KLINIKINTERNE, INDIVIDUELLE LEISTUNGSERFASSUNG UND GEBURTSHILFE QUALITATSSICHERUNG

Obstetrical management and fetal outcome were individually analysed annually from 1987 to 1990, using computerised equipment. The individual results were discussed anonymously with all colleagues, but every colleague knew his own results. Clinical methods and obstetrical management had not been changed during the investigation period. The number of high-risk pregnancies increased significantly, whereby the incidence of risk-related surgical interventions decreased at the same rate. The number of FBA and EDA increased significantly (p < 0.001). The mean umbilical artery pH increased during the last four years from 7.27 to 7.30 (p < 0.05), i. e. that each colleague achieved an improvement. The incidence of acidotic values in the umbilical artery decreased significantly (pH < 7.20 from 13.2% to 7.1%, pH < 7.10 from 3.6% to 1.2% p < 0.01). The rate of caesarean section increased (p < 0.05) and the number of vaginal operative deliveries did not change significantly. As early as one year after the introduction of the individual efficiency control, a significant improvement in obstetrical results could be demonstrated.