We believe CanOSS could facilitate the collection of data on modifiable factors that contribute to SMM, which will enable development of recommendations to improve care. We conducted a research study that aimed to assess the feasibility of gathering such data from Canadian birthing units through an OSS.
We distributed a nationwide survey, with multiple-choice and open-ended questions, to birthing unit leads across all provinces and territories using REDCap. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using content analysis. Participation rates were summarized as pooled participation rates (95% confidence intervals [CI]) across birthing units from lowest, medium, and highest tiers of service using Freeman-Tukey double arcsine transformations and common-effect models.
A majority of the 289 Canadian birthing units participated in the survey. Most respondents reported that their units had a system in place for reviewing SMM, which most often occurred on an as-needed basis. Although review systems involved a diverse multidisciplinary panel, specialties such as Obstetric Anaesthesia, Midwifery, and Internal Medicine were underrepresented. Lessons learned were rarely shared outside the hospital, and never shared beyond regional levels. Importantly, the vast majority of respondents were willing to contribute anonymized data on SMM within a centralized reporting system.
Most responding Canadian birthing units have a process in place to review SMM and would be willing to share anonymized data as part of a centralized initiative, thereby demonstrating the feasibility of leveraging existing infrastructures to establish a Canada-OSS.
Relevant Publications:
Study Protocol:
D’Souza, R., Seymour, R. J., Knight, M., Dzakpasu, S., Joseph, K. S., Thorne, S., Ospina, M. B., Barrett, J., Cook, J., Fell, D. B., Scott, H., Metcalfe, A., van den Akker, T., Lapinsky, S., Skeith, L., Murray-Davis, B., Shah, P., Forte, M., Ashraf, R., Chundamala, J., … Malhamé, I. (2022). Feasibility of establishing a Canadian Obstetric Survey System (CanOSS) for severe maternal morbidity: a study protocol. BMJ open, 12(3), e061093. https://doi.org/10.1136/bmjopen-2022-061093
Published Commentary:
Malhamé, Knight, M., & D’Souza, R. (2022). Initial Steps in Developing and Implementing a Canadian Obstetric Survey System (CanOSS) for Severe Maternal Morbidity. Journal of Obstetrics and Gynaecology Canada: JOGC, 44(6), 637–638. https://doi.org/10.1016/j.jogc.2022.02.002
Malhamé, Knight, M., & D’Souza, R. (2022). Prémices de la conception et mise en œuvre d’un système d’enquête canadien en obstétrique sur la morbidité maternelle grave. Journal D’obstétrique et Gynécologie Du Canada: JOGC., 44(6), 639–640. https://doi.org/10.1016/j.jogc.2022.04.001