Schlembach D, Simeoni U, Nagy Bonnard L, Bernloehr A, Cetin I, Grosek S, Johnston L, Jourdain G, Rossi R
Click on the image to read the standard in brief.
Target group
Infants, parents, and families
User group
Healthcare professionals, perinatal units, hospitals, and health services
Statement of standard
Perinatal care is organised in specialist and non-specialist centres to ensure access to optimal, preferably evidence-based, care with respect to medical knowledge, organisation structure, and staff.
Rationale
In order to deliver the appropriate level of maternal and perinatal care tailored to the severity of risk, the regional organisation of care needs to be based on designated centres of care, categorised as specialist or non-specialist centres, specifying activity that is appropriate in each. (1–10) Establishing clear, uniform criteria for designation of maternal and perinatal centres that are integrated with emergency response systems will help ensure that the appropriate numbers of trained personnel, physical space, equipment and technology are available to achieve optimal outcomes. It will also facilitate subsequent data collection regarding risk-appropriate care and has been shown to be efficient and effective in producing the best outcome for mothers and infants. (1–35)
Benefits
Improved medical care for all pregnant women and their partners, but especially for women at risk for pregnancy complications (1,10,15,23–25,27,28,34–36)
Improved (physical and psychological) maternal outcome (1,10,15,22,24,25,27–29,34,36)
Improved neonatal care and outcome (1,8,10,11,13,14,16,18,19,21,23,26,30–33,36)
Improved education/training for healthcare professionals (1,27,28,36,37)
Care is relocated as close as possible to home as soon as clinically indicated. (5)
A (Low quality) B (High quality)
Audit report2
For healthcare professionals
A unit guideline on the management of high risk pregnancies is adhered to by all healthcare professionals.
B (High quality)
Guideline
Training on the management of high risk pregnancies is attended by all responsible healthcare professionals.
B (High quality)
Training documentation
Healthcare professionals practice as part of a regional perinatal care network with access to agreed protocols and guidelines.
B (Moderate quality)
Audit report2, training documentation
For perinatal unit
A unit guideline on the management of high risk pregnancies is available and regularly updated.
B (High quality)
Guideline
Expertise in the management of high risk pregnancies is developed in specialist centres.
B (Moderate quality)
Audit report2
Capacity planning is facilitated.
B (Moderate quality)
Audit report2
Care is enhanced by network based education in non-specialist centres.
B (Moderate quality)
Audit report2
For hospital
Training on the management of high risk pregnancies is ensured.
B (High quality)
Training documentation
Appropriate resources are available for the level of perinatal care. (38)
C (Moderate quality)
Audit report2, training documentation
A continuous perinatal care quality improvement programme is established. (38)
C (Moderate quality)
Audit report2
Accommodation is available for the partner when required. (see NICU design)
B (Moderate quality)
Audit report2
For health service
Regional perinatal networks are organised.
B (High quality)
Audit report2
A national guideline on the management of high risk pregnancies is available and regularly updated.
B (High quality)
Guideline
Regional / national oversight is established to ensure safety requirements for pregnancy and birth. (9,36)
A (Low quality)
Audit report2
A perinatal information system to support quality assessment, certification, and audit of network units is established and maintained. (38)
C (Moderate quality)
Audit report2
1The indicator “patient information sheet” is an example for written, detailed information, in which digital solutions are included, such as web-based systems, apps, brochures, information leaflets, and booklets.
2The indicator “audit report” can also be defined as a benchmarking report.
Where to go
Further development
Grading of evidence
For parents and family
Parents are involved in the monitoring of quality of organisation of perinatal care and neonatal transport.
B (Low quality)
For healthcare professionals
N/A
For perinatal unit
Ensure the availability of trained and experienced maternal-fetal specialists throughout the 24 hours.
B (High quality)
Dedicate accommodation within the hospital for expectant parents.
B (Low quality)
Benchmark services against national/international data (such as Europeristat). (38)
A (High quality)
For hospital
N/A
For health service
Benchmark perinatal outcomes using European obstetric surveillance system (such as Europeristat). (38)
A (High quality)
Regional / National oversight is established to ensure safety requirements for pregnancy and birth. (9,36)
A (Low quality)
Getting started
Initial steps
For parents and family
Parents are verbally informed by healthcare professionals about perinatal care.
For healthcare professionals
Attend training on perinatal care.
Enhance specialty training through on-the-job training and professional education programmes.
For perinatal unit
Develop and implement a unit guideline for standard and emergency care as well as transfer.
Distribute information material for parents on perinatal care.
Develop clinical perinatal networks.
For hospital
Support healthcare professionals to participate in training on perinatal care.
Collect information on perinatal care standards and equip perinatal units with appropriate healthcare professionals and material for patient care and training.
Provide resources for establishing and maintaining a perinatal unit.
Provide opportunities for on-the-job training, and experiential learning environments (clinical placements) for students undertaking professional education programmes.
Develop clinical perinatal networks.
For health service
Develop and implement a national guideline for standard and emergency care as well as transfer.
Develop information material for parents on perinatal care.
Submit and review perinatal data and output of surveillance systems.
Monitor perinatal outcomes using European obstetric surveillance system (such as Europeristat).
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