Obstetrical safety indicators for preventing hospital harms: a scoping review protocol

Introduction: Optimizing the safety of obstetric patient care is a primary concern for many hospitals. Identifying performance indicators that measure aspects of patient care processes related to preventable harms can present opportunities to improve health systems. In this paper, we present our protocol for a scoping review to identify performance indicators for obstetric safety. We aim to identify a comprehensive list of obstetric safety indicators which may help reduce the number of preventable patient harms, to summarize the data and to synthesize the results. Methods and analysis: We will use the methodological framework described by Arksey and O Malley and further expanded by Levac. We will search multiple electronic databases such as Medline, Embase, CINAHL and the Cochrane Library as well as websites from professional bodies and other organisations, using an iterative search strategy. We will include indicators that relate to preventable harms in the process of obstetric care. Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. For records where eligibility is not clear, the reviewers will screen the full text version. If reviewers decisions regarding eligibility differ, a third reviewer will review the full text record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardized data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators identified during our scoping review and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications of the indicators for future research, clinical practice and policy making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA ScR) Checklist. Ethics and Dissemination: The sources of information included in this scoping review will be available to the public. Therefore, ethical review for this research is not warranted. We will disseminate our research results using multiple modes of delivery such as a peer-reviewed publication, conference presentations and stakeholder communications. Keywords: Obstetrics, patient safety, performance indicators, prevention, hospital harms, scoping review, protocol.