ArticleBMC pregnancy and childbirth2017
Development of quality indicators for low-risk labor care provided by midwives using a RAND-modified Delphi method.
Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Evolving determinants of implementing low-risk childbirth quality improvement in Japan: a longitudinal qualitative study.BMC health services research · 2026Article
- Development and 2025 re-evaluation of a Japanese quality indicator set for adult intensive care: a modified RAND/UCLA Delphi study.Journal of intensive care · 2026Article
- Study protocol for a midwife-led psychoeducational intervention to reduce pregnancy-related anxiety in low-risk pregnant women.Frontiers in public health · 2026Article
- Effect of a multifaceted intervention with audit and feedback on low-risk childbirth practice: a multicentre prospective study.BMC pregnancy and childbirth · 2025Article
- Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method.BMJ paediatrics open · 2023Article
- Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records.Scientific reports · 2020Article
- Updating quality indicators for low-risk labour care in Japan using current clinical practice guidelines: a modified Delphi method.BMJ open · 2019Article
- Best practices for preventing malfunctions in rule-based clinical decision support alerts and reminders: Results of a Delphi study.International journal of medical informatics · 2018Article
- Evidence Synthesis for the Development of National Nursing-Sensitive Indicators in Malaysia: A Literature Review and Stakeholder Engagement Approach.SAGE open nursingReview
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn childbirth, most deliveries are low-risk, defined as spontaneous labor at full term without special high-risk facts or complications, especially in high-resource countries where maternal and perinatal mortality rates are very low. Indeed, the majority of mothers and infants have no serious conditions during labor. However, the quality of care provided is not assured, and performance may vary by birthing facility and provider. The overuse of technology in childbirth in some parts of the world is almost certainly based on assumptions like, "something can go wrong at any minute." There is a need to assess the quality of care provided for mothers and infants in low-risk labor. We aimed to develop specific quality indicators for low-risk labor care provided primarily by midwives in Japan.
methodsWe used a RAND-modified Delphi method, which integrates evidence review with expert consensus development. The procedure comprises five steps: (1) literature review, including clinical practice guidelines, to extract and develop quality indicator candidates; (2) formation of a multidisciplinary panel; (3) independent panel ratings (Round 1); (4) panel meeting and independent panel ratings (Round 2); and (5) independent panel ratings (Round 3). The three independent panel ratings (Rounds 1-3) were held between July and December 2012.
resultsThe assembled multidisciplinary panel comprised eight clinicians (two pediatricians, three obstetricians, and three midwives) and three mothers who were nonclinicians. Evidentiary review extracted 166 key recommendations from 32 clinical practice guidelines, and 31 existing quality indicators were added. After excluding duplicate recommendations and quality indicators, the panel discussed 25 candidate indicators. Of these, 18 were adopted, one was modified, six were not adopted, and four were added during the meeting, respectively.
conclusionsWe established 23 quality indicators for low-risk labor care provided by midwives in labor units in Japan.
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