Aghlmand S¹ * , (MD, PhD) Akbari F², (PhD) Lameei A³, (MD) Kazem M⁴, (PhD) Arab M², (PhD).

  1- Department of Public Health, School of Public Health, Urmia University of Medical Sciences

  2- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences

  3- Department of Infectious Diseases, School of Medicine, Urmia University of Medical Sciences

  4- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences

Introduction: Current Iranian perinatal statistics indicate that maternity care needs improvement. We used the quality function deployment (QFD) method to improve the quality of maternity care in an Iranian Social Security hospital.

Methods: The major steps of the study were to identify the most important women’s needs via interview (n=18) and a baseline survey (n=89) establish a set of relationship matrices (house of quality analysis) to link the women’s requirements with the best combination of the relevant performance measures, organizational functions and tasks analyzing the potential failure modes that might be experienced by the functions redesigning maternity care processes based on the selected functions and failure modes, and implementation of the new care model. We measured maternal satisfaction and caesarean birth rates before and after implementation of the new care model.

Results: Six necessary organizational functions and three potential failure modes were identified as the basis for the new process development to satisfy the top twenty needs and requirements. Introduction of the new care model improved women’s satisfaction level in 16 of the 20 items (p< 0.0001). 78% of women experienced care consistent with the new model and the rate of caesarean decreased (30% vs. 42%).

Conclusion: Using QFD method to redesign maternity care process improved women’s satisfaction levels, and decreased the rate of caesarean section. However, the large size of the QFD matrices and its time-consuming nature hinders its efficacy in large projects. Reducing the complexity of this method can be useful for its application in everyday clinical settings.

Keywords : Quality, Quality function deployment (QFD), Maternity care, Patient satisfaction, Cesarean birth

Hakim Research Journal 2009 12(1): 55- 65.

  * Corresponding Author: Vice-chancellor for education, Central building of Urmia University of Medical Sciences, Jahad Ave, Urmia, IRAN, Post code: 5714783734, Tel: +98(441)2244686, Fax: +98(441)2240655, Email: saghlmand@umsu.ac.ir