An Update on Research Issues in the Assessment of Birth Settings


Book Description

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.




An Update on Research Issues in the Assessment of Birth Settings


Book Description

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.




Research Issues in the Assessment of Birth Settings


Book Description

The Institute of Medicine (IOM) of the National Academy of Sciences (NAS) collaborated in this study with the Board on Maternal, Child, and Family Health Research of the Commission on Life Sciences of the National Research Council (NRC) to determine methodologies needed to evaluate current childbirth settings in the United States. Although the proportion of non-hospital births runs as high as 4.4 percent annually in Oregon, insufficient data exist to permit complete evaluation of the various birth settings. The application of good research methods should lead to scientific findings that provide the basis for informed, rational decision making about alternative settings for childbirth. A committee of 11 experts was appointed to review current knowledge, provide background knowledge, and identify the kinds of research designs useful for assessing such matters as the safety, quality of maternity care, costs, psychological factors, and family satisfaction of different birth settings. The committee was also charged with preparing a report that could be used to solicit, evaluate, and fund proposals for studies on childbirth settings. The committee did not design specific studies to be carried out, but rather attempted to point out issues that should be considered by researchers because it believed that the best proposals would arise from investigator-initiated research. Gaps in research could be filled by requests for proposals developed by agency staff and the agency peer review committee. In addition, IOM staff members and several consultants provided background papers for the committee's consideration. The research that results from this report will be useful to policymakers and to consumers searching for information to aid in making decisions about birth settings. Research Issues in the Assessment of Birth Settings summarizes the study.




Birth Settings in America


Book Description

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.




Research Issues in the Assessment of Birth Settings


Book Description

The Institute of Medicine (IOM) of the National Academy of Sciences (NAS) collaborated in this study with the Board on Maternal, Child, and Family Health Research of the Commission on Life Sciences of the National Research Council (NRC) to determine methodologies needed to evaluate current childbirth settings in the United States. Although the proportion of non-hospital births runs as high as 4.4 percent annually in Oregon, insufficient data exist to permit complete evaluation of the various birth settings. The application of good research methods should lead to scientific findings that provide the basis for informed, rational decision making about alternative settings for childbirth. A committee of 11 experts was appointed to review current knowledge, provide background knowledge, and identify the kinds of research designs useful for assessing such matters as the safety, quality of maternity care, costs, psychological factors, and family satisfaction of different birth settings. The committee was also charged with preparing a report that could be used to solicit, evaluate, and fund proposals for studies on childbirth settings. The committee did not design specific studies to be carried out, but rather attempted to point out issues that should be considered by researchers because it believed that the best proposals would arise from investigator-initiated research. Gaps in research could be filled by requests for proposals developed by agency staff and the agency peer review committee. In addition, IOM staff members and several consultants provided background papers for the committee's consideration. The research that results from this report will be useful to policymakers and to consumers searching for information to aid in making decisions about birth settings. Research Issues in the Assessment of Birth Settings summarizes the study.







An Update on Research Issues in the Assessment of Birth Settings


Book Description

"More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns"--Publisher's description.




Transforming the Workforce for Children Birth Through Age 8


Book Description

Children are already learning at birth, and they develop and learn at a rapid pace in their early years. This provides a critical foundation for lifelong progress, and the adults who provide for the care and the education of young children bear a great responsibility for their health, development, and learning. Despite the fact that they share the same objective - to nurture young children and secure their future success - the various practitioners who contribute to the care and the education of children from birth through age 8 are not acknowledged as a workforce unified by the common knowledge and competencies needed to do their jobs well. Transforming the Workforce for Children Birth Through Age 8 explores the science of child development, particularly looking at implications for the professionals who work with children. This report examines the current capacities and practices of the workforce, the settings in which they work, the policies and infrastructure that set qualifications and provide professional learning, and the government agencies and other funders who support and oversee these systems. This book then makes recommendations to improve the quality of professional practice and the practice environment for care and education professionals. These detailed recommendations create a blueprint for action that builds on a unifying foundation of child development and early learning, shared knowledge and competencies for care and education professionals, and principles for effective professional learning. Young children thrive and learn best when they have secure, positive relationships with adults who are knowledgeable about how to support their development and learning and are responsive to their individual progress. Transforming the Workforce for Children Birth Through Age 8 offers guidance on system changes to improve the quality of professional practice, specific actions to improve professional learning systems and workforce development, and research to continue to build the knowledge base in ways that will directly advance and inform future actions. The recommendations of this book provide an opportunity to improve the quality of the care and the education that children receive, and ultimately improve outcomes for children.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Preventing Low Birthweight


Book Description

Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.