An electronic health registry with interactive checklists and clinical decision support for improving quality of antenatal care

Conditions

Antenatal care Pregnancy and Childbirth Antenatal care

Mahima Venkateswaran, Zaher Nazzal, Buthaina Ghanem, Reham Khraiwesh, Eatimad Abbas et al. (12 authors)

JMIR Formative Research2022-05-135 citations

A digital health registry with clinical decision support for improving quality of antenatal care in Palestine (eRegQual): a pragmatic, cluster-randomised, controlled, superiority trial.

Venkateswaran M, Ghanem B, Abbas E, Khader KA, Ward IA, Awwad T, Baniode M, Frost MJ, Hijaz T, Isbeih M, Mørkrid K, Rose CJ, Frøen JF.

2022-02-0124 citations

10.1016/s2589-7500(21)00269-7

eRegQual-an electronic health registry with interactive checklists and clinical decision support for improving quality of antenatal care: study protocol for a cluster randomized trial.

Venkateswaran M, Mørkrid K, Ghanem B, Abbas E, Abuward I, Baniode M, Norheim OF, Frøen JF.

2018-01-2213 citations

10.1186/s13063-017-2386-5

Interventions

Primary healthcare clinics are randomized to one of two groups, stratified by district and constrained on the following characteristics: 1. Number of new enrollments of pregnancies per

Eligibility

Sex/Gender

Female

Inclusion criteria

Inclusion criteria: Current participant inclusion criteria as of 24/04/2018: eRegQual - Clinics: 1. Clinics run by the Ministry of Health, Palestine 2. Clinics located in the 5 districts: Bethlehem, Nablus, Jenin, Ramallah/ Al-Bireh, Salfit 3. Clinics run by non-governmental organizations but still reporting to the Ministry of Health, Palestine eRegTime - Clinics: 4. Clinics that have one nurse or one midwife providing antenatal care services on a given workday 5. Clinics that have, on average, at least one booking visit per workday Patients: There are no eligibility criteria based on individual patient characteristics. Previous participant inclusion criteria: Clinics: 1. Clinics run by the Ministry of Health, Palestine 2. Clinics located in the 5 districts: Bethlehem, Nablus, Jenin, Ramallah/ Al-Bireh, Salfit 3. Clinics run by non-governmental organizations but still reporting to the Ministry of Health, Palestine Patients: There are no eligibility criteria based on individual patient characteristics.

Exclusion criteria

Exclusion criteria: Clinics: 1. Primary healthcare clinics that are defined as level 1 2. Primary healthcare clinics with no pregnant women enrolled in 2013 3. Primary healthcare clinics providing high-risk management 4. Primary healthcare clinics participating in another health systems study addressing the quality of antenatal care

Design outcomes

Primary

Measure	Time frame
1. Adverse pregnancy outcomes are masured using data from hospitals in the eRegistry, registered continuously at point-of-care and exported monthly. This is a composite outcome that includes the following adverse pregnancy outcomes: 1.1. Moderate or severe anemia at admission for labor 1.2. Severe hypertension at admission for labor 1.3. Malpresentation at delivery undetected during pregnancy 1.4. Large for gestational age baby at delivery 1.5. Small-for-gestational age baby at delivery undetected during pregnancy 2. Process (adherence) outcomes are measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care and exported monthly. These include timely and appropriate screening and management of: 2.1. Anemia during pregnancy 2.2. Hypertension in pregnancy 2.3. Diabetes in pregnancy 2.4. Abnormal fetal growth	—

Measure

Time frame

1. Adverse pregnancy outcomes are masured using data from hospitals in the eRegistry, registered continuously at point-of-care and exported monthly. This is a composite outcome that includes the following adverse pregnancy outcomes: 1.1. Moderate or severe anemia at admission for labor 1.2. Severe hypertension at admission for labor 1.3. Malpresentation at delivery undetected during pregnancy 1.4. Large for gestational age baby at delivery 1.5. Small-for-gestational age baby at delivery undetected during pregnancy 2. Process (adherence) outcomes are measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care and exported monthly. These include timely and appropriate screening and management of: 2.1. Anemia during pregnancy 2.2. Hypertension in pregnancy 2.3. Diabetes in pregnancy 2.4. Abnormal fetal growth

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Secondary

Measure	Time frame
Current secondary outcome measures as of 24/04/2018: eRegQual: 1. Timely ANC visit rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 2. Timely and appropriate screening and management of malpresentation = 36 weeks rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 3. Stillbirth rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly eRegTime: 4. Time spent on health information management per antenatal consultation, measured using data collected by time-motion observations of care providers’ entire work days in the primary healthcare clinics. Health information management is defined as time spent by care providers on accessing, documenting and reporting health information. Previous secondary outcome measures: 1. Timely ANC visit rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 2. Timely and appropriate screening and management of malpresentation = 36 weeks rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 3. Stillbirth rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly	—

Measure

Time frame

Current secondary outcome measures as of 24/04/2018: eRegQual: 1. Timely ANC visit rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 2. Timely and appropriate screening and management of malpresentation = 36 weeks rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 3. Stillbirth rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly eRegTime: 4. Time spent on health information management per antenatal consultation, measured using data collected by time-motion observations of care providers’ entire work days in the primary healthcare clinics. Health information management is defined as time spent by care providers on accessing, documenting and reporting health information. Previous secondary outcome measures: 1. Timely ANC visit rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 2. Timely and appropriate screening and management of malpresentation = 36 weeks rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly 3. Stillbirth rate is measured using data from primary healthcare clinics in the eRegistry, registered continuously at point-of-care into the eRegistry and exported monthly

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Countries

Palestinian Territory

Contacts

Public ContactJ. Frederik Frøen

frederik.froen@fhi.no+47 (0)210 78 194

Outcome results

None listed