The New Zealand Maternity Clinical Indicators are the result of collaboration between the Ministry of Health and maternity stakeholders representing consumer, midwifery, obstetric, general practice, paediatric, and anaesthetic perspectives. In 2011 an expert working group established a set of 12 maternity clinical indicators that could be measured using the available data collections at that time.
In 2013 the National Maternity Monitoring Group reviewed the original indicator set and recommended a range of changes to improve the quality, completeness and scope of the New Zealand Maternity Clinical Indicators. These proposed changes were further reviewed and developed by the original expert working group to ensure the objectives of the New Zealand Maternity Clinical Indicators were retained; that being a tool for assessing the quality and national consistency in the delivery of maternity services in New Zealand.
This report presents the first year of these revised indicators. In addition to improved quality and completeness of the existing 12 indicators, three new indicators have been added that reflect care during pregnancy and the postnatal period and severe maternal morbidity.
For this report, as with previous reports in this series, the ‘standard primipara’ definition is used to identify a group of women for whom interventions and outcomes should be similar. Of the 15 indicators covered in this report, eight apply to standard primiparae, four apply to all women giving birth, two apply to women who registered with a Lead Maternity Carer and one applies to all babies born.
Since 2012, district health boards (DHBs) and maternity stakeholders have used the indicators in their local maternity quality and safety programmes to identify areas warranting further investigation at a local level. Using the data in this report DHBs and local maternity stakeholders can expand the scope of their investigations and view trends over a four year period.
As the three previous reports demonstrated, maternity service delivery and outcomes vary between DHBs and between individual secondary and tertiary facilities. These findings merit further investigation of data quality and integrity as well as the local clinical practice management reasons for these variations.