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## Complete Summary

#### TITLE

Routine prenatal care: percentage of pregnant women who report to have
received counseling and education by the 28th week visit.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Routine prenatal
care. Bloomington (MN): Institute for Clinical Systems Improvement
(ICSI); 2008 Aug. 89 p. \[290 references\]

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Process

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of pregnant women who
report to have received counseling and education by the 28th week visit.

#### RATIONALE

The priority aim addressed by this measure is to increase the percentage
of pregnant women who receive timely prenatal counseling and education.

#### PRIMARY CLINICAL COMPONENT

Prenatal care; counseling and education (breast feeding, vaginal
bleeding during pregnancy, childbirth classes)

#### DENOMINATOR DESCRIPTION

Total number of questions on returned surveys\*

\*See the \"Numerator Description\" field.

#### NUMERATOR DESCRIPTION

Number of \"Yes\" answers on the survey

The survey questions are:

1.  Has your provider or someone from the clinic, community health
    program, or worksite explained the benefits of breastfeeding?
    (Yes/No)

2.  Has your provider or someone from the clinic, community health
    program, or worksite told you to report vaginal bleeding during your
    pregnancy? (Yes/No)

3.  Has your provider or someone from the clinic, community health
    program, or worksite discussed attending or availability of
    childbirth classes with you? (Yes/No)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A clinical practice guideline or other peer-reviewed synthesis of
    the clinical evidence

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Unspecified

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Women of childbearing age

#### TARGET POPULATION GENDER

Female (only)

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Staying Healthy

#### IOM DOMAIN

Effectiveness\
Patient-centeredness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

All women who are in the course of prenatal care and who are present for
the 28th week visit.

These data can be collected by a patient survey at the 28th week visit.
Since that visit uses a glucose tolerance test and there is a waiting
time for completion of the test, this survey can be completed during
that waiting time. The patient completes the survey by herself.

This may be collected on everybody, or a sample. If a sample is done, it
is suggested that the data be collected on specific days (or times) to
create a regular pattern for data collection. This pattern will allow
for more consistent and regular data collection. The minimum sample size
is 20 per month or 60 per quarter, or total population if you have less
than 15 prenatal patients at 28^th^ week visit per month.

The surveys can be collected monthly.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of questions on returned surveys\*

\*See the \"Numerator Inclusions/Exclusions\" field.

**Exclusions**\
Unspecified

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Encounter

#### DENOMINATOR TIME WINDOW

Time window is a single point in time

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of \"Yes\" answers on the survey

The survey questions are:

1.  Has your provider or someone from the clinic, community health
    program, or worksite explained the benefits of breastfeeding?
    (Yes/No)

2.  Has your provider or someone from the clinic, community health
    program, or worksite told you to report vaginal bleeding during your
    pregnancy? (Yes/No)

3.  Has your provider or someone from the clinic, community health
    program, or worksite discussed attending or availability of
    childbirth classes with you? (Yes/No)

**Exclusions**\
Unspecified

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Episode of care

#### DATA SOURCE

Patient survey

#### LEVEL OF DETERMINATION OF QUALITY

Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Percentage of pregnant women who report to have received counseling and
education by the 28th week visit.

#### MEASURE COLLECTION

[Routine Prenatal Care
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=4498)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2003 Jul

#### REVISION DATE

2008 Aug

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Routine prenatal care. Bloomington (MN): Institute
for Clinical Systems Improvement (ICSI); 2007 Aug. 87 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Routine prenatal
care. Bloomington (MN): Institute for Clinical Systems Improvement
(ICSI); 2008 Aug. 89 p. \[290 references\]

#### MEASURE AVAILABILITY

The individual measure, \"Percentage of Pregnant Women Who Report to
Have Received Counseling and Education by the 28th Week Visit,\" is
published in \"Health Care Guideline: Routine Prenatal Care.\" This
document is available from the [Institute for Clinical Systems
Improvement (ICSI) Web
site](http://www.icsi.org/guidelines_and_more/guidelines__order_sets___protocols/).

For more information, contact ICSI at, 8009 34th Avenue South, Suite
1200, Bloomington, MN 55425; phone: 952-814-7060; fax: 952-858-9675; Web
site: [www.icsi.org](http://www.icsi.org/); e-mail:
<icsi.info@icsi.org>.

#### NQMC STATUS

This NQMC summary was completed by ECRI on March 29, 2004. This summary
was updated by ECRI Institute on November 11, 2004, October 18, 2005,
December 26, 2007, and again on October 20, 2008.

#### COPYRIGHT STATEMENT

This NQMC summary (abstracted Institute for Clinical Systems Improvement
\[ICSI\] Measure) is based on the original measure, which is subject to
the measure developer\'s copyright restrictions.

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All other copyright rights in the abstracted ICSI Measures are reserved
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for Clinical Systems Improvement, Inc. assumes no liability for any
adaptations or revisions or modifications made to the abstracts of the
ICSI Measures.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/17/2008