, Hafsatou;Declercq, Eugene R.;Liu, Chia-Ling;Cabral, Howard J.;Cui, Xiaohui;Amutah-Onukagha, Ndidiamaka;Meadows, Audra
通讯作者：
Meadows, Audra