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Care Around Stillbirth and Neonatal Death (CASaND) Clinical Practice Guideline

Review processes and quality improvement

It is important that all perinatal deaths are carefully reviewed through appropriate processes to provide answers for families/whānau about why their baby died, and to identify improvements in care for future families/whānau. The perinatal mortality audit review process has been shown to improve care that services and healthcare professionals provide to parents and families/whānau when their baby dies.51,52 Refer to Section 7 for more information on the perinatal mortality review process and engagement with parents.

Parent experiences of care are integral to quality improvement practices in maternal and newborn services. Most bereaved parents want to provide feedback to health services about the care they received when their baby died and appreciate being sensitively asked to share their experiences. Patient-reported outcomes measures (PROMs) are an effective method of assessing quality of care and can inform practice improvements from an individual level to a system level.

Good feedback mechanisms provide parents with opportunities to inform service improvements and feel listened to.51

In Australia, the Stillbirth Clinical Care Standard recommends health services use the Australian Hospital Patient Experience Question Set (AHPEQS)9,53 to understand care experiences. In the UK, the National Bereavement Care Pathway recommends services use the Maternity Bereavement Experience Measure (MBEM).14 Parent experience measures are being adapted and co-designed for Australian services as part of a national perinatal loss care pathway similar to that implemented in the UK.14,54,55

Consensus-based recommendation 8.12

All maternal and newborn services should implement a perinatal mortality audit program that is integrated into quality improvement activities to ensure practice improvement in the provision of care around stillbirth and neonatal death. The audit program should include parent experiences of care.

Supporting healthcare professional wellbeing
Section 8 references
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Western Pacific Regional Office of the International Stillbirth Alliance
Coordinating Centre, Stillbirth and Neonatal Death Alliance, Perinatal Society of Australia and New Zealand

Level 3, Aubigny Place
Mater Research Institute
Raymond Terrace,
South Brisbane QLD 4101
The University of Queensland Faculty of Medicine

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