New perinatal quality measures from the National Quality Forum, the Joint Commission and the Leapfrog Group

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Abstract
Hospital quality measures have matured in many specialties but have lagged behind in maternity care. Recently, the National Quality Forum (NQF) has endorsed a series of 17 quality measures for perinatal care. It is important for all obstetric practitioners and leaders to understand these measures, as they form the basis of judging the quality of our hospital services for the next decade. Measure characteristics are examined including how they are developed and judged, and then the nine obstetric care measures are discussed in detail, including their literature support and specifications. The challenges of designing and testing new measures are explored. The importance of this measure set is stressed, as both the Joint Commission and the Leapfrog Group have chosen their next set of perinatal measures from this group as will state and regional public reporting organizations. Hospital quality improvement activities will be increasingly focused on improving performance on these measures. The current NQF measure set is not perfect but represents a reasonable start, covering a range of obstetric practice. Many of the measures could use further refinement and we need research and testing of additional measures going forward.