Society for Maternal-Fetal Medicine Special Statement: Clinical quality measures in obstetrics

Introduction

As consumers, we are bombarded by requests to provide feedback to companies that want to know “How did we do?” for seemingly every transaction from ordering a pizza to buying a car. Companies spend untold millions of dollars to obtain this feedback because they want to know if there is anything they can do to improve their products or their customer service.

As health care providers, we want to provide the best care to achieve the best possible outcomes and the best patient experience. However, we are often indignant at the suggestion that the quality of our care should be measured. In part, our negative reaction is due to past and current efforts by payers to impose financial penalties or rewards based on poorly conceived, misleading, or oversimplified measures of quality. Furthermore, it is in part due to our fundamental belief that we are already doing the best that we can, so the notion that our performance needs to be assessed seems insulting and threatens our professional pride. Nonetheless, if we do not seek feedback on the care we provide, we may miss important opportunities to improve it. Clinical quality measures (CQMs) provide a structured, quantitative means to obtain that feedback.

The goal of this article is to provide an overview and critique of CQMs relevant for the evaluation of obstetrical care in the United States. The article is an update to the 2016 Society for Maternal-Fetal Medicine (SMFM) Special Report on the same topic.

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 A glossary of acronyms and terminology used in this review is provided in the Box.