• Institute for Clinical Systems Improvement (ICSI). Management of labor. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Mar. 72 p. [126 references]

Does not apply to this measure

The priority aim addressed by this measure is to increase the use of procedures that assist in progress to vaginal birth.

Labor; spontaneous rupture of membranes (SROM); amniotomy

All births among the denominator with no intact membrane at beginning of active labor. This is accomplished by either spontaneous rupture of membranes (SROM) or amniotomy.

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Hospitals

Physicians

Group Clinical Practices

Unspecified

Female (only)

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Unspecified

Getting Better

Effectiveness

Users of care only

All women giving birth who are:

• Full term (36 completed weeks)
• Nullipara
• Without concomitant medical problems
• Having contractions
• Singleton fetus
• Cephalic presentation
• No evidence of fetal distress
• Expected to have a normal spontaneous vaginal delivery

Any one of several possible data collection methods may be used by the medical group to capture data for this particular population.

1. Data may be obtained retrospectively by a chart audit (using a minimum sample of 20 charts per month).
2. Data may be obtained through discharge abstract coding or other data base from the hospital.
3. The hospital may send the medical group a copy of the labor and delivery summary sheet for deliveries.
4. A copy of the nursing checklist form is sent to the medical group for data collection.

Data are reviewed to determine if the delivery fits the inclusion criteria for the measure. If no, the birth is not reviewed. If yes, the birth data are reviewed to assess if amniotomy or spontaneous rupture of membranes (SROM) occurred.

It is suggested that these data are collected monthly.

Patients associated with provider

All cases in the denominator are equally eligible to appear in the numerator

Clinical Condition
Institutionalization
Therapeutic Intervention

Time window brackets index event

Inclusions
All births among the denominator with no intact membrane at beginning of active labor. This is accomplished by either spontaneous rupture of membranes (SROM) or amniotomy.

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Episode of care

Administrative data
Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percent of women in the guideline population who have SROM or early amniotomy.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: John Jefferies, MD (Work Group Leader) (Mayo Clinic) (OB/Gyn); Leslie Atwood, MD (Allina Medical Clinic) (Family Medicine); Lori Bates, MD (Mayo Clinic) (Family Medicine); Brendon Cullinan, MD (Hennepin County Medical Center) (Family Medicine); Mark Matthias, MD (Mankato Clinic) (Family Medicine); Amy Knox, CNM (Park Nicollet Health Services) (Nurse Midwife); Cherida McCall, CNM (HealthPartners Medical Group) (Nurse Midwife); Brielle Stoyke, CNM (CentraCare) (Nurse Midwife); Ruth Wingeier, CNM (CentraCare) (Nurse Midwife); Jenny Senti, APRN (Altru Health System) (Nursing); Dale Akkerman, MD (Park Nicollet Health Services) (OB/Gyn); Leslie Pratt, MD (Park Nicollet Health Services) (Perinatal Medicine); Peter VanEerden, MD (Sioux Valley Hospitals) (Perinatal Medicine); Nancy Jaeckels (Institute for Clinical Systems Improvement) (Implementation Advisor); Linda Setterlund, MA, CPHQ (Institute for Clinical Systems Improvement) (Facilitator)

Measure was not adapted from another source.

2003 Oct

2007 Mar

Please note: This measure has been updated. The National Quality Measures Clearinghouse is working to update this summary.

• Institute for Clinical Systems Improvement (ICSI). Management of labor. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Mar. 72 p. [126 references]

This NQMC summary was completed by ECRI on July 16, 2004. This NQMC summary was updated by ECRI on December 23, 2004, November 21, 2005, and again on May 29, 2007.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

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