ArticleBMJ open2019
Updating quality indicators for low-risk labour care in Japan using current clinical practice guidelines: a modified Delphi method.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Approaches of integrating the development of guidelines and quality indicators: a systematic review.BMC health services research · 2020Pooled it
- Evolving determinants of implementing low-risk childbirth quality improvement in Japan: a longitudinal qualitative study.BMC health services research · 2026Article
- Monitoring childbirth and immediate postpartum care quality: A scoping review of indicators in high-income countries.PloS one · 2026Article
- Effect of a multifaceted intervention with audit and feedback on low-risk childbirth practice: a multicentre prospective study.BMC pregnancy and childbirth · 2025Article
- Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase.Healthcare (Basel, Switzerland) · 2023Article
- Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesQuality indicators are measurable elements widely used to assess the quality of care. They are often developed from the results of systematic reviews or clinical practice guidelines. These sources are regularly updated in line with new clinical evidence, but there are few articles on updating quality indicators based on clinical practice guidelines. This study aimed to update the quality indicators developed for low-risk labour care in Japan in 2012, mainly drawing on new or updated clinical practice guidelines, and making the process clearly visible and assessable. DESIGN AND
settingWe used a modified Delphi method for the update. The procedure included four steps: (1) updating the definition of low-risk labour; (2) reviewing the literature published between June 2012 and December 2015 using five guidelines and two quality indicator databases to extract potential candidate indicators; (3) formation of a multidisciplinary panel including mothers and (4) panel ratings (two rounds between February and April 2016) on the validity of the candidate indicators, and judging the validity of the previous quality indicators drawing on the new evidence.
participantsA multidisciplinary panel of 13 clinicians, including obstetricians, paediatricians and midwives, plus 3 non-clinician mothers.
resultsThe literature review identified 276 new recommendations from 27 clinical practice guidelines including 2 published in Japan and 21 quality indicators. We developed 13 new candidate indicators from these sources and panel recommendations, 12 of which were approved by the multidisciplinary panel. The panel also accepted all 23 existing quality indicators as still valid, resulting in a total of 35 quality indicators for low-risk labour.
conclusionsWe successfully updated the quality indicators for low-risk labour care in Japan. The procedure developed may be useful for updating other quality indicators based on new clinical practice guidelines.
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