Sustainable Metrics: Using Measurement-Based Quality Improvement to Improve Maternity Practice While Avoiding Frustration and Pitfalls

The recent focus on measurement-based quality improvement to assess and improve maternity care has yielded important gains. However, to make quality measurement more sustainable, measure users must avoid or solve several common pitfalls, and measures must be carefully designed to maximize success. In this chapter, we describe the background and history of maternal care quality measurement in the United States (including some key measurement successes such as reducing early elective deliveries), discuss key design considerations for quality measurements, and detail some of the most common pitfalls of quality measurement initiatives. Carefully designing and selecting quality measures with attention to local practices and contexts of use can help lead to successful and sustainable quality measurement programs.