Reliability of a preventability model in maternal death and morbidity

Abstract

Objective The purpose of this study was to measure the reliability of a model that defines preventability in maternal morbidity and death. Study design One hundred cases of serious morbidity and death among peripartum women were reviewed by 2 independent groups of medical experts to identify potentially preventable provider or system events that may have led to the progression of illness. Results Seventy-seven percent of the cases had concordant findings in both groups regarding the identification of any preventable events. Interrater agreement, which was measured by Cohen's Kappa, was 0.49, which suggests moderate to good reliability. Cases with multiple comorbidities, poor documentation, or preventable patient factors tended to have higher levels of disagreement. Conclusion There was high agreement between the 2 groups regarding the identification of preventable events that impact maternal morbidity and death. The reliability of this model for the assessment of preventability is an important step for improvement in obstetric and medical care.