TJC introduces perinatal care core measure set

Replacing the core measure set for pregnancy and related conditions, which comprised three measures, The Joint Commission has introduced a core measure set on perinatal care, with data collection beginning with April 1 discharges.

The set includes five measures:

  • elective delivery;
  • Cesarean section;
  • use of antenatal steroids;
  • health care-associated bloodstream infections in newborns;
  • exclusive breast milk feeding.

"These measures are actually coming from the National Quality Forum-endorsed perinatal care measures. There's approximately 17 measures that they endorsed in October 2008," says Celeste Milton, MPH, BSN, RN, associate project director in The Joint Commission's division of research. The Joint Commission convened a technical advisory board, which recommended the use of the five measures.

With the addition of the measure set, The Joint Commission's intent "is to give people the knowledge of what the current baseline is so that determinations can be made whether we want to make the rates higher or lower. But [this] actually gives us a national baseline, which we don't even have at this point," says Ann Watt, MBA, RHIA, associate director in the division of quality measurement and research at The Joint Commission.

"That's why our expert panel chose these measures. Because there are good, valid scientific studies that have determined that people who have these elective deliveries, these babies — even if its just a couple of weeks before their normal due date or their expected due date — that they don't do as well. Their outcomes are not as good. It's true also for the Cesarean sections — that with people who have Cesarean sections, there is a greater occurrence of infection," she says.

Maureen Corry, MPH, executive director of Childbirth Connection, says she is pleased to see the addition and believes that this is a good start. She agrees that getting a baseline established in this area of care is important. "Performance measurement and reporting is really important but only if it's used to improve the care," she says.

And with pregnancy and childbirth being the leading reasons for hospital admission, it's an area she hopes will get more attention in terms of incentivizing and standardizing quality of care.